Delbert L. and Margaret J. Baker v. Commissioner ( 2004 )


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  •                      122 T.C. No. 8
    UNITED STATES TAX COURT
    DELBERT L. AND MARGARET J. BAKER, Petitioners v.
    COMMISSIONER OF INTERNAL REVENUE, Respondent
    Docket No. 448-02.              Filed February 19, 2004.
    Ps and AFVW executed a residence agreement
    entitling Ps to lifetime residence at VW. VW provides
    four different levels of accommodations. During the
    years in issue, Ps resided in an independent living
    accommodation which provides the lowest level of care
    and resembles a regular residence that can be found in
    any nonretirement living community. Ps paid monthly
    service fees of $2,170 and $2,254 for 1997 and 1998,
    respectively. Several amenities were available to Ps,
    including medical services and the use of pool, spa,
    and exercise facilities.
    D, the vice president of finance for AFVW, the
    operator of VW, calculated the portions of the monthly
    service fees paid by independent living residents that
    were allocable to medical care. C, an ad hoc
    committee, of which P-H was a member, reviewed D’s
    calculations. On the basis of certified financial
    information provided by AFVW, C calculated a higher
    amount allocable to medical care. Both D and C used
    the percentage method to calculate the portions
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    allocable to medical care. Ps claimed medical
    deductions based on C’s calculations, and also claimed
    additional deductions as a result of P-H’s use of the
    pool, spa, and exercise facilities.
    R audited Ps and issued a notice of deficiency
    determining deficiencies on the basis of D’s
    calculations, and also disallowing the deductions for
    use of the pool, spa, and exercise facilities. R
    subsequently sought the advice of an actuary and, on
    the basis of the actuary’s report, now claims that the
    actuarial method must be used to determine the portion
    allocable to medical care. The actuary provided
    calculations using both the actuarial method and the
    percentage method. Ps rely on C’s calculations and a
    supplemental report prepared by P-H.
    Held: Ps are not required to use the actuarial
    method and may use the percentage method to determine
    the portions of the monthly service fees that are
    allocable to medical care.
    Held, further: Sec. 7491(a), I.R.C., places the
    burden of proof on R in certain situations. R concedes
    that Ps have satisfied the requirements of sec.
    7491(a)(2), I.R.C. Ps submitted credible evidence
    under sec. 7491(a)(1), I.R.C., with regard to the
    factual issue of the portions of monthly service fees
    allocable to medical care. Ps did not submit credible
    evidence regarding claimed deductions for use of the
    pool, spa, and exercise facilities. Therefore, R bears
    the burden of proof on the monthly fees issue but not
    on the facilities issue.
    Held, further: Sec. 213(a), I.R.C., allows
    deductions for expenditures for medical care, subject
    to certain limitations. Using the percentage method,
    the annual amounts of monthly service fees paid by Ps
    that are allocable to medical care are $7,766 and
    $8,476 for 1997 and 1998, respectively. Ps are not
    entitled to additional deductions for use of the pool,
    spa, and exercise facilities.
    Delbert L. Baker and Margaret J. Baker, pro sese.
    Guy H. Glaser and Vicken Abajian, for respondent.
    - 3 -
    GOEKE, Judge:    Respondent determined deficiencies in
    petitioners’ Federal income taxes of $983 and $1,252 for the
    taxable years 1997 and 1998, respectively.   After a concession,1
    the issues for decision are:   (1) What portions of monthly
    services fees paid by petitioners for lifetime residence at a
    continuing care retirement community are allocable to medical
    care under section 213;2 and (2) whether petitioners are entitled
    to deduct additional amounts under section 213 for medical use of
    pool, spa, and exercise facilities at the retirement community.
    We hold that the portions of the monthly service fees paid by
    petitioners for medical care were $7,766 and $8,476 for 1997 and
    1998, respectively.   We further hold that petitioners are not
    entitled to any deductions for 1997 and 1998, respectively, for
    the use of the pool, spa, and exercise facilities.
    FINDINGS OF FACT
    Some of the facts have been stipulated and are so found.
    The stipulation of facts and the attached exhibits are
    1
    Petitioners concede that they are not entitled to claim as
    a depreciation expense $595 of the $775 reported on their 1997
    return. Respondent’s determination with respect to 1997 includes
    a computational adjustment to petitioners’ Social Security
    benefits and/or Tier I Railroad Retirement benefits based on
    other changes to adjusted gross income. This adjustment will be
    taken into account by the parties in the Rule 155 computation.
    2
    Unless otherwise indicated, all section references are to
    the Internal Revenue Code in effect for the years in issue, and
    all Rule references are to the Tax Court Rules of Practice and
    Procedure. Dollar amounts are generally rounded to the nearest
    dollar.
    - 4 -
    incorporated herein by this reference.   Petitioners, Mr. Baker
    and Mrs. Baker, resided in Riverside, California, at the time
    they filed their petition.
    I.   Background
    On December 22, 1989, petitioners and Air Force Village
    West, Inc. (AFVW) executed a residence agreement entitling
    petitioners to a lifetime residence at Air Force Village West
    (Village West).   AFVW is a nonprofit organization that was
    incorporated in the State of California on September 21, 1984.
    AFVW was organized to establish, maintain, endow, and operate
    continuing care retirement communities (CCRCs) for officers (and
    their spouses and qualified dependents) of the U.S. uniformed
    services who are more than 60 years old and have been retired or
    honorably separated from active duty.    Village West is one of the
    CCRCs owned and operated by AFVW.   Village West is a gated,
    guarded, perimeter-fenced, resortlike retirement community
    located on 153 acres of land in Riverside, California.
    A.   Construction of Village West
    The construction of Village West occurred in three phases.
    The first phase involved the construction of the following living
    units and health care facilities:   (1) Independent Living Unit
    (ILU) apartments, duplexes, and cottages; (2) an Assisted Living
    Unit (ALU) facility with 20 rooms; (3) a Skilled Nursing Facility
    (SNF) with 59 beds; (4) a Commons building with a suite of rooms
    - 5 -
    set aside, in part, for an outpatient medical services clinic;
    (5) an F-Wing of apartment units; (6) a G-Wing of apartment
    units; (7) a pool area with Jacuzzi; (8) a maintenance and
    housekeeping building; (9) a mechanical building; and (10) an
    outside courtyard.   The first phase was substantially completed
    in December 1989, and initial operation began, and the first
    residents moved in, at that time.
    The second phase of the construction of Village West
    involved the construction of the following additional housing,
    administration, and maintenance buildings:   (1) A landscape
    building; (2) administrative offices located at the Commons
    building; and (3) additional ILU cottages.   The second phase was
    completed in October 1993 and started operation at that time.
    The final phase of the construction of Village West involved
    the expansion of the existing ALU facility and the construction
    of a new Special Care Unit (SCU) facility.   The final phase was
    completed in June 1997 and started operation at that time.
    B.   Living Accommodations at Village West
    Village West provides the following four different levels of
    living accommodations:   (1) Independent living, or ILU; (2)
    assisted living, or personal care (previously referred to as
    ALU); (3) special care, or SCU (Alzheimer’s/Dementia unit); and
    (4) skilled nursing, or SNF.   The ALU, SCU, SNF, and outpatient
    medical services clinic are located in one building which also
    - 6 -
    houses the administrative offices of AFVW, the dining room, and
    apartment units.    This building is known as the Village West
    Health Center and is also called the Commons building.    During
    the years in issue, the Village West Health Center was available
    for patient use by both residents of Village West (hereinafter
    sometimes referred to as AFVW residents) and nonresidents of
    Village West who lived in the surrounding community (hereinafter
    referred to as noncontract patients).    Noncontract patients were
    charged higher rates for use of the Village West Health Center
    and certain services were billed to them on a fee-for-service
    basis.
    1.     Independent Living Units
    The ILU apartments, duplexes, and cottages are designed for
    normal, everyday independent living of AFVW residents, and
    resemble regular residences that can be found in any
    nonretirement living community.    All ILUs are initially equipped
    with miniblinds, wall-to-wall carpeting, and standard kitchen
    appliances.    These are paid for by AFVW.
    During 1997 and 1998, several amenities were available to
    AFVW residents living in the ILUs, including:    (1) An emergency-
    pull-cord system installed in each ILU; (2) complete building and
    grounds maintenance; (3) weekly housekeeping services; (4) a 24-
    hour front desk service; (5) access to a fitness center,
    available for medical therapy, with spa and exercise areas; (6)
    - 7 -
    an indoor/outdoor swimming pool and Jacuzzi; and (7) complete
    patient access to all on-campus health services provided in the
    Village West Health Center.   Beginning in June 1997, AFVW
    residents living in ILUs gained access as patients to the newly
    opened SCU also located in the Village West Health Center.
    The front desk is staffed 24 hours a day and is the focal
    point for information, service, and assistance to residents.      One
    of the duties of the front desk was monitoring and responding to
    the emergency-pull-cord system installed in the ILUs and other
    areas of AFVW where the system is in place.    The emergency-pull-
    cord system was connected directly to the front desk and a crisis
    nurse, an assistant, and a security guard would be dispatched to
    the ILU if necessary.
    During the years in issue, Mr. Baker used the pool, spa, and
    exercise facilities at Village West.    Petitioners, like other
    AFVW residents, were not charged a separate fee to use these
    facilities.
    2.    Assisted Living Units
    The ALU facilities represent an intermediate step between
    independent living and the need for a higher level of care; i.e.,
    skilled nursing care.   The ALUs are designed for two types of
    individuals.   They are designed for individuals who are unable to
    leave a building unassisted under emergency conditions, including
    but not limited to, individuals who depend on mechanical aids
    - 8 -
    such as crutches, walkers, and wheelchairs and who are unable or
    likely to be unable to respond physically or mentally to an
    emergency situation such as a fire.       The ALUs are also designed
    for individuals who need care and supervision with the activities
    of daily living, such as eating, bathing, and dressing.      The ALUs
    are designed to provide occupants with a comfortable, homelike
    atmosphere where they are encouraged to provide their own
    furniture, bedding, and linens.
    During the years in issue, both AFVW residents and
    noncontract patients occupied rooms as patients in the ALU
    facilities.      AFVW residents who became patients in the ALUs
    received a 60-percent discount off the regular rate charged to
    noncontract patients who occupied similar units as patients.
    3.     Special Care Units
    The SCU at Village West is a special unit designed to
    provide living accommodations to individuals with diagnosed
    Alzheimer’s disease and/or similar forms of irreversible
    dementia.    Admission is based strictly on doctor’s orders.      The
    SCU is fully enclosed, can only be accessed through a security-
    locked door, and is manned 24 hours per day by nursing staff
    members.    Patients in the SCU are provided the same services as
    the individuals occupying the ALUs.       Additionally, other programs
    are provided which are specially geared to enhancing the dignity
    and lifestyle of patients during the remainder of their lives.
