topic Deduction for home health care in Deductions & credits

Deduction for home health care

rickj1954 — Tue, 24 Feb 2026 08:15:11 GMT

My mother has been diagnosed with Dementia. The doctor says she needs 24-hour care/supervision and has placed this diagnosis in her record. Her insurance will not cover. We hired a friend 2023 to help her while we work and pay her hourly. The friend is not a professional.

I thought I had to prepare a 1099 (NEC or MISC) to report this service and take a deduction for the cost. However, my research indicates that only businesses are required to file 1099s, and Turbo Tax will not let prepare a 1099 without an EIN. Obviously, my mother is not a business. I believe the proper way to take this deduction is to report it on Schedule A and provide the provider (our friend) with documentation to report the income on her Schedule C. Is this correct? If not, what is the proper way to handle this for both my mother's taxes and the provider's taxes? Thanks

Re: Deduction for home health care

xmasbaby0 — Thu, 28 Dec 2023 16:01:08 GMT

You and/or your mother are not a business so you do not issue a 1099NEC to the friend who is helping with your mom. The friend who is providing care to your mom is receiving self-employment income, and can enter it on their tax return whether they have a tax document or not. Many self-employed people enter that sort of income without 1099's.

What is unclear is how you are trying to deduct the cost of the care for your mom. Is your mother claimed as a dependent on your own tax return? Are you trying to enter the home care as a medical expense? Or are you trying to enter it for the child and dependent care credit? You mentioned that the care is taking place while you work. If you are trying to use the child and dependent care credit you will need the Tax ID or SSN of the care provider. The care provider then must report the self-employment income on their own return-----and the amount you report must match the amount they enter.

And.....does the friend providing care actually have expenses to enter on a Schedule C? What expenses do they have for caring for your mom? Where is the care taking place? In the care provider's home? Your home? Mom's home? Whose money is paying the care provider? Your money? Mom's money?

Re: Deduction for home health care

rickj1954 — Thu, 28 Dec 2023 16:27:22 GMT

Thanks for the quick response. I am not claiming my mother as a dependent on my taxes. I have financial and medical power of attorney for her and am preparing her taxes and claiming the home care cost as a medical expense on her taxes. the friend has no out of pocket expenses and the care takes place at my mother's home which is an apartment I built next to my house. All payments to our friend are paid out of my mother’s checking account.

Re: Deduction for home health care

xmasbaby0 — Thu, 28 Dec 2023 16:58:26 GMT

If the care is taking place in your mother's home, and is being paid by your mother's money, the care provider may be a household employee---for which your mother needs to issue a W-2.

https://ttlc.intuit.com/turbotax-support/en-us/help-article/taxation/considered-household-employee/L8WWhbPfO_US_en_US?uid=lqpfcv4j

https://ttlc.intuit.com/turbotax-support/en-us/help-article/tax-credits-deductions/kinds-medical-expenses-deductible/L6LZVQeQh_US_en_US?uid=lqpffsj8

So you are entering the expense for the care as a medical expense on your mother's return? Does your mom have enough other itemized deductions to exceed her standard deduction---like property tax or mortgage interest? (You say she lives in an apartment that you built....)

MEDICAL EXPENSES

The medical expense deduction has to meet a rather large threshold before it can affect your return. The amount of medical (including dental, vision, etc.) expenses that will count toward itemization is the amount that is OVER 7.5% of your adjusted gross income. You should only enter the amount that you paid in 2023—do not include any amounts that were covered by insurance or that are still outstanding. Of course, your medical expenses plus your other itemized deductions still have to exceed your standard deduction before you will see a difference in your tax due or refund.

To enter your medical expenses go to Federal>Deductions and Credits>Medical>Medical Expenses

2023 STANDARD DEDUCTION AMOUNTS

SINGLE $13,850 (65 or older/legally blind + $1850)

MARRIED FILING SEPARATELY $12,850 (65 or older/legally blind + $1500)

MARRIED FILING JOINTLY $27,700 (65+/legally blind) ) + $1500 per spouse

HEAD OF HOUSEHOLD $20,800 (65 or older/blind) + $1850)

Thoughts? @Critter-3 ??? @DoninGA ??? @Opus 17 ???

