29 May 1996 External T.I. 9609065 - CARE MANAGEMENT PROGRAM ADMIN BY NURSES AS MED EX

Please note that the following document, although believed to be correct at the time of issue, may not represent the current position of the CRA.
Prenez note que ce document, bien qu'exact au moment émis, peut ne pas représenter la position actuelle de l'ARC.

Please note that the following document, although believed to be correct at the time of issue, may not represent the current position of the Department.

Prenez note que ce document, bien qu'exact au moment émis, peut ne pas représenter la position actuelle du ministère.

Principal Issues:

def'n of medical services in respect of fees paid to a nurse

Position:

question of fact, look to the relevant provincial acts for clarification on any service in the "grey" area

Reasons:

			960906
XXXXXXXXXX		A. Humenuk

Attention: XXXXXXXXXX

May 30, 1996

Dear XXXXXXXXXX:

Re: Medical Expenses

We are replying to your letter of February 12, 1996, concerning the eligibility of fees paid to XXXXXXXXXX as a medical expense for the purpose of the Income Tax Act (the Act).

You have asked that the fees charged by XXXXXXXXXX be accepted as a medical expense for the purpose of the medical expense tax credit. The law dealing with this credit is explained in Interpretation Bulletin IT-519R "Medical Expense and Disability Tax Credits and Attendant Care Expense Deduction."

Based on our telephone conversation of April 18, 1996 (XXXXXXXXXX\Humenuk), and the pamphlet describing the services you offer, it is our understanding that XXXXXXXXXX is an association which employs registered nurses and registered psychiatric nurses to provide a network of support services for senior citizens living in the city of XXXXXXXXXX While the specific services offered to any particular client will vary according to the client's needs, the primary role of the organization is to act as an independent care manager, as an advocate for families and to provide support services for senior citizens. You advised us that XXXXXXXXXX does not provide any physical care for its clients in order to ensure that the advice provided to clients concerning their medical needs is free from any bias.

As stated in paragraphs 5 and 22 of Interpretation Bulletin IT-519R, amounts paid to a nurse for medical services will qualify as a medical expense under paragraph 118.2(2)(a) of the Act. When the individual rendering the medical service is an employee of a partnership, society or association, the fee paid to that partnership, society or association will qualify as a medical expense to the same extent as it would, if it were paid directly to the individual providing the service.

Further, paragraph 22 of IT-519R states that medical services must be diagnostic, therapeutic or rehabilitative in nature. Paragraph 5 of IT-519R also provides comments on the relevance of the provincial jurisdiction in determining whether a particular person is qualified to provide medical services. With respect to services provided by a nurse in XXXXXXXXXX Registered Nurses Act, Registered Psychiatric Nurses Act and Licensed Practical Nurses Act set out the relevant definition of nursing for each category of nurse.

The pamphlet describing the services offered by XXXXXXXXXX suggests that the range of services offered by XXXXXXXXXX is not restricted to services which are considered to be medical services. Thus, it is our view that fees paid for a program of care management such as that described in your letter do not normally qualify as a medical expense. However, to the extent that the services provided entail the practice of "nursing" or "psychiatric nursing," as defined in the relevant XXXXXXXXXX legislation, and are part of the treatment required to relieve a health problem, the fees paid would qualify as a medical expense.

We trust our comments will be of assistance to you.

Yours truly,

John F. Oulton
for Director
Business and Publications Division
Income Tax Rulings and
Interpretations Directorate
Policy and Legislation Branch