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    During the years in issue, both AFVW residents and
    noncontract patients occupied rooms as patients in the SCU.    AFVW
    residents who became patients in the SCU received a 60-percent
    discount off the regular rate charged to noncontract patients who
    occupied similar units as patients.
    4.   Skilled Nursing Care
    The SNF at Village West provides the highest level of care
    of all the health care facilities located at Village West.
    Admission to this facility is based strictly on doctor’s orders.
    The accommodations provided in the SNF include a skilled nursing
    facility bed, 24-hour nursing care, and three meals per day.   In
    addition, occupants of the SNF receive services such as long-term
    maintenance care, necessary diagnostic care, preventative care,
    therapeutic care, and rehabilitative care required by the
    chronically ill.
    During the years in issue, both AFVW residents and
    noncontract patients occupied rooms as patients in the SNF.    AFVW
    residents who became patients in the SNFs received an
    approximately 50-percent discount off the regular rate charged to
    noncontract patients who occupied similar units as patients.
    C.   The Residence Agreement
    Petitioners chose a 1,427-square foot, two bedroom, two
    bathroom, duplex unit for their ILU accommodations.   Under the
    residence agreement executed on December 22, 1989, they were
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    required to pay certain fees in exchange for a lifetime residence
    at Village West.   Petitioners were required to pay:   (1) A
    nonrefundable processing fee of $500; (2) an entrance fee of
    $130,015; and (3) an initial monthly service fee of $1,418, which
    was subject to annual increases by AFVW.3   The residence
    agreement states that in the case of two individual AFVW
    residents, the entrance fee is considered paid one-half by each.
    Petitioners deducted $34,541 of the entrance fee as a medical
    expense on their jointly filed 1989 tax return.4   Petitioners
    paid monthly service fees to AFVW of $2,170 and $2,254 for 1997
    and 1998, respectively.
    Under the terms of the residence agreement, petitioners were
    guaranteed several amenities in exchange for their payment of
    monthly service fees, including:   (1) The emergency-pull-cord
    system; (2) 24-hour availability of a licensed nurse from the SNF
    to respond to medical emergencies; (3) outpatient and other non-
    life-threatening nursing services provided at the Village West
    Health Center outpatient medical services clinic by their nursing
    3
    The residence agreement does not indicate how the entrance
    fee would be used by Village West. An independent auditor’s
    report of AFVW provides that the entrance fees, net of the
    portion that is refundable to the residents, are recorded as
    deferred revenue and amortized into income. The portion of the
    entrance fees that is estimated to be refundable is reflected as
    a liability on the statements of financial position.
    4
    The record does not indicate how this figure was
    calculated.
    - 11 -
    staff; and (4) a guaranty from AFVW of a bed in the Village West
    units or SNF and that the fees charged for use of the unit or the
    facility would be at a reduced rate from the standard fees
    charged to noncontract patients occupying such facilities.     The
    residence agreement is silent as to the amount of the fee
    reduction for use of the units or the facility.
    Under the terms of the residence agreement, AFVW could
    require that petitioners be transferred to a different level of
    living accommodation if certain medical conditions existed.
    Additionally, the terms of the agreement provided that
    petitioners were entitled to lifetime care.
    II.   AFVW’s Financial Information and Calculation of Deductible
    Medical Expenditures
    A.   AFVW’s Financial Information for 1997 and 1998
    In a report entitled “Air Force Village West - Health
    Facility Information” (hereinafter referred to as the report or
    the Health Facility Information report), Charles L. Dalton (Mr.
    Dalton), vice president of finance for AFVW, certified that
    financial information, allocation tables, and supplemental
    accounting data contained in the report had been compiled from
    the accounting records of AFVW.   The report included information
    for the years ended December 31, 1997, and December 31, 1998.
    - 12 -
    The following chart represents various revenue and expense
    items for 1997 listed in the report:
    REVENUES
    Description                                       Amount
    Monthly fees                                           $7,979,906
    Entrance fee revenue                                    2,978,303
    Entrance fee terminations                                 551,616
    Resident ALU fees                                         301,321
    Noncontract patient ALU fees                               80,156
    Resident SCU fees                                          55,445
    Noncontract patient SCU fees                                3,640
    Resident SNF fees                                         470,787
    Noncontract patient SNF fees                            1,207,747
    Investment income                                       2,890,228
    Gain from sale of securities                              107,335
    Net, direct billings                                      355,185
    EXPENSES
    Description                                      Amount
    Total operating expenses                              $16,069,104
    Total interest expense                                  4,797,339
    Total depreciation and amortization                     2,161,331
    Total issue cost                                           98,395
    Total environmental services                            1,028,776
    SNF expenses                                            3,044,041
    ALU and SCU expenses                                      929,275
    - 13 -
    Various SNF revenue and expenses for 1997 were listed as follows:
    REVENUES
    Description                                  Amount
    SNF room and board, private/Medicare/                    $795,567
    HMO fees for residents
    SNF room and board, private/Medicare/                   1,207,747
    HMO fees for noncontract patients
    SNF ancillary services, Medicare/HMO                      365,444
    billings for residents
    SNF ancillary services, Medicare/HMO                      448,462
    billings for noncontract patients
    EXPENSES
    Description                                   Amount
    Direct Expenses:
    Food service                                           $163,348
    Payroll and benefits                                  1,342,771
    Departmental costs                                      214,727
    Patient charges                                         726,229
    Purchased Services:
    Housekeeping and laundry                                 99,092
    Food service (benefits)                                  22,106
    Maintenance                                              39,316
    Landscape                                                29,833
    Administration                                          123,011
    Insurance                                                21,970
    Linens                                                    8,403
    Depreciation and amortization                           211,343
    Contracts                                                 8,206
    Utilities                                                33,686
    Total expenses                                       3,044,041
    - 14 -
    The following chart represents various revenue and expense
    items for 1998 listed in the report:
    REVENUES
    Description                                   Amount
    SNF room and board, private/Medicare/                    $585,802
    HMO fees for residents
    SNF room and board, private/Medicare/                   1,315,694
    HMO fees for noncontract patients
    SNF ancillary services, Medicare/HMO                      315,969
    billings for residents
    SNF ancillary services, Medicare/HMO                      378,905
    billings for noncontract patients
    EXPENSES
    Description                                   Amount
    Total operating expenses                              $17,759,058
    Interest expense                                        4,669,121
    Depreciation and amortization                           2,321,300
    Issue costs                                               107,134
    Total environmental services                            1,030,677
    SNF expenses                                            3,330,031
    ALU expenses                                              984,333
    SCU expenses                                              796,306
    - 15 -
    In a separate document (hereinafter referred to as the 1998
    financial document) that should have been included in the Health
    Facility Information report because it represents the most
    accurate data, the following relevant revenue and expense items
    were listed for 1998:
    REVENUES
    Description                                      Amount
    Monthly fees                                           $8,329,241
    SNF noncontract patient fees                            1,301,382
    ALU noncontract patient fees                              104,083
    SCU noncontract patient fees                              110,202
    EXPENSES
    Description                                      Amount
    Total operating expenses                              $16,986,770
    Interest expense                                        4,704,320
    Depreciation and amortization                           2,338,558
    Issue costs                                               107,134
    Total environmental services                            1,020,109
    - 16 -
    Various SNF expenses for 1998 were listed in the Health
    Facility Information report as follows:
    REVENUES
    Description                                 Amount
    SNF resident fees                                        $585,802
    SNF noncontract patient fees                            1,315,694
    SNF Medicare/HMO billings for residents                   315,969
    SNF Medicare/HMO billings for                             378,905
    noncontract patients
    SNF other                                                  15,696
    Home care                                                  49,578
    EXPENSES
    Description                                Amount
    Direct Expenses:
    Health services - payroll and benefits                 $374,008
    SNF - payroll and benefits                              964,802
    Clinic - payroll and benefits                           120,955
    SNF - departmental expenses                             197,028
    Clinic - departmental expenses                           40,446
    Patient chargeables                                     677,894
    Depreciation                                            166,303
    Insurance                                                32,531
    Utilities                                                26,073
    Contract                                                  3,055
    Purchased Services:
    Corporate administration                                125,684
    Environmental services                                  144,295
    Food services                                           381,040
    Maintenance                                              36,111
    Landscaping                                              30,306
    Linens                                                    9,500
    Total expenses                                       3,330,031
    - 17 -
    Similar charts were included detailing an allocation of expenses
    to the ALU and SCU.   The report states that the SNF, ALU, and SCU
    expense information listed above does not include an allocation
    of amortization of debt issue cost, amortization of preopening
    cost, or an allocation of interest expense.   Specific expenses
    associated with the pool, spa, and exercise facilities at Village
    West are not identified in the financial information in the
    report.
    In allocating expenses to the SNF, the following explanation
    was provided:
    Line Item                             Description
    Food service                   Percent of total contract
    Payroll and benefit            Direct labor costs plus benefits
    Departmental costs             All expenses in specific dept.,
    except payroll and benefits
    Housekeeping and laundry       Percent of total contract
    Food service                   Benefits of employees directly
    allocated to cost center
    Maintenance                    A specific employee dedicated to
    the health care facility
    Landscape                      Based on previous time study
    Administration                 Based on previous time study
    Insurance                      Policies directly related to
    facility plus 10 percent of other
    policies
    Linens                         Linens purchased directly for the
    SNF
    Depreciation and               Directly from the fixed asset
    amortization                 program
    Contracts                      Alarm system, copiers, fire drill,
    Medical Director, etc. (No
    ancillary contractors)
    Utilities                      10 percent of the total utilities
    for AFVW
    Interest expense               10 percent of total interest
    expense for AFVW
    - 18 -
    The explanation notes that allocations for ALUs and SCUs are the
    same except for maintenance, landscaping, administration,
    insurance, contracts, utilities, and interest, which were
    allocated on the basis of two-thirds of the SNF costs.
    The report contains an allocation of costs to the emergency-
    pull-cord system for ILUs for 1998.5   The cost was determined by
    developing an average hourly rate for front desk staff monitoring
    the system, multiplying this by the number of hours in a year
    (because the system was monitored 24 hours a day), and then
    adding an overhead cost factor of 30 percent of the staff cost.
    On the basis of an average hourly rate of $7.75, the total cost
    to monitor the emergency-pull-cord system for ILUs was determined
    to be $88,257.6   Mr. Dalton calculated this allocation.
    The report contains revenue totals for 1997 and 1998 for
    monthly services fees from ILU residents.   For 1997, the total
    monthly service fees from ILU residents are listed as $7,979,906.
    For 1998, the report lists total monthly service fee revenue of
    5
    The report does not contain a cost allocation to monitor
    the system for ILUs for 1997.
