21 April 2004 GST/HST Ruling 50434 - Application of GST on Investment Management Services Provided by a Number of Third Party Service Providers

Please note that the following document, although correct at the time of issue, may not represent the current position of the Agency. / Veuillez prendre note que ce document, bien qu'exact au moment émis, peut ne pas représenter la position actuelle de l'Agence.

Dear XXXXX:

This is in reply to your letter XXXXX, with attachments, and further to our telephone conversation XXXXX, concerning the application of the Goods and Services Tax (GST)/Harmonized Sales Tax (HST) to the supply of consultant services by XXXXX R.N., to the XXXXX pursuant to a contract engagement.

Statement of Facts

Our understanding of the facts is as follows:

1. XXXXX entered into a contract for services with the XXXXX for the period XXXXX. Pursuant to this contract, XXXXX will serve as a consultant to the XXXXX on the research project entitled the XXXXX.

2. You advised that under the contract engagement, XXXXX activities include reviewing information pertaining to patient charts XXXXX. In addition, XXXXX provides related consultation as may be requested by the XXXXX.

3. The engagement contract specifies that as a consultant, XXXXX will engage in the following activities:

(a) XXXXX;

(b) XXXXX; and

(c) XXXXX.

4. The XXXXX component of the research study commenced XXXXX and is to be completed by XXXXX.

5. XXXXX is paid $XXXXX per day for participating in research training and $XXXXX. The contract also sets out amounts for reimbursement of expenses, such as travel, accommodation, and meals. XXXXX will invoice the XXXXX for fees and expenses monthly.

6. You advised that the contract engagement between XXXXX and the XXXXX is a contract for self-employed service.

Ruling Requested

The supply of XXXXX consultant services to the XXXXX pursuant to the engagement contract described above are exempt under paragraph 6(c) of Part II of Schedule V to the Excise Tax Act (the "ETA") as a supply of a nursing service rendered by a registered nurse that is made to a public sector body.

Ruling Given

Based on the facts set out above, we rule that the supply of XXXXX consultant services to the XXXXX pursuant to the engagement contract described above is a taxable supply at the rate of 7%.

That is, XXXXX consultant services are not exempt supplies under paragraph 6(c) of Part II of Schedule V to the ETA.

This ruling is subject to the general limitations and qualifications outlined in section 1.4 of Chapter 1 of the GST/HST Memoranda Series. We are bound by this ruling provided that none of the above issues is currently under audit, objection, or appeal; that there are no relevant changes in the future to the ETA, or to our interpretative policy; and that you have fully described all necessary facts and transactions for which you requested a ruling.

Explanation

As you noted, paragraph 6(c) exempts the following supply:

"A supply of a nursing service rendered by a registered nurse, a registered nursing assistant, a licensed or registered practical nurse or a registered psychiatric nurse, where

...

(c) the supply is made to a public sector body."

Accordingly, to fall within the exemption, the supply must first be that of a "nursing service". Nursing services are understood to be the provision of care for, and the treatment of health conditions of, an individual by supportive, preventive, therapeutic, palliative and rehabilitative means in order to attain or maintain optimal function. We consider the scope of nursing to be the diagnosis and treatment of health problems, involving nursing interventions used in caring for the individual, who we understand may also be referred to as a patient or client. A nurse carries out skilled nursing care and nursing interventions of patients, such as wound care and medication administration.

It is important to note that "nursing service" and "registered nurse" are separate terms where neither term is defined by the other; rather the meaning of each term is evaluated independently. "Nursing service" is the activity described as the skilled practice of nursing involving procedures, treatments, drug administration, and other interventions, which are acts performed on patients by nurses as part of a care plan or on the order of a physician. A "registered nurse" is the person who meets certain prescribed standards of education, clinical competence and registration or other licensing requirements. Together these terms fulfill the requirements of section 6 of Part II of Schedule V to the ETA. A nursing service arises from the provision of treatment or care rendered to a patient by a registered nurse or other nurse professional included in the ETA. Therefore, a service provided within the context of a therapeutic nurse-patient relationship established by the registered nurse for providing nursing services is a nursing service for purposes of the ETA.

Registered nurses may be employed in a variety of activities. These activities may involve the provision of care to patients, but registered nurses may also perform administrative, supervisory, consultant, teaching, and researching activities. A determination of the nature of a particular supply is not based solely on a person's qualifications and knowledge. Accordingly, where a registered nurse, a registered nursing assistant, a licensed or registered practical nurse or a registered psychiatric nurse, renders (nursing) services in the capacity of a care provider, i.e., care involving personal interaction with a patient in a professional therapeutic relationship these nursing services are exempt if they are supplied within one of the circumstances specified in section 6 of Part II of Schedule V to the ETA.

We understand that it is your view that XXXXX status as a registered nurse and her knowledge are sufficient to conclude that she is providing nursing services because these are factors necessary for the research project undertaken by the XXXXX. However, as explained above, XXXXX qualifications and knowledge are not sufficient to conclude that in acting as a consultant she is rendering "nursing services". In our view, XXXXX has been hired under a personal services contract to provide general consultant services; the XXXXX has not contracted with XXXXX for nursing services.

Should you have any further questions or require clarification on the above matter, please do not hesitate to contact me at (613) 952-6761.

Yours truly,

Susan Eastman
Municipalities and Healthcare Services Unit
Public Service Bodies and Governments Division

2004/04/07 F — RITS 50865 — Valeur de l'importation temporaire d'un autobus loué