"and she was not able to pay them until she received the money in 2020."

Then 2019 is meaningless. You have a scenario of expenses Paid in 2020 for a cash basis tax payer. Read Pub 502.

https://www.irs.gov/taxtopics/tc502

Have you confirmed the LTC payouts are taxable?

You might be worrying about two conditions that don't apply.