    6
    The following represents the calculations contained in the
    report:
    Hours required (365 days x 24 hours)     8,760
    Average hourly rate                       7.75
    Total staff cost                       $67,890
    Overhead of 30 percent                  20,367
    Total cost to monitor                $88,257
    - 19 -
    $8,327,083.    The report also shows average census figures for the
    ILUs for 1997 and 1998.    The schedule reflects that for 1997
    there were 372 occupied ILUs containing 574 residents.    For 1998,
    there were 386 occupied ILUs containing 591 residents.
    B.   Mr. Dalton’s Calculations
    On behalf of AFVW, Mr. Dalton calculated the deductible
    portion of the monthly service fees paid in 1997 and 1998 for
    AFVW residents living in ILUs.    Mr. Dalton informed ILU residents
    of his calculations and advised them to consult their tax adviser
    for possible application on their tax returns.    The general
    approach utilized by Mr. Dalton was to use costs associated with
    the SNF in determining the medical expense attributable to ILU
    residents.    Some of the figures used by Mr. Dalton to calculate
    the allocation percentage are different from those outlined in
    the Health Facility Information report.
    1.     Calculation of 1997 Medical Expenses
    For 1997, Mr. Dalton used a percentage method to determine
    the proper allocation of monthly service fees to medical care.
    Mr. Dalton calculated the allocation percentage by determining
    the total expenses associated with the SNF and subtracting from
    this figure depreciation, interest expense, and Medicare and HMO
    insurance reimbursements allocable to the SNF.7 He then divided
    7
    Mr. Dalton did not allocate any medical costs for the
    emergency-pull-cord system for 1997 or 1998.
    - 20 -
    this amount by the total costs, excluding total depreciation and
    interest expense, of Village West.    Mr. Dalton calculated that
    17.78 percent of the total monthly service fees paid by residents
    living in ILUs were allocable to medical care. Applying slightly
    different residency and monthly service fee figures than those
    contained in the Health Facility Information report, Mr. Dalton
    concluded that the portion of monthly service fees for ILU
    residents that was allocable to medical care was $374 per
    residence per month.
    2.   Calculation of 1998 Medical Expenses
    In 1998, AFVW switched to an actuarial method to determine
    the deductible portion of monthly service fees.8   However, Mr.
    Dalton still prepared a calculation for that year using the
    percentage method so that AFVW residents joining the community
    prior to January 1, 1998, would have information comparable to
    prior years for tax return preparation.    Using the same
    methodology as in 1997, Mr. Dalton calculated that 19.01 percent
    of the total monthly service fees paid by residents living in
    ILUs were allocable to medical care.    Applying slightly different
    residency and monthly service fee figures than those contained in
    the Health Facility Information report, Mr. Dalton concluded that
    8
    The evidence in the record does not contain calculations by
    AFVW or Mr. Dalton using the actuarial method to determine the
    deductible portion of monthly service fees paid in 1998.
    - 21 -
    the portion of monthly service fee for ILU residents that was
    allocable to medical care was $416 per residence per month.
    C.    Ad Hoc Committee’s Calculation of Medical Expenses
    In 1997, the resident council of Village West established an
    ad hoc committee (hereinafter sometimes referred to as the
    committee) to recalculate what portion of the monthly service
    fees paid by residents living in ILUs should be allocated to
    medical care.   The ad hoc committee reported to the resident
    council.   Petitioner was a participant of the ad hoc committee.
    In February 1998, Mr. Dalton supplied the resident council with
    information for purposes of determining the appropriate medical
    deductions for ILU residents for 1997 and 1998.9
    In a letter dated March 13, 2000, the ad hoc committee
    reported to the resident council its findings regarding income
    tax deductions for ILU residents for health care expenses.     Using
    the percentage method, the committee calculated that the portions
    of monthly services fees allocable to medical care were 40.3
    percent and 41.6 percent for the years 1997 and 1998,
    respectively.   In calculating total operating expenses, the
    committee subtracted interest expense, depreciation and
    amortization, issue cost, and noncontract patient expenses from
    total AFVW expenses. In calculating medical expenses, the
    9
    The information supplied included the 1998 financial
    document that should have been included in the Health Facility
    Information report.
    - 22 -
    committee included SNF, ALU, and SCU operating expenses, and
    subtracted out noncontract patient fees and depreciation and
    amortization allocable to the three facilities.   The committee
    then made certain upward adjustments to account for the
    emergency-pull-cord system, food service, environmental service,
    utilities, and insurance.   The adjustments for food service and
    environmental expenses were based on formulas provided by the
    food service contractor and the environmental service contractor.
    The adjustment for utilities was based on a square-footage method
    and the adjustment for the insurance was based on a ratio- and
    square-footage methodology.
    - 23 -
    The following chart prepared by the ad hoc committee
    represents its calculations for 1997:
    Operating Expenses                                 Amount
    Total expenses                                            $16,069,104
    Interest expense                                           (4,797,339)
    Depreciation and amortization                              (2,161,331)
    Issue cost                                                    (98,395)
    Noncontract patient expense                                (1,291,543)
    Total operating expenses                                  7,720,496
    Medical Expenses                                  Amount
    SNF operating expenses                                    $3,044,041
    ALU and SCU operating expenses                               929,275
    Emergency pull-cord system                                    87,374
    Food service adjustment                                      482,769
    Environmental service adjustment                             112,617
    Utilities adjustment                                          81,146
    Insurance adjustment                                          18,234
    SNF noncontract patient fees                              (1,207,747)
    SNF depreciation and amortization                           (211,343)
    ALU noncontract patient fees                                 (80,156)
    SCU noncontract patient fees                                  (3,640)
    ALU and SCU depreciation and amortization                   (140,895)
    Allocable medical expenses                               3,111,675
    Dividing medical expenses by total operating expenses, the
    committee calculated that the allocation percentage for 1997 was
    40.3 percent.10
    10
    3,111,675 ÷ 7,720,496 = .403 or 40.3 percent.
    - 24 -
    The following chart prepared by the ad hoc committee
    represents its calculations for 1998:
    Operating Expenses                                     Amount
    Total expenses                                            $16,986,770
    Interest expense                                           (4,704,320)
    Depreciation and amortization                              (2,338,558)
    Issue cost                                                   (107,134)
    Noncontract patient expense                                (1,515,667)
    Total operating expenses                                 8,321,091
    Allocable Medical Expenses                             Amount
    SNF operating expenses                                    $3,330,031
    ALU and SCU operating expenses                             1,780,639
    Emergency pull-cord system                                    88,257
    Utilities adjustment                                         103,641
    SNF noncontract patient fees                              (1,301,382)
    SNF depreciation and amortization                           (166,303)
    ALU noncontract patient fees                                (104,083)
    SCU noncontract patient fees                                (110,202)
    ALU and SCU depreciation and amortization                   (161,071)
    Allocable medical expenses                               3,459,527
    The operating expenses figures used by the committee were taken
    from the 1998 financial document that should have been included
    in the Health Facility Information report, not from the figures
    actually contained in the report.     Dividing medical expenses by
    total operating expenses, the committee calculated that the
    allocation percentage for 1998 was 41.6 percent.11
    In a memorandum dated March 15, 2000, the resident council
    reported to AFVW residents a summary of the ad hoc committee’s
    findings.     Attached to the memorandum was a chart showing that
    11
    3,459,527 ÷ 8,321,091 = .416 or 41.6 percent.
    - 25 -
    the annual deduction could be calculated by dividing total
    monthly service fees for the year by 12 months to arrive at the
    total average monthly service fees paid by ILU residents per
    month.    This amount is then divided by the number of ILU
    residents shown in the census chart, resulting in the average
    monthly service fee per resident.      Multiplying the average
    monthly service fee by the allocation percentage provides the
    medical deduction per resident per month.      The chart contained
    the following information relevant to monthly service fees for
    ILU residents for 1997 and 1998:
    Independent Living Units
    Year        Number Occupied   Residents      Total Yearly Service Fee
    1997             372             574               $7,979,906
    1998             386             591                8,329,241
    In a memorandum to AFVW residents dated February 1, 2002,
    the resident council, in conjunction with AFVW management,
    provided information to residents regarding income tax deductions
    for health care expenses.    The memorandum states that management
    changed from the percentage method to the actuarial method in
    1998 to determine the allowable deduction, and that management
    planned to continue to use the actuarial method for new
    residents.    It is noted that the actuarial method will produce a
    different deduction than the percentage method, and individual
    residents are advised to analyze each method and select the one
    most beneficial for his or her tax situation.
    - 26 -
    The memorandum further states that for the years 1997, 1998,
    and 1999, the ad hoc committee had coordinated and worked with
    AFVW management to review and make recommendations regarding the
    portion of monthly service fees allocable to medical care.      In
    addition, the memorandum states that certified data from the
    financial records of AFVW for these years was provided to the ad
    hoc committee and that data was used to determine the appropriate
    allocation percentage.   The allocation percentage is listed as
    40.3 percent and 41.6 percent for the years 1997 and 1998,
    respectively.   The memorandum then states that the portion of the
    monthly service fees allocable to medical care is determined per
    resident.   AFVW residents were advised to consult their tax
    adviser for possible application of the information contained in
    the memorandum, and it is stated that neither AFVW nor the
    resident council is a tax adviser.       The memorandum is signed by
    the chairman of the resident council and the president/CEO of
    AFVW.
    III. Petitioners’ Tax Returns
    On their jointly filed 1997 and 1998 Forms 1040, U.S.
    Individual Income Tax Return, petitioners reported medical and
    dental expenses of $12,743 and $16,828, respectively.12      Of these
    amounts, $6,557 and $9,891 for the years 1997 and 1998,
    12
    The amounts stated in this paragraph are before
    application of the 7.5-percent floor contained in sec. 213(a).
    - 27 -
    respectively, related to the portion of the monthly services fees
    paid allocable to medical care.    These amounts are primarily
    derived from the ad hoc committee’s calculations.    The amounts of
    $3,461 and $3,596 for the years 1997 and 1998, respectively,
    related to Mr. Baker’s use of the pool, spa, and exercise
    facilities at Village West.   The remainder of the reported
    amounts was for various other items.
    Petitioners’ claimed entitlement to deductions for Mr.
    Baker’s use of the pool, spa, and exercise facilities is based in
    part on a letter dated July 29, 1991, from Elaine K. Jones, M.D.,
    which states that her evaluation confirms Mr. Baker’s previous
    diagnoses of hypertension, valvular heart disease,
    hyperlipidemia, and degenerative arthritis.    The letter states
    that to treat the above medical conditions it is imperative that
    Mr. Baker continue his exercise program, including the exercise
    room, swimming pool, and whirlpool at least three times a week.
    The letter also states that the exercise program will help
    alleviate the symptoms of Mr. Baker’s chronic illnesses.
    IV.   Respondent’s Determination
    The examination in this case commenced after July 22, 1998.