Re: Deduction for home health care

xmasbaby0 — Thu, 28 Dec 2023 17:01:54 GMT

@rickj1954 I have asked for some other Champs to weigh in on this issue. What you describe is kind of a gray area----- not sure how much of the care your mom is receiving would be regarded by the IRS as "nursing" care---which would be a medical expense and how much might just be household tasks, etc.

And...unless your mom has enough other itemized deductions, and the amount paid reaches the threshold to be a medical expense, it might all be moot anyway.

Re: Deduction for home health care

Opus 17 — Fri, 29 Dec 2023 02:44:51 GMT

By the way, if your mother is still competent to make financial decisions, you need to get her to execute a durable power of attorney to give you authority to handle her financial and tax issues, and also execute an IRS form 2848, which is a special POA form for taxes (of course the IRS has their own forms). .https://www.irs.gov/forms-pubs/about-form-2848

If she is no longer competent and you don't already have a POA, you need to go to court to be appointed her conservator. If not, you have no authority to file her taxes or issue tax forms.

The caregiver is a household employee and your mother issues a W-2 and files and pays household employee tax on her tax return.

https://www.irs.gov/publications/p926

Separately, your mother can deduct expenses for medical care as an itemized deduction on schedule A. The actual tax value of the deduction will depend on her other tax situations.

You can deduct costs for providing maintenance care and personal services to a chronically ill persons if you meet the tests below, summarized as:

1. The person is chronically ill or has an impairment that makes it dangerous to leave them alone.

2. Care is provided according to a written care plan that is reviewed and updated at least once a year (as the person's needs may change).

Normally, you could only deduct costs for nursing care and not costs for companionship or housekeeping services, and you must allocate the costs accordingly. Under the rules for chronically ill persons, you can include companionship (keeping them out of danger, see below). Housekeeping may be a bit of a gray area, but food prep is probably allowed; and if the person was in assisted living, the entire cost would be allowed, so I think you can probably include food prep under "providing of a chronically ill individual with needed assistance with the individual’s disabilities" because they can no longer prepare their own meals. However, this also depends on the person's individual needs, which may be different for different persons, and may change as time passes, which is why a specific written care plan is needed in addition to a general diagnosis.

Therefore, you need a written plan of care, and that is more than just noting in her medical record that she has a dementia diagnosis and requires an aide. The care plan should document the activities the aide will perform and how they relate to the person's "needed assistance with the individual’s disabilities". It can be a simple plan, and it can be written by a qualified social worker instead of a doctor (check with Alzheimers Association for example), but you should have it in writing in case of audit.

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Qualified Long-Term Care Services

Qualified long-term care services are necessary diagnostic, preventive, therapeutic, curing, treating, mitigating, rehabilitative services, and maintenance and personal care services (defined later) that are:

Required by a chronically ill individual, and
Provided pursuant to a plan of care prescribed by a licensed health care practitioner.

Chronically ill individual.

An individual is chronically ill if, within the previous 12 months, a licensed health care practitioner has certified that the individual meets either of the following descriptions.

The individual is unable to perform at least two activities of daily living without substantial assistance from another individual for at least 90 days, due to a loss of functional capacity. Activities of daily living are eating, toileting, transferring, bathing, dressing, and continence.
The individual requires substantial supervision to be protected from threats to health and safety due to severe cognitive impairment.

Maintenance and personal care services.

Maintenance or personal care services is care which has as its primary purpose the providing of a chronically ill individual with needed assistance with the individual’s disabilities (including protection from threats to health and safety due to severe cognitive impairment).

Re: Deduction for home health care

rickj1954 — Sun, 31 Dec 2023 13:31:04 GMT

Very helpful. thank you

Re: Deduction for home health care

rickj1954 — Sun, 31 Dec 2023 13:32:06 GMT

total rxpenses would be more than the standard deduction. Thank you

Re: Deduction for home health care

rickj1954 — Sun, 31 Dec 2023 13:32:42 GMT

Thank you

Re: Deduction for home health care

xmasbaby0 — Sun, 31 Dec 2023 14:42:45 GMT

@rickj1954

"total rxpenses would be more than the standard deduction. "

That is only one of the two thresholds that must be met. Only the amount that is more than 7.5% of your mother's AGI "counts" as a medical expense.