Is a nursing home tax deductible?

The principal reason test

Everything turns on why the person is in the home. If a principal reason is to get medical care, the cost of meals and lodging is includible along with the care itself. If the reason is personal, such as companionship, convenience or the lack of a place to live, the meals and lodging are not includible, but you can still include the portion of the bill that is for medical or nursing care.

That second sentence is why a facility’s itemized statement matters. A facility that bills a single monthly rate may be able to give you a statement allocating the medical part, which is what the publication’s rule on lifetime-care fees also relies on.

Long-term care and chronically ill residents

Pub 502 also has a separate Long-Term Care entry. Qualified long-term care services are necessary diagnostic, preventive, therapeutic, curing, treating, mitigating and rehabilitative services, plus maintenance and personal care services, that are required by a chronically ill individual and provided under a plan of care prescribed by a licensed health care practitioner. A person is chronically ill if, within the previous 12 months, a licensed practitioner certified that they cannot perform at least two activities of daily living without substantial help for at least 90 days, or need substantial supervision because of severe cognitive impairment. Activities of daily living are eating, toileting, transferring, bathing, dressing and continence.

Premiums, retirement homes and paying for a parent

Premiums for qualified long-term care insurance contracts count up to age-based limits per person for 2025: $480 for age 40 or under, $900 for 41 to 50, $1,800 for 51 to 60, $4,810 for 61 to 70, and $6,020 for 71 or over. A life-care or founder’s fee paid to a retirement home counts for the portion properly allocable to medical care. If you pay for a parent’s care, you can include it if the parent is your dependent under the publication’s tests, so read the Whose Medical Expenses Can You Include section.

Illustration with numbers

This is an illustration, not an example from the publication. A dependent parent lives in a nursing home where a principal reason is medical care. You pay $41,000 for the year after Medicare and insurance reimbursements. With AGI of $90,000 the floor is $6,750, so the deduction is $34,250. If the stay were personal and the facility’s statement allocated $14,000 to nursing care, the includible amount would be $14,000 and the deduction $7,250.

How the floor, timing and itemizing apply here

For a nursing home, the same three rules from Publication 502 decide the final number. First, the deduction is only the part of your total medical and dental expenses that is more than 7.5% of your adjusted gross income, so a $1,000 cost does nothing until the year’s total passes the floor. Second, you include only what you paid during the tax year and were not reimbursed for, and you may include costs for yourself, your spouse and your dependents. Third, the deduction is claimed on Schedule A (Form 1040), so it helps only if your itemized deductions add up to more than your standard deduction. Amounts paid with a tax-free health savings account distribution cannot be counted again, and pre-tax flexible spending arrangement reimbursements are excluded.

Related medical expense topics

More from the same IRS publication: Is lodging tax deductible?, Is oxygen tax deductible?, Is drug addiction treatment tax deductible?. For a full calculation across all your expenses, use the medical expense deduction calculator, and see whether itemizing beats the standard deduction.

Sources

• IRS Publication 502, Medical and Dental Expenses (2025): the “Nursing Home”, “Long-Term Care”, “Lifetime Care—Advance Payments” and “Whose Medical Expenses Can You Include” sections, the 7.5% of AGI rule and the reimbursement rules. Read November 2, 2026.

Edition read: Publication 502 (2025), for use in preparing 2025 returns. Dollar limits and rates in this publication are for 2025; the publication notes that later legislation (P.L. 119-21) may affect federal deductions, so check the current publication and the Schedule A instructions for your tax year. This page summarizes the publication and does not replace it. Marked for human review.