    On September 28, 2001, respondent issued a notice of deficiency
    to petitioners for their 1997 and 1998 taxable years.    In the
    notice, respondent determined that the portion of the monthly
    service fees attributable to medical care was limited to $4,488
    - 28 -
    and $5,142 for the years 1997 and 1998, respectively.13
    Respondent’s determination for 1997 was based on Mr. Dalton’s
    determination that $374 of the monthly service fees per residence
    in an ILU was allocable to medical care.14     The determination for
    1998 was calculated by multiplying the 19.01-percent allocation
    figure determined by Mr. Dalton by petitioners’ total monthly
    service fees paid to AFVW.15     These determinations are based on
    the percentage method, not the actuarial method.16     Respondent
    completely disallowed petitioners’ claimed deductions for both
    years relating to Mr. Baker’s use of the pool, spa, and exercise
    facilities at Village West.     The remaining claimed medical
    deductions were allowed.
    Respondent subsequently sought the advice of Alwyn V. Powell
    (Mr. Powell), an actuary, for the purpose of determining the
    portion of the monthly services fees allocable to medical care.
    On the basis of Mr. Powell’s expert report, respondent now
    asserts that $4,584 and $5,304 are the correct amounts allocable
    13
    The amounts stated in this paragraph are before
    application of the 7.5-percent floor contained in sec. 213(a).
    14
    $374 x 12 months = $4,488.
    15
    ($2,254 x 12 months) x 19.01 percent = $5,142.
    16
    Respondent’s determinations based on the percentage method
    are inconsistent because for 1997 he determined the amount
    allocable to medical care based on the weighted average of
    monthly service fees paid by ILU residents but for 1998 he
    determined the amount allocable based on the actual monthly
    service fees paid by petitioners.
    - 29 -
    to medical care for petitioners for the years 1997 and 1998,
    respectively.   In his report, Mr. Powell calculated the amounts
    allocable to medical care for petitioners using the actuarial
    method, an alternative actuarial method,17 and the percentage
    method.   Mr. Powell relied on the financial information contained
    in the Health Facility Information report for purposes of
    applying the above three methods.
    Respondent’s current position is that the actuarial method
    is the correct way to calculate the deductible portion of
    petitioners’ monthly service fees.     In the event that the
    percentage method must be used, respondent generally argues that
    the percentage method calculations performed by Mr. Powell are
    the correct calculations to use.18
    OPINION
    During the years in issue, petitioners lived in an ILU,
    which, as stated above, is a residential unit designed for
    normal, everyday independent living of AFVW residents, and
    resembles a regular residential accommodation that can be found
    in any nonretirement living community.     The primary issue in this
    case is the amount of the monthly service fees paid while
    17
    On brief, respondent expressly states that use of the
    alternative actuarial method is not being advocated in this case.
    18
    Respondent does not argue that we should use any of the
    figures used by Mr. Dalton in his calculations under the
    percentage method, which figures were the basis of the
    determination in the notice of deficiency.
    - 30 -
    petitioners resided in an ILU that is allocable to medical
    care.19     Resolution of this issue depends in part on whether we
    apply the percentage method or the actuarial method.
    Additionally, we must decide whether petitioners are entitled to
    medical deductions for amounts they claim are attributable to Mr.
    Baker’s use of the pool, spa, and exercise facilities at AFVW.
    Section 213(a) allows as a deduction any expenses that are
    paid during the taxable year for the medical care of the
    taxpayer, his spouse, and dependents and that are not compensated
    for by insurance or otherwise.     Estate of Smith v. Commissioner,
    
    79 T.C. 313
    , 318 (1982).     The deduction is allowed only to the
    extent the amount exceeds 7.5 percent of adjusted gross income.
    Sec. 213(a); sec. 1.213-1(a)(3), Income Tax Regs.     The term
    “medical care” includes amounts paid “for the diagnosis, cure,
    mitigation, treatment or prevention of disease, or for the
    purpose of affecting any structure or function of the body”.
    Sec. 213(d)(1)(A); Estate of Smith v. Commissioner, supra at 318-
    319.
    19
    The portion of fees paid by residents in higher levels of
    care, such as ALUs, SCUs, or the SNF, that is allocable to
    medical care is not at issue in this case. For further
    discussion of the treatment of costs incurred while residing in a
    retirement home, see Levine v. Commissioner, 
    695 F.2d 57
    , 59-60
    (2d Cir. 1982), affg. T.C. Memo. 1981-437, Estate of Smith v.
    Commissioner, 
    79 T.C. 313
    , 319 (1982), and sec. 1.213-1(e)(1)(v),
    Income Tax Regs.
    - 31 -
    Petitioners claim that they are entitled to a medical
    deduction related to the monthly service fees paid using the
    percentage method and applying an allocation percentage of
    approximately 41 percent.     Petitioners also claim that they are
    entitled to additional medical deductions as a result of Mr.
    Baker’s use of the pool and spa facilities at AFVW.
    Respondent agrees that petitioners are entitled to deduct
    under section 213 a portion of the monthly service fees paid to
    AFVW.     However, respondent argues that the actuarial method
    should be used to calculate the amount allocable to medical care.
    Respondent contends that petitioners are not entitled to any
    deductions for Mr. Baker’s use of the pool, spa, and exercise
    facilities at Village West because petitioners have not
    substantiated how the claimed amounts were calculated or that the
    expenditures were paid for the primary purpose of and are
    directly related to the medical care of the taxpayers.
    I.   The Allocation Methods
    The primary disagreement between the parties with respect to
    the monthly service fees issue is the appropriate method to use
    to calculate the portion of the fees allocable to medical care.
    Petitioners, relying on published guidance by the Commissioner,
    argue that they are entitled to use the percentage method.
    Respondent, relying on the expert report of Mr. Powell, argues
    that the actuarial method should be used.
    - 32 -
    A.   The Percentage Method
    The percentage method assumes that the medical care portion
    of entrance fees and monthly service fees is the same portion or
    percentage as the CCRC’s medical expenses to total costs because
    the sum of the fees over the resident’s lifetime is expected to
    cover the costs of care for residents in a CCRC.    Thus, the
    percentage method generally involves analyzing each expense
    category to determine what portion of each category’s total costs
    is for medical purposes.   In his report, Mr. Powell explained
    that this allocation process is fairly straightforward for CCRCs
    that provide medical care through stand alone detached units with
    budgets separate from the nonmedical center or that purchase
    medical services from a third party.    However, most CCRCs that
    Mr. Powell was familiar with (including Village West) do not make
    this distinction in their budgets and operate on a blended basis
    for the entire facility.
    Under the percentage method, once total medical expenses are
    determined, this amount is divided by the CCRC’s costs to
    determine the medical expense allocation percentage.    This
    percentage is then multiplied by the total monthly fees collected
    from ILU residents for the year to find the total medical costs
    allocable to monthly fees revenue.     This total is then divided by
    the number of ILU residents to determine the portion of the fees
    that is allocable to medical care.
    - 33 -
    B.      The Actuarial Method
    According to respondent’s expert, Mr. Powell,20 the
    actuarial method is a procedure based on actuarial projections of
    longevity and health care utilization for estimating the
    deductible portion of fees paid by a taxpayer to a CCRC.        Like
    the percentage method, the actuarial method initially requires
    that expenses be allocated between medical care and nonmedical
    care.        The following is a simplified description of the actuarial
    method used by Mr. Powell and relied on by respondent.        On brief,
    respondent acknowledges that this description does not detail
    much of the complexity in actually applying the method.
    The first step in applying the actuarial method is to
    determine operating expenses and capital expenses for the use of
    fixed assets.       The second step is to estimate the length of time
    a resident will spend in each level of care.       Although this is
    normally accomplished using actuarial tables, CCRCs present a
    complicating factor because survivorship possibilities and the
    corresponding life expectancies need to be refined by the level
    of care (e.g., independent living versus assisted living versus
    skilled nursing care).       The third step is to combine the
    20
    Mr. Powell is the chairman and CEO of A.V. Powell &
    Associates, LLC, a firm of consulting actuaries and accountants.
    Mr. Powell has an undergraduate degree in major statistics from
    Harvard and a master’s degree in actuarial science from Georgia
    State University. Mr. Powell was recognized by the Court as an
    expert in actuarial science.
    - 34 -
    assumptions about costs of services with the longevity projection
    to determine the lifetime total costs of care and the lifetime
    total medical care costs.     By applying the lifetime medical care
    costs, the fourth step uses the contract provision about monthly
    service fees paid to determine the prepaid medical care costs.
    The amount of medical care that is funded before transfer to
    assisted living or nursing care is the difference between
    lifetime medical care costs and the sum of monthly service fees
    paid.     This difference is referred to as the prepaid medical care
    costs and should be considered deductible under section 213(a).
    The calculation of the portion of the prepaid medical care costs
    that can be claimed for the entrance fee and the portion that can
    be claimed for the total monthly service fees for the year is at
    the discretion of the taxpayer with the limitation that the
    actuarial present value sum of all deductions does not exceed the
    prepaid medical care costs.
    C.      Appropriate Allocation Method
    The threshold dispute is over which method to use to
    determine the portion of the monthly service fees that is
    allocable to medical care.     As explained in detail below, the
    percentage method preferred by petitioners has been accepted by
    respondent and generally relied upon since at least 1967.
    Properly applied, the percentage method provides a reasonable and
    straightforward approach for determining the portion of monthly
    - 35 -
    service fees that is allocable to medical care.   The method
    provides a direct link between the actual fees paid by the
    residents and the medical costs incurred by the CCRC during the
    taxable year.   Despite this, respondent asserts that the
    actuarial method is more precise and accurate.    Respondent freely
    admits that the actuarial method is more complex, indeed, so
    complex as to defy full explanation in testimony and on brief.
    Both methods involve subjective judgments, so neither is immune
    from differences of opinion.   We hold under these circumstances
    that petitioners are not compelled to adopt a new method, and we
    decline respondent’s suggestion that the percentage method be
    usurped by the actuarial method.
    As noted above, use of the percentage method has been
    sanctioned by respondent for over 35 years.   In Rev. Rul. 67-185,
    1967-1 C.B. 70, Rev. Rul. 75-302, 1975-2 C.B. 86, and Rev. Rul.
    76-481, 1976-2 C.B. 82,21 the Commissioner addressed similar
    situations involving the issue of whether the portion of a
    monthly fee paid by individuals in connection with their
    21
    We are aware that revenue rulings are not binding on this
    Court or other Federal courts. Rauenhorst v. Commissioner, 
    119 T.C. 157
    , 171 (2002); Frazier v. Commissioner, 
    111 T.C. 243
    , 248
    (1998). However, the public has a right to rely on positions
    taken by the Commissioner in published guidance. Alumax, Inc. v.
    Commissioner, 
    109 T.C. 133
    , 163 n.12 (1997), affd. 
