Which nursing home expenses are tax-deductible
Some nursing home costs are deductible on your federal income tax return, but only the portion that counts as medical care. The IRS allows you to deduct unreimbursed medical expenses that exceed 7.5% of your adjusted gross income (AGI). Nursing home room, board, and care can may have access to — but the rules are strict about what counts and what does not.
The key question is whether you are in the nursing home primarily for medical reasons or primarily for custodial care (help with daily living because of age or general frailty). If a doctor determined you need skilled nursing care — wound care, medication management, physical therapy, or monitoring of a medical condition — the full cost of room, board, meals, and nursing services is deductible. If you are there mainly because you need help with bathing, dressing, and meals but do not have a medical condition requiring skilled care, only the medical portion (nursing staff time, medications, therapies) is deductible, not room and board.
You can only deduct what you paid out of pocket and what was not reimbursed by insurance, Medicaid, or any other source. If Medicare or your insurance covered part of the bill, you deduct only your share.
Key Takeaways
- Nursing home costs are deductible only if they exceed 7.5% of your adjusted gross income, and only the medical portion qualifies unless you are there for skilled nursing care ordered by a doctor.
- You must itemize deductions on your tax return to claim medical expenses; the standard deduction does not include them.
- Room and board are fully deductible only if a physician determined you need skilled nursing care for a medical condition, not just help with daily living.
- Your nursing home or your insurance company should provide a statement showing what portion of your bill was for medical care versus room and board.
- You can deduct only the amount you paid yourself; reimbursements from insurance or Medicaid reduce what you can claim.
How to determine if your nursing home stay qualifies
Start by looking at why you entered the nursing home. If your doctor wrote an order for skilled nursing care — because you have a wound that needs daily dressing changes, you are recovering from surgery, you need physical therapy, or you have a condition like heart failure or dementia that requires nursing monitoring — then the entire cost of your stay is likely deductible as medical care.
If you moved to a nursing home because you are elderly and need help with bathing, dressing, toileting, and meals, but you do not have an acute medical condition requiring skilled care, then only the costs directly tied to medical services are deductible. This might include the nurse's salary (a portion of your bill), medications, and therapies, but not the room itself or meals.
The distinction matters because many nursing homes provide both skilled care and custodial care. Ask your facility for a breakdown of your bill. Some facilities separate the charges; others do not. If your bill is not itemized, ask the business office to provide a statement showing what portion was for medical care and what portion was for room and board. You will need this to complete your tax return accurately.
What counts as a deductible medical expense at a nursing home
The IRS considers these nursing home costs medical expenses: nursing care, medications, medical equipment (walkers, wheelchairs, oxygen), therapy services (physical, occupational, speech), and diagnostic tests. If your bill includes a charge for a nurse on staff, that is deductible. If you pay separately for medications or medical supplies, those are deductible.
Meals and lodging are deductible only if you are there for skilled nursing care. If you are there for custodial care, meals and lodging are not deductible because you would have to eat and sleep somewhere regardless of whether you were in a nursing home.
Do not deduct costs for services that are not medical: housekeeping, laundry, entertainment, or transportation to non-medical appointments. Some nursing homes bundle these into one bill. If you cannot get an itemized statement, you may need to contact the IRS or work with a tax professional to estimate the medical portion.
How to claim nursing home deductions on your tax return
You can only claim medical expenses if you itemize deductions on Schedule A of your Form 1040. You cannot claim them if you take the standard deduction. For the 2024 tax year, the standard deduction is $14,600 for single filers and $29,200 for married filing jointly. If your medical expenses plus other itemized deductions (mortgage interest, property taxes, charitable donations) exceed the standard deduction, itemizing will save you money.
To claim nursing home expenses, you must subtract 7.5% of your adjusted gross income (AGI) from your total medical expenses. Only the amount above that threshold is deductible. For example, if your AGI is $50,000, you can deduct only medical expenses over $3,750. If your nursing home costs were $5,000 and that was your only medical expense, you could deduct $1,250.
Keep receipts, bills, and statements from your nursing home for at least three years. The IRS may ask for proof. If you paid by check or credit card, your bank or credit card statement also serves as documentation. If you received any reimbursement from insurance or Medicaid, keep those letters too, because you must subtract reimbursements from the amount you claim.
Medicaid and Medicare: how they affect your deduction
If Medicaid paid part of your nursing home bill, you can deduct only the portion you paid yourself. Medicaid is a needs-based program, so if you may have access to, your income was likely low enough that you may not benefit from itemizing deductions anyway. However, if you have other medical expenses or significant charitable donations, it is still worth calculating.
Medicare covers skilled nursing care for a limited time after a hospital stay — usually up to 100 days. If Medicare paid your nursing home bill, you cannot deduct that portion. You can deduct only what you paid out of pocket, such as copayments or costs after Medicare coverage ended.
If you have a long-term care insurance policy, any benefits it paid reduce the amount you can deduct. Report the reimbursement on your tax return and subtract it from your total nursing home costs before calculating your deduction.
When to talk to a tax professional
Nursing home deductions can be complicated, especially if you have multiple sources of payment (your own money, insurance, Medicaid, Medicare) or if your nursing home bill is not itemized. A tax professional or certified public accountant (CPA) can review your situation, help you determine what qualifies, and make sure you claim the right amount.
You should also consult a tax professional if your nursing home stay spans two tax years, if you are unsure whether your care was skilled or custodial, or if the nursing home cannot provide a breakdown of medical versus non-medical charges. The cost of tax preparation may be worth it if you have a large nursing home bill or complex income situation.
Frequently Asked Questions
Can I deduct nursing home costs if I am there for Alzheimer's disease or dementia?
It depends on why you are there. If a doctor ordered skilled nursing care because you need monitoring, medication management, or behavioral support related to your condition, the full cost is deductible. If you are there only because you need help with daily living and supervision, only the medical portion (nursing staff, medications) is deductible, not room and board.
What if my nursing home does not give me an itemized bill?
Ask the business office in writing for a breakdown of medical versus non-medical charges. If they cannot or will not provide one, keep all your bills and consult a tax professional or the IRS. You may be able to estimate the medical portion based on the services you received, but documentation helps if the IRS questions your return.
Can my adult child deduct my nursing home costs on their tax return?
Only if they paid the bill themselves and you are their dependent. Your child must claim you as a dependent on their return, and the nursing home costs must be their unreimbursed medical expenses. If you paid the bill or Medicare and Medicaid paid it, your child cannot deduct it.
Does long-term care insurance change what I can deduct?
Yes. You can deduct only the nursing home costs you paid out of pocket. If your long-term care insurance reimbursed part of the bill, subtract that reimbursement from your total before calculating your deduction. The insurance benefit itself is not taxable income, but it reduces your deductible expense.
What if I moved to a nursing home in December but only stayed a few weeks?
You can deduct the costs for the weeks you were there, as long as they meet the medical expense rules. The length of stay does not matter — only whether the care was medically necessary and whether it exceeded 7.5% of your AGI when combined with other medical expenses.