Attendant Care and Care in a Facility (Group Home, Nursing Home, Respite Care)

Is attendant care and care in a facility CRA eligible in Canada?

Conditionally. Attendant care and care in certain facilities (group homes, nursing homes, schools, and institutions) are eligible medical expenses under the CRA's Medical Expense Tax Credit (METC), but the rules vary significantly depending on the type of care and the patient's situation. There are six separate provisions under subsection 118.2(2), each with its own conditions, limits, and documentation requirements. Because these expenses are METC eligible when the conditions are met, they can also be reimbursed through an HSA or PHSP.

What Qualifies

• Full-time attendant care or full-time nursing home care for an eligible person with a disability (paragraph 118.2(2)(b)) — T2201 must be on file; no dollar limit; DTC cannot also be claimed
• Limited attendant care in Canada, up to $10,000 per year ($20,000 in year of death), for an eligible person with a disability (paragraph 118.2(2)(b.1)) — T2201 must be on file; receipts must include payee's SIN; this is the only provision that preserves the DTC
• Care or supervision in a group home in Canada maintained exclusively for persons with severe and prolonged impairments (paragraph 118.2(2)(b.2)) — T2201 must be on file; receipts must include payee's SIN
• Full-time attendant in a self-contained domestic establishment (the patient's own home), certified by a medical practitioner (paragraph 118.2(2)(c)) — no T2201 required; medical practitioner letter required; receipts must include payee's SIN
• Full-time nursing home care for a patient lacking normal mental capacity, certified by a medical practitioner (paragraph 118.2(2)(d)) — no T2201 required; medical practitioner letter required
• Care and training at a school, institution, or other place for a person with a physical or mental handicap, certified by an appropriately qualified person (paragraph 118.2(2)(e)) — no T2201 required; the patient must require the specialized equipment, facilities, or personnel provided by that place
• Attendant care means personal tasks the patient cannot perform independently (meal preparation, housekeeping, laundry, transportation, dressing, bathing, feeding, companionship); multiple attendants may be used, provided only one is on duty at any given time
• Qualifying amounts include actual salary and remuneration, plus the employer's portion of employment insurance premiums, CPP/QPP contributions, and workers' compensation insurance premiums
• A nursing home must be of a "public character" — providing 24-hour nursing care to unrelated patients with features equivalent to a licensed nursing home

What Does Not Qualify

• Childcare or babysitting not related to a disability or medical need
• General housekeeping services without a medical requirement
• Attendant care provided by the claimant's spouse or common-law partner
• Attendant care provided by a person under 18 years of age
• Single-service providers such as a maid, driver, or gardener only (the care must address personal needs the patient cannot do for themselves)
• Care in a retirement home (retirement homes do not qualify as nursing homes)
• Recreational facilities such as summer camps
• Imputed salary (only actual salary and remuneration qualify)

Good to Know

• The Six Provisions at a Glance:

Provision	Type of Care	DTC Required?	Dollar Limit	Key Certification
(b)	Full-time attendant or full-time nursing home	Yes	None	T2201 on file
(b.1)	Limited attendant care (in Canada)	Yes	$10,000/year ($20,000 in year of death)	T2201 on file; payee SIN on receipts
(b.2)	Group home care (in Canada)	Yes	None	T2201 on file; payee SIN on receipts
(c)	Full-time attendant in patient's home	No	None	Medical practitioner letter; payee SIN on receipts
(d)	Full-time nursing home (lack of mental capacity)	No	None	Medical practitioner letter
(e)	School, institution, or other place	No	None	Letter from appropriately qualified person

• Provisions (b.1) and (b.2) explicitly require that the care be provided in Canada; the other provisions do not have this geographic restriction.
• For provision (e), an appropriately qualified person includes a medical practitioner and may also include the principal of the school or head of the institution.
• Fees paid to a school under provision (e) are eligible even if some fees could be construed as tuition, provided the patient's attendance is required for treatment.

Frequently Asked Questions

Do I need a Disability Tax Credit Certificate (T2201)?

It depends on which provision applies. Provisions (b), (b.1), and (b.2) require a T2201 on file. Provisions (c), (d), and (e) do not — they require written certification from a medical practitioner or appropriately qualified person instead.

Can I claim both attendant care and the disability tax credit?

Only under provision (b.1) (the limited $10,000 claim) and generally under (b.2) (group home). Using provisions (b), (c), or (d) for an eligible person with a disability prevents any taxpayer from claiming the DTC for that person that year.

Is attendant care CRA eligible?

Yes, when the specific conditions of at least one provision under subsection 118.2(2) are met.

Can I claim nursing home or group home costs through my HSA?

Yes. These costs are METC eligible when the conditions are met and can be reimbursed through your HSA.

What is the $10,000 limit?

The $10,000 annual limit applies only to the limited attendant care claim under paragraph 118.2(2)(b.1). It increases to $20,000 in the year the individual dies. The other provisions have no dollar limit.

Do receipts need to include a social insurance number?

Yes, for provisions (b.1), (b.2), and (c). Receipts must include the payee's SIN if the payee is an individual.

Source

Based on the CRA's official eligible medical expenses list and Income Tax Folio S1-F1-C1, "Cost of attendant care and care in certain types of facilities".