    165 F.3d 822
    (11th Cir. 1999); Am. Campaign Acad. v. Commissioner, 
    92 T.C. 1053
    , 1070 (1989); Nissho Iwai Am. Corp. v. Commissioner, 
    89 T.C. 765
    , 778 (1987); see also Rev. Proc. 89-14, sec. 7.01(5), 1989-1
    C.B. 814 (taxpayers may rely on published revenue rulings in
    determining the tax treatment of their own transactions).
    - 36 -
    residence at a retirement home under a lifetime care contract was
    deductible by the individuals as an expense for medical care
    under section 213, subject to the limitations of the statute.     In
    the rulings, the taxpayers had entered into agreements with a
    retirement home under which they became entitled to live in the
    home and to receive lifetime care that included specified
    residential accommodations, meals, and medical care.      In exchange
    for the promise of the lifetime care, the taxpayers paid a
    monthly fee to the homes.
    In Rev. Rul. 67-185, supra at 70, the taxpayers proved that
    on the basis of the retirement home’s experience, a portion of
    the monthly fee was for costs of providing medical care,
    medicine, and hospitalization.    The ruling cited the holding in
    Rev. Rul. 54-457, 1954-2 C.B. 100, that where a university
    charges a student a lump-sum fee which includes his education,
    board, medical care, etc., the portion of the charge which was
    allocable to medical care is considered a proper medical expenses
    deduction if there is a breakdown showing the amount of the fee
    allocable to medical care, or such information was readily
    available to the university.     Id. at 71.   Rev. Rul. 67-185,
    supra, then stated that the principle in Rev. Rev. 54-457, supra,
    relating to allocation of the fee, was equally applicable to its
    situation.   Rev. Rul. 67-185, supra at 71, concluded:
    - 37 -
    Accordingly, where the taxpayers, a husband and
    his wife, pay a monthly life-care fee to a retirement
    home, and prove that a specific portion of the fee
    covers the costs of providing medical care for them,
    that portion of the fee is deductible by the taxpayers
    as an expense for medical care in the year paid,
    subject to the limitations prescribed in section 213 of
    the Code.[22]
    In Rev. Rul. 75-302, supra, the taxpayer, pursuant to a
    lifetime care contract with a retirement home, was required to
    pay a lump-sum fee.   The Commissioner ruled that the portion of
    the lump-sum fee that was properly allocable to the taxpayer’s
    medical care was deductible as an expense for medical care in the
    year paid, subject to the limitations in section 213.
    The facts involved in Rev. Rul. 76-481, supra, are similar
    to those in Rev. Rul. 67-185, supra.   Rev. Rul. 76-481, supra at
    82, noted that the fees were calculated without reference to any
    similar contract with other patients at the institution and was
    not medical insurance.   Additionally, because the home had not
    been in operation for a sufficient length of time to demonstrate
    from its own financial experience what portion of the fees was
    allocable to medical care of the residents, the home used long-
    term financial information from a comparable retirement home.
    Id. at 83.   The home determined that 15 percent of the monthly
    fee would be used to discharge the home’s obligations to provide
    medical care to its residents.   Id.
    22
    See also Rev. Rul. 68-525, 1968-2 C.B. 112 (relying on the
    statement in Rev. Rul. 67-185, 1967-1 C.B. 70).
    - 38 -
    The ruling first examined previous rulings discussing the
    deductible portion of fees paid by taxpayers for lifetime care
    from retirement homes.   Id.   The ruling cited the statement in
    Rev. Rul. 67-185, supra, quoted above.    The ruling then addressed
    the monthly fee issue and stated:
    In addition, the portion of the monthly fee (15
    percent * * *) paid by the taxpayers that is properly
    allocable to medical care is also deductible as an
    expense for medical care in the year paid, subject to
    the limitations prescribed in section 213 of the Code.
    [Id.]
    The ruling also discussed the deductibility of portions of an
    entrance fee paid by the taxpayers.23    Id.
    23
    In other rulings, taxpayers have been allowed to deduct
    specific portions of entrance fees paid to retirement homes,
    subject to the limitations of sec. 213. See Rev. Rul. 76-481,
    1976-2 C.B. 82 (10 percent of entrance fee allocable to medical
    care); Rev. Rul. 75-302, 1975-2 C.B. 86 (30 percent of entrance
    fee allocable to medical care). In Estate of Smith v.
    Commissioner, 
    79 T.C. 313
    , 321-322 (1982), we held that 7 percent
    of an entrance fee paid to a retirement home was allocable to
    medical care because this percentage was determined to be the
    cost of providing free days of standard care in a convalescent
    center for the residents’ lifetimes. The Commissioner acquiesced
    in our decision in Estate of Smith at 1984-2 C.B. 1.
    - 39 -
    None of the above rulings have been revoked or modified,24
    and the Commissioner has relied on these rulings in issuing
    private letter rulings regarding the deductible portion of
    monthly service fees.25   Indeed, the Commissioner in private
    letter rulings has cited the above revenue rulings and sanctioned
    use of the percentage method.    See, e.g., Priv. Ltr. Rul. 86-30-
    005 (Apr. 4, 1986), which states in relevant part:
    The proper allocation of medical to total fees may
    be determined by dividing all directly related medical
    expenses by total expenses. To the extent that they
    can be substantiated and are allocable to medical care
    facilities, medically related expenses may include,
    24
    Although Rev. Rul. 76-481, supra, was clarified by Rev.
    Rul. 93-72, 1993-2 C.B. 77, the clarification does not affect the
    issue in the instant case. It is unclear whether the
    Commissioner has considered the issue of the deductibility of
    monthly service fees since 1993. See Rev. Proc. 93-43, 1993-2
    C.B. 544 (stating that no further rulings will be issued on the
    issue of whether amounts paid for medical care extending
    substantially beyond the taxable year may be deducted under
    section 213); see also Rev. Proc. 99-3, 1999-1 C.B. 103
    (designating the issue stated in Rev. Proc. 93-43, supra as an
    area under extensive study in which rulings or determination
    letters will not be issued until the Service resolves the issue
    through publication of a revenue ruling, revenue procedure,
    regulations, or otherwise). We note that the monthly service
    fees in this case relate to current medical care.
    25
    See, e.g., Priv. Ltr. Rul. 86-51-028 (Sept. 19, 1986);
    Priv. Ltr. Rul. 86-41-037 (July 11, 1986); Priv. Ltr. Rul. 86-30-
    005 (Apr. 4, 1986); Priv. Ltr. Rul. 82-13-102 (Dec. 30, 1981).
    Private letter rulings are not regarded as precedent in this
    Court and may not be relied on by the public. Sec. 6110(j)(3);
    Alumax, Inc. v. Commissioner, 109 T.C. at 163 n.12. However,
    private letter rulings may be cited to show the practice of the
    Commissioner. Rowan Cos., Inc. v. United States, 
    452 U.S. 247
    ,
    261 n.17 (1981); Hanover Bank v. Commissioner, 
    369 U.S. 672
    , 686-
    687 (1962); Rauenhorst v. Commissioner, 119 T.C. at 170 n.8;
    Estate of Cristofani v. Commissioner, 
    97 T.C. 74
    , 84 n.5 (1991).
    - 40 -
    among other items, salaries of nurses, nurses’ aides,
    orderlies and incidental medication and supplies, as
    well as expenses allocable to the facility, such as,
    housekeeping, maintenance and utilities, a
    proportionate share of interest on indebtedness, real
    estate taxes, insurance, and depreciation.
    *    *    *      *     *      *    *
    (5) Medical expenses for purposes of the
    computation of the ratio of medical to total expenses
    include, but are not limited to, salaries of the
    Medical Center staff, incidental medication and
    supplies, the proportionate amount attributable to the
    provision of medical care of housekeeping, maintenance,
    utilities, administrative and marketing costs, interest
    on indebtedness, real estate taxes and depreciation of
    the nursing facility.
    There is no requirement in the revenue rulings that
    taxpayers engage in an actuarial analysis to factor in life
    expectancy and health care level expectancy on the basis of the
    residency population of a CCRC to determine estimated lifetime
    medical care costs and total costs.       The rulings focus on the
    amount of fees paid by residents to the CCRC during the taxable
    year that are properly allocable to medical care in the year
    paid, and imply that the percentage method is an appropriate
    method for taxpayers to use.    The actuarial method used by
    respondent’s expert requires estimating total lifetime costs of
    services and lifetime medical care costs, steps that are not
    anticipated or required by the revenue rulings.       Additionally,
    the longstanding practice of the Commissioner has been to allow
    use of the percentage method.    The Commissioner’s guidance
    - 41 -
    provides further justification for our holding that petitioners
    are not required to use the actuarial method.
    II.   Burden of Proof
    We must now determine which party bears the burden of proof
    as to the factual issues in this case.    Generally, the taxpayer
    bears the burden of establishing the entitlement to any deduction
    claimed.   INDOPCO, Inc. v. Commissioner, 
    503 U.S. 79
    , 84 (1992);
    New Colonial Ice Co. v. Helvering, 
    292 U.S. 435
    , 440 (1934).
    However, in certain circumstances, if the taxpayer introduces
    credible evidence with respect to any factual issue relevant to
    ascertaining the proper tax liability, section 7491 places the
    burden of proof on the Commissioner.     Sec. 7491(a)(1).   Credible
    evidence is “‘the quality of evidence which, after critical
    analysis, the court would find sufficient upon which to base a
    decision on the issue if no contrary evidence were submitted’”.
    Higbee v. Commissioner, 
    116 T.C. 438
    , 442 (2001) (quoting H.
    Conf. Rept. 105-599, at 240 (1998), 1998-3 C.B. 755, 994).
    Section 7491(a)(1) applies only if an individual taxpayer
    complies with substantiation requirements, maintains all required
    records, and cooperates with reasonable requests by the
    Commissioner for witnesses, information, documents, meetings, and
    interviews.   Sec. 7491(a)(2).26
    26
    Sec. 7491 is effective with respect to court proceedings
    arising in connection with examinations commencing after July 22,
    (continued...)
    - 42 -
    Whether an expense is for medical care is primarily a
    question of fact.   Levine v. Commissioner, 
    695 F.2d 57
    , 59 (2d
    Cir. 1982), affg. T.C. Memo. 1981-437; Counts v. Commissioner, 
    42 T.C. 755
    , 764 (1964); Estate of Smith v. Commissioner, 79 T.C. at
    319; sec. 1.213-1(e)(1)(v), Income Tax Regs.   For purposes of
    this case, the factual issues involved are:    (1) The portions of
    the monthly service fees allocable to medical care under the
    percentage method; and (2) the amounts, if any, that petitioners
    are entitled to deduct for Mr. Baker’s use of the pool, spa, and
    exercise facilities.
    On brief, respondent argues that petitioners have failed to
    present credible evidence that they are entitled to the amounts
    of the medical deductions claimed on their returns for the years
    in issue and that they did not comply with the substantiation,
    recordkeeping, and cooperation requirements of section
    7491(a)(2).   However, at trial, respondent specifically stated
    that petitioners had cooperated and maintained records.
