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Skilled Nursing Facilities
Cost: Average cost of a private room in a Skilled Nursing Facility is
$9,034 per month
While assisted living facilities can help family members maintain a certain level of independence, it sometimes may not be enough support. Declining health may require rehabilitation or around-the-clock care from trained staff at nursing homes. Assisted living is a great option for seniors who need extra support or assistance with day-to-day tasks.
However, skilled nursing or healthcare community, once referred to as a nursing home, offers more comprehensive support to seniors with extensive medical needs. These facilities offer a continuum of care by contracting with skilled nursing companies or offering an on-site nursing home for residents who require 24-hour support.
According to the National Institute of Health, an estimated 1.5 million older adults live in nursing homes, which is about 4.5% of the total older adult population.
What Is A Skilled Nursing Facility?
More commonly known as a skilled nursing facility, a nursing home provides the highest level of care possible outside of a hospital. Many seniors move to a nursing home following a hospital stay, surgery, or procedure. Nursing homes deliver 24-hour care to seniors who have complex medical conditions and need hands-on assistance and monitoring.
In many cases, residents are there short-term to recover from a hospital stay or procedure. In other cases, residents are there long-term to receive comprehensive healthcare interventions 24 hours a day.
A licensed physician supervises each patient’s care, a nurse is always on the premises, and other medical professionals — such as occupational, physical, or speech therapists — are also on hand. Many nursing homes have medical equipment that is normally found in hospitals, such as X-ray machines or electric beds.
What Do Nursing Homes Offer?
Nursing homes, Skilled Nursing Facilities or Long-term Care Facilities, offer medical services for residents who need comprehensive care. Most nursing homes have nursing aides and skilled nurses on hand 24 hours a day. The key difference from assisted living facilities is that nursing homes provide around-the-clock medical care and assistance with everyday activities, while assisted living facilities encourage residents to remain as independent as possible and offer help when needed.
Nursing home facilities provide a wide range of services including:
Dietary services.
Health care, including physician and nurse care.
Laundry services.
Meals, offered three times a day.
Medication management.
Personal care needs, such as bathing, dressing and toileting.
Rehabilitation services, including short- and long-term care.
Social activities, such as entertainment, music, crafts and trips.
Therapy, including occupational, physical or speech.
Nursing Home Admission Requirements
Individuals may choose to move to Nursing Home care for a variety of reasons that may include:
1. Medical – such as they require assistance with medications, catheters, IV drips ventilators or other medical devices.
2. Cognitive – such as memory issues resulting from Alzheimer’s / dementia or an inability to process information
3. Behavioral – such as an inability to control their actions or moods
4. Functional – such as an inability to manage activities of daily living (ADLs) like dressing, toileting and eating
Residents in skilled nursing facilities typically need assistance with tasks that go beyond ADLs.
What qualifies a person for a nursing home will vary. Before moving into a nursing home, a thorough assessment is conducted to determine the right level of care for the individual’s needs. These assessments vary from state to state. Nursing home services are generally intended for seniors with debilitating health issues or serious conditions that require frequent medical supervision and round-the-clock care. In order to be admitted to a nursing home, senior needs to meet the state’s criteria for nursing home care and any medical conditions must be documented and confirmed by a physician. The Centers for Medicare & Medicaid Services (CMS) requires states to follow some general guidelines. However, states retain the flexibility to create their own assessments within CMS’s rules.
Paying For Nursing Home Care
According to a 2021 Cost of Care Survey by Genworth, a private room in a nursing home costs $297 per day, or $9,034 per month. Semiprivate rooms are more affordable, with a median cost of $260 per day, or $7,908 per month. The median cost of assisted living facilities is $148 per day, which equates to $4,500 per month. A Nursing Home or Skilled Nursing Facility will generally be twice the cost of Assisted Living.
Skilled nursing facilities typically are more expensive than assisted living communities because of the type of care offered. However, it is important to keep in mind that nearly all nursing homes are certified to participate in Medicare or Medicaid financial assistance programs.
Medicare Coverage for Nursing Home Costs
Medicare will only cover skilled nursing care expenses in very specific situations and is not designed to pay for nursing home or custodial care costs long term. One such situation is when a senior has been hospitalized and released, but still requires a bit of specialized care.
Medicare will help pay for short-terms stays in nursing homes if they:
· Were admitted to the hospital for a minimum of three days as an inpatient.
· Have been admitted to a Medicare-certified facility within 30 days of the hospital stay.
· Need skilled care like physical therapy, speech therapy, and other types of rehabilitation.
Those who meet all of these conditions under original Medicare will qualify for assistance as follows:
· Up to 20 days of nursing care is 100 percent by Medicare.
· After day 21 and up to day 100, patients will pay a copay that is up to $200 per day.
· After 100 days, all Medicare coverage ends, and all payments are the patient's responsibility.
Medicaid
Medicaid is one of the most common ways to pay for a nursing home when you have no money available. Even if you have had too much money to qualify for Medicaid in the past, you may find that you are eligible for Medicaid nursing home care because the income limits are higher for this purpose.
Some people may qualify for Medicaid, a combined Federal and State program for low-income people and families. This program covers the costs of medical care and some types of long-term care for people who have limited income.
Veterans Affairs Aid and Attendance
According to VeteranAid.org, the VA Aid and Attendance pension can provide up to $1,881 per month to a veteran, $1,209 per month to a surviving spouse or $2,230 per month to a couple. Like Social Security, this pension is dependable and is paid directly to you by the Department of the Treasury.
Navigating the specifics of VA benefits related to long-term care can be challenging. The American Health Care Association suggests going to the VA website for details about general benefits and to the VA Geriatrics and Extended Care page for information about benefits and costs for services in residential settings, such as assisted living communities and nursing homes.
Private Insurance
Most private health insurance plans do not cover long-term care facilities like nursing homes. However, you can purchase long-term insurance plans that will cover some of their costs. Long-term insurance plans offer coverage that health-care plans –– Medicare or Medicaid –– will not normally cover.
It is important to note that long-term care insurance is not an investment like life insurance and it is a use-or-lose type of coverage. If you do not end up needing long-term care, you are not guaranteed the money. It does provide a sense of security in case skilled nursing home care is needed.
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