    Respondent represented to the Court that the only issue under
    section 7491(a) was whether petitioners had presented credible
    evidence.   We treat respondent’s representation at trial as a
    26
    (...continued)
    1998. Internal Revenue Service Restructuring and Reform Act of
    1998, Pub. L. 105-206, sec. 3001(c), 112 Stat. 727. Respondent
    has conceded that the examination in this case commenced after
    July 22, 1998.
    - 43 -
    concession that petitioners have satisfied the requirements of
    section 7491(a)(2).
    The stipulated joint exhibits and petitioners’ exhibits
    contain detailed financial information, including total revenue
    and expenses figures for Village West for the years in issue.
    Petitioners rely primarily on the findings of the ad hoc
    committee, of which Mr. Baker was a member, with certain
    adjustments.   AFVW management informed its AFVW residents that
    certified data from the financial records of AFVW for the years
    in issue was provided to the ad hoc committee and that the
    committee coordinated and worked with management to review and
    make recommendations regarding the allowable deductions for
    medical expense.   This financial information and the ad hoc
    committee’s report are detailed and contain the revenue and
    expense figures necessary to calculate petitioners’ medical
    deductions for the years in issue.     After discussing this issue
    with the parties at trial and examining their briefs, we
    interpret petitioners’ position to be that both the ad hoc
    committee’s findings and the findings resulting from petitioners’
    subsequent adjustments are appropriate methods of calculating the
    appropriate allocation percentage and determining petitioners’
    medical deductions.
    After thorough review and critical analysis of the
    stipulated joint exhibits and petitioners’ exhibits, we find that
    - 44 -
    petitioners have submitted credible evidence; i.e., evidence
    which, after critical analysis, is sufficient on which to base a
    decision sustaining the ad hoc committee’s calculations regarding
    the portion of the monthly service fees that is allocable to
    medical care under the percentage method.27   Accordingly, we hold
    that respondent bears the burden of proof regarding the portions
    of the monthly service fees paid by petitioners in 1997 and 1998
    that are allocable to medical care under the percentage method.28
    However, with respect to the claimed deductions for medical
    use of the pool, spa, and exercise facilities, we find that
    petitioners have not submitted credible evidence.   The financial
    information discussed above, as further explained below, does not
    contain specific figures or calculations by Mr. Dalton or AFVW
    relating to expenditures for the facilities that are sufficient
    27
    See Forste v. Commissioner, T.C. Memo. 2003-103 (holding
    that taxpayers produced credible evidence in the form of draft
    proposal offers and final settlement agreement that was
    sufficient to show that a payment was made in settlement of tort
    or tort-type claim for personal injury).
    28
    On brief, petitioners argue that respondent’s reliance on
    Mr. Powell’s report and use of the actuarial method constitutes a
    new matter. Petitioners may be correct, especially in light of
    the fact that any appeal in this case would normally lie to the
    Court of Appeals for the Ninth Circuit. See, e.g., Estate of
    Harper v. Commissioner, T.C. Memo. 2002-121 (discussing recent
    decisions by the Court of Appeals for the Ninth Circuit regarding
    burden of proof). However, because we have already held that
    respondent has the burden of proof, we need not reach this issue.
    - 45 -
    for us to base our decision.    Therefore, we conclude that the
    burden of proof does not shift to respondent on this issue.29
    III. Portion of Monthly Services Fees Allocable to Medical Care
    Under the Percentage Method
    The parties’ positions regarding the application of the
    percentage method are based primarily on the ad hoc committee’s
    report and the portion of Mr. Powell’s report discussing this
    method.   Respondent argues that Mr. Powell’s application of the
    method and the resulting conclusion should be followed if the
    percentage method is applied.    Petitioners rely primarily on the
    ad hoc committee’s findings with certain adjustments contained in
    a supplemental calculation.    After discussing this issue with the
    parties at trial and examining their briefs, we interpret
    petitioners’ position to be that both the ad hoc committee’s
    findings and the findings resulting from petitioners’ subsequent
    adjustments are appropriate methods of determining the
    appropriate allocation percentage.       Petitioners ultimately argue
    that, based on either calculation, the appropriate allocation is
    approximately 41 percent.
    A.    Petitioners’ Calculations
    Petitioners generally agree with the approach and financial
    figures used by the ad hoc committee, of which Mr. Baker was a
    29
    Petitioners do not argue that respondent raised a new
    matter with respect to the disallowance of the claimed deductions
    for Mr. Baker’s use of the pool, spa, and exercise facilities.
    - 46 -
    member.   They also presented a supplemental report prepared by
    Mr. Baker as another means of establishing the appropriate
    allocation percentage.   As previously mentioned, we interpret
    their position to be that the allocation percentage is
    approximately 41 percent under either the ad hoc committee’s
    calculations or Mr. Baker’s supplemental report.
    In order to complete its calculations regarding the
    appropriate allocation percentage, the ad hoc committee relied on
    certified data from the financial records of AFVW.     The committee
    coordinated and worked with AFVW’s management in reaching its
    calculations.   Petitioners have adequately demonstrated to the
    Court how the ad hoc committee used the information provided by
    AFVW management to arrive at its conclusions regarding the
    appropriate allocation percentage.
    The ad hoc committee calculated an allocation percentage by
    dividing medical expenses by total operating costs, with specific
    item adjustments to both figures.    In calculating total operating
    costs, the committee subtracted interest expense, depreciation
    and amortization, issue cost, and noncontract patient expenses
    from total costs.   In calculating medical expenses, the committee
    included SNF, ALU, and SCU operating expenses, and subtracted out
    noncontract patient fees and depreciation and amortization
    allocable to the three facilities.     The committee then made
    certain upward adjustments to account for the emergency-pull-cord
    - 47 -
    system, food service, environmental service, utilities, and
    insurance.   The adjustments for food service and environmental
    expenses were based on formulas provided by the food service
    contractor and the environmental service contractor.    The
    adjustment for utilities was based on a square-footage method and
    the adjustment for insurance was based on a ratio- and square-
    footage methodology.
    The committee ultimately concluded that the allocation
    percentages were 40.3 percent and 41.6 percent for the years 1997
    and 1998, respectively.   The resident council reported to AFVW
    residents a summary of the ad hoc committee’s findings.    The
    resident council explained how the allocation percentage was to
    be applied, provided the same census figures used in the Health
    Facility Information report, and stated what the medical
    deduction was per resident.
    Mr. Baker testified that the calculations in the
    supplemental report he prepared were similar to the ad hoc
    committee’s calculations.   He testified that his calculations
    assumed that the fee charged for a medical service approximated
    the cost of Village West’s providing that service.   Mr. Baker did
    not explain in detail the adjustments contained in his
    supplemental report, and we are unable to satisfactorily connect
    his figures to the financial information contained in the record.
    As a result, we find the supplemental report to not be helpful,
    - 48 -
    and we choose not to rely on it in our analysis.    Accordingly, we
    will examine respondent’s position to determine whether he has
    shown that the allocation percentages and portions of the monthly
    service fees allocable to medical care are different from those
    calculated by the ad hoc committee.
    B.    Mr. Powell’s Calculations
    Respondent relies on the percentage method as applied by Mr.
    Powell.    Although Mr. Powell did not believe that the percentage
    method should be used, he developed a procedure for generating a
    percentage for use with the percentage method.    Mr. Powell stated
    that the basic formula would examine the relationship between
    total costs and amounts allocated to medical care, with
    adjustments for specific items.    In his report, Mr. Powell stated
    that because the sum of entrance fees and monthly service fees
    over the resident’s lifetime is expected to cover the costs of
    care for residents in a CCRC, it is reasonable to assume that the
    costs of medical care in the fee structure represent the same
    proportion or percentage in the total costs.    Mr. Powell relied
    on the financial figures in AFVW’s Health Facility Information
    report.    He did not rely on the 1998 financial document.
    Mr. Powell stated that total costs would include
    departmental cash expenses plus depreciation and interest
    expense.    Subtractions would be made for issuance costs
    associated with debt financing, room and board revenues and
    - 49 -
    Medicare and HMO billings for noncontract patients in the SNF,
    and ancillary services associated with the SNF.   He stated that
    it is reasonable to subtract medical expenses not associated with
    the residents from both the numerator and denominator of the
    formula.   Additionally, the ancillary fees that are paid on a
    fee-for-service basis and expected reimbursements from Medicare
    and HMO insurance should also be subtracted from both the
    numerator and denominator because these expenses are not expected
    to be covered by entrance fees or monthly service fees.
    Similar to the ad hoc committee, Mr. Powell believed that
    the expenses for medical care would include expenses allocated to
    the ALU, SCU,30 and SNF, plus a portion of the interest expense
    allocable to these facilities.   The same debt finance costs, SNF
    room and board revenues, and ancillary services and Medicare and
    HMO billings subtracted from the total costs would also be
    subtracted from the medical expense.   In addition, ancillary
    services, Medicare, and HMO billings for residents should be
    subtracted; however, Mr. Powell stated that he could not obtain
    an accurate amount due to a difference between the accrual and
    cash bases for those revenues.
    30
    The SCU was completed in June 1997 and began operation at
    that time. Mr. Powell did not allocate any medical expenses to
    the SCU for 1997.
    - 50 -
    The following chart prepared by Mr. Powell reflects his
    calculations for 1997:
    Operating Expenses                   Source for Amount
    $16,069,104          Total operating expenses for AFVW,
    including depreciation and interest
    expense
    (93,395)      Issuance costs associated with debt
    financing
    (1,207,747)      SNF room and board revenues for
    noncontract patients
    (448,462)      SNF ancillary services, Medicare, and
    HMO billings for noncontract patients
    14,319,500       Total for denominator
    Medical Expenses                     Source for Amount
    $3,044,014           Operating expenses allocated to SNF
    929,275           Operating expenses allocated to ALU
    479,734           10 percent of interest expenses to SNF
    319,823           6.67 percent of interest expenses to ALU
    (1,207,747)          SNF room and board revenues for
    noncontract patients
    (448,462)       SNF ancillary services, Medicare, and
    HMO billings for noncontract patients
    (0)       Ancillary services, Medicare, and HMO
    billings for residents; not included
    1
    3,116,664        Total for numerator
    For 1997, the percentage is 21.8 percent ($3,116,664 ÷
    $14,319,500).2
    1
    We note that the total of the medical expenses is $3,116,637,
    not $3,116,664 as listed in Mr. Powell’s report.
    2
    We note that application of the corrected medical expense
    figure still produces a percentage of 21.8 percent.
    - 51 -
    The following chart prepared by Mr. Powell reflects his
    calculations for 1998:
    Operating Expenses                   Source for Amount
    $17,759,058           Total operating expenses for AFVW,
    including depreciation and interest
    expense
    (107,134)          Issuance costs associated with debt
    financing
    (1,315,694)          SNF room and board revenues for
    noncontract patients
    (378,905)          SNF ancillary services, Medicare, and
    HMO billings for noncontract patients
    15,957,325           Total for denominator
    Medical Expenses                     Source for Amount
    $3,330,031            Operating expenses allocated to SNF
    984,333            Operating expenses allocated to ALU
    796,306            Operating expenses allocated to SCU
    466,912            10 percent of interest expenses to SNF
    311,275            6.67 percent of interest expenses to ALU
    311,275            6.67 percent of interest expenses to SCU
    (1,315,694)           SNF room and board revenues for
    noncontract patients
    (378,905)           SNF ancillary services, Medicare, and
    HMO billings for noncontract patients
    (0)           Ancillary services, Medicare, and HMO
    billings for residents; not included
    4,505,533           Total for numerator
    For 1998, the percentage is 28.2 percent ($4,505,533 ÷
    $15,957,325).
    To complete his procedure, Mr. Powell chose to apply the
    percentages to the total monthly service fees that petitioners
    paid to Village West.    As previously mentioned, petitioners’
    monthly service fees were $2,170 and $2,254 for 1997 and 1998,
    respectively.   Thus, Mr. Powell calculated that petitioners were
    - 52 -
    entitled to deductions (before application of the 7.5-percent
    floor) of $5,67731 and $7,628.32
    C.      Analysis of Parties’ Positions
    Our approach in this case is to examine the ad hoc
    committee’s calculations regarding the appropriate allocation
    percentage in light of respondent’s allegations of error, which
    are primarily based on Mr. Powell’s calculations, his testimony,
    and the testimony of Mr. Dalton.33     In order to accomplish this
    task, we will address the portions of the committee’s
    calculations that respondent claims are inaccurate.     Because
    respondent relies on Mr. Powell’s application of the percentage
    method, we generally compare this approach with that used by the
    ad hoc committee.
    The ad hoc committee computed the denominator by starting
    with total costs and subtracting total interest expense, total
    depreciation and amortization, total issue cost, and total
    noncontract patient expense.     Mr. Powell did not subtract total
    interest expense and total depreciation and amortization.
    31
    Calculated as 21.8 percent of 12 x $2,170.
    32
    Calculated as 28.2 percent of 12 x $2,254.
    33
    We note that to the extent respondent has not challenged
    certain assumptions by the ad hoc committee, we treat these as
    concessions by respondent and express no opinion as to the
    validity or accuracy of the assumptions.
    - 53 -
    However, Mr. Powell did subtract SNF ancillary services,
    Medicare, and HMO billings for noncontract patients.
    The ad hoc committee calculated medical expenses by first
    calculating the sum of SNF, ALU, and SCU operating expenses,
    expenses related to the emergency-pull-cord system, and certain
    adjustments related to food service, environmental service,
    utilities, and insurance.   It then subtracted noncontract patient
    fees for the SNF, ALU, and SCU, and depreciation and amortization
    allocable to the SNF, ALU, and SCU.34   In addition to including
    operating expenses of the SNF, ALU, and SCU, Mr. Powell included
    interest expense allocable to the SNF and ALU.   He did not
    include an expense for the emergency-pull-cord system or
    adjustments for food service, environmental service, utilities,
    or insurance.   Mr. Powell did not subtract either noncontract
    patient fees for the ALU and SCU or depreciation and amortization
    of the SNF, ALU, and SCU.   However, he did subtract SNF ancillary
    services, Medicare, and HMO billings for noncontract patients.
    The ad hoc committee and Mr. Powell used slightly different
    financial figures in their reports.
    34
    In the Health Facility Information report, expenses
    related to depreciation are included in the medical expenses
    allocable to the SNF, ALU, and SCU. Allocations for amortization
    of debt issue cost, amortization of preopening cost, and interest
    expense are not included.
    - 54 -
    1.    Appropriate Financial Information To Use
    The ad hoc committee and Mr. Powell both relied primarily on
    the financial information for 1997 and 1998 that was contained in
    the Health Facility Information report.   For 1998 revenues and
    expenses, the committee relied on the 1998 financial document
    that should have been included in the report.   There are minor
    differences between the figures presented in the 1998 financial
    document and the report.   Respondent has not argued that the
    financial information used by the ad hoc committee is inaccurate
    or unreliable, and Mr. Powell acknowledges in his report that the
    1998 financial document was based on actual results for that
    year.   With respect to the explanation of expense allocation
    assumptions by AFVW, Mr. Powell stated that he reviewed the
    assumptions and relied on AFVW’s management’s judgment because he
    believed the final results were reasonable.   Accordingly, we
    proceed under the assumption that the financial figures and
    expense allocation assumptions contained in the Health Facility
    Information report are appropriate, with the exception that
    revenue and expense figures for 1998 should be based on the 1998
    financial document.
    2.   Interest Expense and Depreciation and Amortization
    In calculating total costs, the ad hoc committee subtracted
    interest expenses and depreciation and amortization.   In
    calculating allocable medical costs, the committee also
    - 55 -
    subtracted interest expense and depreciation and amortization
    allocable to the SNF, ALU, and SCU.     Mr. Powell included both
    interest expense and depreciation and amortization in his
    calculations.
    Mr. Powell testified that it was not technically accurate to
    subtract depreciation and interest expense from total costs and
    medical expenses.    He explained that entrance fees and monthly
    service fees are used to cover the total costs of AFVW, which
    includes capital costs.   Therefore, he felt that excluding these
    two items from total costs would distort the allocation
    percentages.    Petitioners argue that under the percentage method
    only operating expenses are included in the denominator of the
    equation.    They claim that interest should not be included
    because it is simply the cost of borrowing capital to fund the
    investment in Village West and does not represent an operating
    expense.    Petitioners claim that depreciation and amortization
    are not operating expenses because they represent the initial
    capital costs of investing in plant and equipment.
    Under the percentage method, the medical expenses of the
    CCRC are calculated and then compared to all the expenses of the
    community to determine the appropriate percentage of expenses
    allocable to medical care.    In applying the percentage method in
    this case, both the numerator and denominator in the equation
    should include interest expenses and depreciation and
    - 56 -
    amortization because the evidence in the record indicates that
    Village West offered a nursing care arrangement where the monthly
    service fees for the years in issue were intended to cover all
    expenses related to AFVW residents.     Neither the residence
    agreement nor the financial information submitted by the parties
    indicates whether the entrance fees or monthly service fees are
    allocated to specific costs or what that allocation is.     Thus,
    the denominator in this case should be based on the total costs
    of the CCRC, which necessarily includes costs for these two
    items.    It is also logical to include interest expense and
    depreciation and amortization costs related to medical facilities
    when other expenditures relating to the operation of those
    facilities (e.g., utilities, food services, health services) are
    included.    Therefore, we assume for purposes of this case that
    the monthly service fees are applied equally to all expenses,
    including interest expense and depreciation and amortization.
    Accordingly, we agree with respondent and Mr. Powell that, in
    this case, interest expense and depreciation and amortization
    should be included in both the numerator and denominator.35
    35
    The SCU was placed in service in June 1997 and started
    operation at that time. Accordingly, in calculating the interest
    expense allocable to the SCU for 1997 we include half the amount
    that would have been allocable had the facility been in operation
    for the entire year.
    - 57 -
    3.   Emergency-Pull-Cord System and Other Adjustments
    The ad hoc committee made upward adjustments to the medical
    expense figures to account for the emergency-pull-cord system and
    food service, environmental service, utilities, and insurance
    figures that it felt were not adequately reflected in AFVW’s
    financial records.   The committee’s calculations for the
    emergency-pull-cord system are based on Mr. Dalton’s calculation
    contained in the Health Facility Information report.
    Respondent’s general argument on this issue is that Mr.
    Powell’s calculations should be followed.   However, Mr. Powell
    did not specifically discuss the emergency-pull-cord system or
    other adjustments either in his report or during trial.
    Respondent’s only specific argument is contained in his reply
    brief wherein he states that “Although it is petitioners’
    contention that the pull cord was not included as a medical
    expense, * * * Mr. Dalton testified the pull cord system became
    an indirect cost.”
    Mr. Dalton prepared the allocation worksheet for the
    emergency-pull-cord system.   He testified that there is a pull-
    cord system in all ILUs so that in case of an emergency a
    resident can pull the cord connected to the front desk and
    Village West can provide a crisis nurse within a number of
    minutes.   Mr. Dalton testified that there were seven or eight
    persons who worked at the front desk and that although other
    - 58 -
    services were provided by front desk staff one of the main
    functions was to address the emergency-pull-cord system.    In
    making the allocation, Mr. Dalton assumed that the allocable cost
    of front desk staff to monitor the system would be an average
    hourly rate for one person for 24 hours a day for 365 days a
    year.   Mr. Dalton explained that the expenditures for the system
    are not set out in a specific account but are charged to a
    general ledger account.   Specifically, he testified that the
    payroll and benefits for a person monitoring the system would be
    found under the resident services expense category, which
    includes certain expenses related to the staffing of the front
    desk.
    After reviewing the financial information and the ad hoc
    committee’s report, we find that no amount from the resident
    services expense account (other than the committee’s allocation
    for the pull-cord system) was included by either Mr. Powell or
    the committee in their medical expense calculations.   Respondent
    does not challenge the amount of the allocation by Mr. Dalton for
    medical expenses associated with the emergency-pull-cord system,
    and we find the calculation to be reasonable based on the
    evidence in the record.   Because respondent has not raised any
    other arguments on this issue or specifically argued or presented
    adequate evidence that the other upward adjustments are
    - 59 -
    inappropriate, we accept the allocations to the pull-cord system
    and the other adjustments made by the ad hoc committee.
    4.     SNF Ancillary Services, Medicare, and HMO
    Billings, and ALU and SCU Noncontract Patient Fees
    In his calculations, Mr. Powell excluded from both total
    costs and medical costs expenses for SNF ancillary services,
    Medicare, and HMO billings for AFVW residents and noncontract
    patients, and ALU and SCU noncontract patient fees.    However, Mr.
    Powell stated that he could not obtain an accurate amount of SNF
    ancillary services, Medicare, and HMO billings for AFVW
    residents, and therefore he did not exclude any amount in his
    calculations.    Respondent has not specifically argued or provided
    any amount that we should exclude for SNF ancillary service,
    Medicare, and HMO billings for AFVW residents.    Accordingly, we
    need only address the remaining items as they relate to whether
    expenses related to noncontract patients should be excluded from
    total costs and medical expenses.
    Both the ad hoc committee and Mr. Powell subtracted
    noncontract patient fees related to the SNF from total costs and
    medical costs.   The committee also subtracted noncontract patient
    fees related to the ALU and SCU.    After reviewing Mr. Powell’s
    reasoning and respondent’s arguments (discussed in further detail
    below) with respect to expenses and reimbursements related to
    noncontract patients, we infer that this was an oversight on the
    part of Mr. Powell, and the committee’s position on this issue is
    - 60 -
    not being challenged.    Accordingly, the noncontract patient fees
    related to the SNF, ALU, and SCU should all be excluded from
    total costs and medical expenses.
    In his report, Mr. Powell states that it is reasonable to
    subtract SNF ancillary service, Medicare, and HMO billings from
    total costs and medical expenses.    Respondent argues that the
    entrance fees and monthly service fees are expected to cover the
    costs of care for residents of a CCRC, and therefore it is
    reasonable to subtract expenses not expected to be covered by the
    fees.    Respondent contends that ancillary services that are paid
    on a fee-for-service basis, and expected reimbursements from
    Medicare and HMO insurance are expenses not covered by the
    entrance fees and monthly service fees.
    At trial, Mr. Dalton testified that if medical care was
    covered by insurance, then the fees were charged directly to the
    insurance company and charged to an expense account.    If payment
    was received from Medicare or an HMO insurance company, the
    payments were credited to a revenue account.
    We agree with respondent on this issue.    Our understanding
    of the facts of this case is that the monthly service fees are
    paid to cover costs related to AFVW residents.    The ad hoc
    committee allocated SNF, ALU, and SCU expenses to medical care;
    however, these facilities are also used by noncontract patients.
    The noncontract patients are charged fees for use of the
    - 61 -
    facilities, and petitioner has not disputed that noncontract
    patients also pay for certain services on a fee-for-service
    basis.    Additionally, AFVW can receive reimbursement from
    Medicare and HMO insurance for care given to noncontract
    patients.    These fee-for-service and reimbursement proceeds are
    included as revenue in AFVW’s books.    Although these proceeds are
    not used specifically to offset expenses in the noncontract
    patient expense accounts, the revenue relates to care given to
    noncontract patients in the SNF, ALU, and SCU, and we believe
    that the expenses of these facilities should be reduced to
    accurately reflect the portion of the monthly service fees paid
    for care of AFVW residents.    In substance, this treatment is
    consistent with the subtraction of SNF, ALU, and SCU noncontract
    patient fees from total costs and medical expenses.    We have
    reviewed the figures used by Mr. Powell and find them consistent
    with AFVW’s financial information and acceptable for purposes of
    this calculation.36
    D.     The Court’s Application of the Percentage Method
    Mr. Dalton and the ad hoc committee applied the allocation
    percentage to a weighted average of monthly service fees paid by
    36
    We are unable to derive the amount for 1998 for SNF
    ancillary services, Medicare, and HMO billings for noncontract
    patients from the 1998 financial document that should have been
    included in the Health Facility Information report. Therefore,
    like Mr. Powell, we rely on the 1998 information contained in the
    report.
    - 62 -
    occupants of ILUs.    Mr. Dalton’s calculations provide a deduction
    per residence while the ad hoc committee’s calculations are per
    resident.   Mr. Powell applied the percentage based on the actual
    monthly service fees paid by petitioners and calculated an
    allocable amount per residence.37    Although respondent states
    that Mr. Powell’s application of the percentage methodology is
    correct, respondent argues that a weighted average should be used
    because it provides some consistency among ILU residents and is
    fair and objective.   Petitioners argue that the allocation
    percentages should be applied to the actual fees they paid.
    We believe that the more appropriate application of the
    percentage method is to allocate to each resident the same amount
    for purposes of determining the appropriate medical deduction
    related to the payment of monthly service fees.    If we accepted
    petitioners’ approach, single residents and residents of double-
    occupancy ILUs that are larger than the average ILU (and thus pay
    higher monthly service fees) would get a larger medical expense
    deduction based solely on the number of occupants of the ILU or
    the square footage of the unit.     We fail to see the relationship
    between the health care expenses of residents and the size and
    37
    This application of the percentage method appears at odds
    with a statement in the section of Mr. Powell’s report providing
    an overview and criteria for the evaluation of the different
    methods. In his report, Mr. Powell states that similar residents
    have the same expected health care usage and thus should receive
    the same deduction regardless of the size of their accommodations
    or the fees they pay.
    - 63 -
    cost of their ILUs.   Accordingly, we hold that the allocation
    percentage must be applied based on the number of residents and
    the average weighted monthly service fees (or weighted annual
    service fees in the case of residents living in ILUs for the
    entire year).
    On the basis of the undisputed assumptions by AFVW and our
    findings above, we have calculated the amounts allocable to ILU
    residents of Village West for medical care related to their
    monthly service fees.   Our calculations show that the amounts of
    $7,766 and $8,476 paid by petitioners as service fees for 1997
    and 1998, respectively, were for medical care.   The details of
    our calculations are contained in the attached appendix.
    IV.   Deductions for Use of Pool, Spa, and Exercise Facilities
    Petitioners claim that they are entitled to deductions for
    Mr. Baker’s use of the pool, spa, and exercise facilities
    because:   (1) The use of the facilities was necessary to
    alleviate his chronic illnesses; and (2) a portion of the monthly
    service fees is properly allocable to the operation and
    maintenance of these facilities.   Respondent argues that no
    deductions are allowable because Mr. Baker’s use of the
    facilities was personal in nature, any expense related to use of
    the facilities would otherwise have been incurred by AFVW
    residents, and the methodology used by petitioners to allocate a
    portion of the monthly service fees to the operation and
    - 64 -
    maintenance of the facilities is flawed and should be
    disregarded.
    Deductions for expenditures for medical care are confined
    strictly to expenses incurred primarily for the prevention or
    alleviation of a physical or mental defect or illness.    Haines v.
    Commissioner, 
    71 T.C. 644
    , 647 (1979); sec. 1.213-1(e)(1)(ii),
    Income Tax Regs.   An expenditure which is merely beneficial to
    the general health of an individual, such as an expenditure for a
    vacation, is not an expenditure for medical care.    Sec. 1.213-
    1(e)(3)(ii), Income Tax Regs.    An important condition that must
    be satisfied for the claim to succeed is whether the expenditure
    would have been made even if there had been no illness.    Jacobs
    v. Commissioner, 
    62 T.C. 813
    , 819 (1974); Lepson v. Commissioner,
    T.C. Memo. 1982-304.
    Petitioners introduced a calculation by Mr. Baker for
    allocating a portion of the monthly service fees to the cost of
    providing the facilities.   Mr. Baker applied varying allocation
    percentages to gross expense figures from eight different expense
    categories to arrive at a total allocation amount.   He then
    divided this amount by the number of occupied ILUs in 1997 and
    1998 to arrive at an allocation amount per residence.
    Petitioners did not explain or introduce credible evidence how
    Mr. Baker arrived at the specific allocation percentages for each
    expense category or the relevance of those specific categories.
    - 65 -
    Although we are permitted in certain circumstances to
    estimate a deductible amount, Cohan v. Commissioner, 
    39 F.2d 540
    ,
    543-544 (2d Cir. 1930), we can only do so when the taxpayer
    provides evidence sufficient to establish a rational basis upon
    which an estimate can be made, Vanicek v. Commissioner, 
    85 T.C. 731
    , 743 (1985).    In this case, even assuming that all other
    requirements for deductibility under section 213 have been
    established, petitioners have failed to provide evidence upon
    which we can make a rational estimate.    Additionally, we note
    that the facilities were available for recreational use by
    petitioners and their family, and petitioners have failed to
    establish what portion of Mr. Baker’s use was for medical
    purposes.    Accordingly, we hold that petitioners are not entitled
    to deductions for Mr. Baker’s use of the pool, spa, and exercise
    facilities.
    Contentions we have not addressed are moot, irrelevant, or
    meritless.    To reflect the foregoing,
    Decision will be entered
    under Rule 155.
    - 66 -
    APPENDIX
    I.   1997
    Total Costs                              Amount
    Total expenses                                       $16,069,104
    Issue cost                                               (98,395)
    SNF noncontract patient fees                          (1,207,747)
    ALU noncontract patient fees                             (80,156)
    SCU noncontract patient fees                              (3,640)
    SNF ancillary services, Medicare, and                   (448,462)
    HMO billings for noncontract patients
    Total costs                                         14,230,704
    Medical Expenses                         Amount
    SNF operating expenses                                $3,044,041
    ALU and SCU operating expenses                           929,275
    Emergency pull-cord system                                87,374
    Food service adjustment                                  482,769
    Environmental service adjustment                         112,617
    Utilities adjustment                                      81,146
    Insurance adjustment                                      18,234
    Interest expense for SNF                                 479,734
    Interest expense for ALU                                 319,823
    Interest expense for SCU                                 159,991
    SNF noncontract patient fees                          (1,207,747)
    ALU noncontract patient fees                             (80,156)
    SCU noncontract patient fees                              (3,640)
    SNF ancillary services, Medicare, and                   (448,462)
    HMO billings for noncontract patients
    Medical expenses                                     3,974,999
    Medical expenses divided by total costs equals an allocation
    percentage of 27.93 percent.
    The number of ILU residents was 574 and they paid a total annual
    service fee of $7,979,906, or an average of $13,902.
    Applying the allocation percentage of 27.93 percent to the
    weighted average annual service fee of $13,902 results in a
    medical care allocation of $3,883 per resident.
    - 67 -
    II.   1998
    Total Costs                             Amount
    Total expenses                                       $16,986,770
    Issue cost                                              (107,134)
    SNF noncontract patient fees                          (1,301,382)
    ALU noncontract patient fees                            (104,083)
    SCU noncontract patient fees                            (110,202)
    SNF ancillary services, Medicare, and                   (378,905)
    HMO billings for noncontract patients
    Total costs                                         14,985,064
    Medical Expenses                         Amount
    SNF operating expenses                                $3,330,031
    ALU and SCU operating expenses                         1,780,639
    Emergency pull-cord system                                88,257
    Utilities adjustment                                     103,641
    Interest expense for SNF                                 470,432
    Interest expense for ALU                                 313,778
    Interest expense for SCU                                 313,778
    SNF noncontract patient fees                          (1,301,382)
    ALU noncontract patient fees                            (104,083)
    SCU noncontract patient fees                            (110,202)
    SNF ancillary services, Medicare, and                   (378,905)
    HMO billings for noncontract patients
    Medical expenses                                     4,505,984
    Medical expenses divided by total costs equals an allocation
    percentage of 30.07 percent.
    The number of ILU residents was 591 and they paid a total annual
    service fee of $8,329,241, or an average of $14,093.
    Applying the allocation percentage of 30.07 percent to the
    weighted average annual service fee of $14,093 results in a
    medical care allocation of $4,238 per resident.
    

Document Info

Docket Number: 448-02

Filed Date: 2/19/2004

Precedential Status: Precedential

Modified Date: 11/14/2018