About Nursing Home Care
A nursing home can be a good option if a senior loved one is in need of more care than a residential facility is capable of providing them - for example if they have medical needs or significant problems attending to daily activities. Seniors that may need nursing home care include those who are in need of help managing medications, as well as those who are in need of mobility help, assistance with hygiene issues such as bathing, dressing, and incontinence, and more. Nursing homes typically include private, semi-private, and shared rooms as well as facilities such as dining halls, social areas, and outdoor areas.
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What is Nursing Home Care?
Nursing home facilities, also referred to as long-term or convalescent care facilities, provide extended senior care, meals, and medical assistance to those who cannot live independently and perform daily living activities like bathing due to disabling medical issues, or other physical or mental conditions that require continuous supervision. In addition, a nursing home offers residents social, recreational and spiritual activities.
Nursing homes tend to provide more frequent and comprehensive personal care services than what is found in assisted living facilities. They also provide easier access to skilled nurses and often have a skilled nursing unit within the facility. The facilities are licensed to provide care to those who are unable to take care of daily living needs. The average stay for those in a nursing home was 835 days according to a Centers for Disease Control 2004 Nursing Home Survey.
Skilled Nursing Facility (SNF) vs. Nursing Home Care
Typically referred to as a nursing home, a skilled nursing facility (SNF) or a skilled nursing unit is similar but more often a temporary, solution to a specific medical need or to aid in recovery after a hospital stay. Offering rehabilitative care, such as physical, occupational, and speech therapy, or specialized care for Alzheimer's patients, a SNF offers more medically involved services and medical staff than a basic nursing home.
SNFs are mostly intended for those who need short-term medical care or services outside of a hospital following surgery or other serious medical treatments. Often times those who discharge from a SNF will remain in a basic nursing home if care is still required. Examples of services provided at a SNF include:
- Planning, managing, and evaluating patient care
- Giving injections
- Inserting catheters and feeding lines
- Using aspiration devices
- Treating skin diseases and applying dressings for wound care
A SNF has specialized staff for the rehabilitation of patients that do not require long-term care services. According to the Centers for Medicare and Medicaid Services, the average stay in a SNF is 28 days. This type of care is also referred to as post-acute care, in that it typically is provided following an emergency hospital stay.
Increasingly, many nursing facilities have skilled medical staff, and for the purpose of clarity it is assumed that the use of the term "nursing home" includes access to the care that a SNF or an onsite skilled care nursing unit provides.
Nursing Home Care vs. Assisted Living
The difference between these services is that the custodial care in an assisted living facility doesn't require the skills of a registered or licensed nurse or physician. Nursing homes have a stronger focus on skilled care for medical conditions. The average stay in a nursing home and an assisted living facility are each just over 2 years. As one might guess, the access to skilled staff at a nursing home increases the costs. According to a survey conducted by Genworth in June 2017, the national average monthly cost for a semi-private room in a nursing home is $7,148 versus a cost of $3,750 for a one bedroom in an assisted living facility.
Nursing Home Care vs. Home Health Care
Home health care is very similar to a nursing home in that it can provide the same level of skilled nursing staff to provide services such as injections, health monitoring and care evaluations, wound care and intravenous or nutrition therapy but it allows the resident to remain at home. Unlike a nursing home with 24-7 monitoring, home health is usually provided for fewer than 8 hours per day and is typically less expensive than a nursing home. According to a survey conducted by Genworth in June 2017, the national average monthly cost for home health services is about $4,100 versus a cost of $7,148 for a semi-private room in a nursing home facility.
What Is the Cost and How Do I Pay?
Considered a long-term care option, nursing home expenses are most frequently paid for out-of-pocket or by a combination of other methods such as Social Security, pensions, Veterans benefits, insurance, home equity, and various savings. According to a Genworth Financial, the national average cost per month for a semi-private room in a nursing home was $7,148. This figure is expected to rise to over $9,600 in the next ten years.
Long-Term Care Insurance
Long-term care insurance is a policy that is purchased through a private insurance company. Similar to health insurance policies, the price varies greatly depending on age, general health and amount of coverage needed. Coverage could be denied for people with pre-existing conditions such as Alzheimer's disease or Parkinson's disease. Not all insurance will deny based on these conditions so it is important to explore different insurance companies.
Medicaid is a Federal and State health insurance program for those with low income and limited assets. Administration of the program varies by state, according to the Centers for Medicare and Medicaid Services (CMS). Medicaid may pay for a stay in a nursing home if the individual meets nursing home functional eligibility criteria and has income and assets below certain guidelines. A large number of Medicaid certified nursing homes and SNFs are available in each state. Unlike Medicare, Medicaid has strict eligibility requirements.
Medicare is a federal government program for those 65 or older with low income and limited assets. Medicare generally does not pay for long-term care like a stay in a nursing home, but it will pay for acute care like that received in a short stay at a SNF. It may pay for rehab while someone recovers from an illness, injury, or surgery.
Aid and Attendance Benefit for Veterans
According to the VA website, the Aid and Attendance benefit (A&A) benefit is a special benefit for war era veterans and their surviving spouses. It is a tax-free benefit designed to provide financial assistance to help cover the cost of long-term care in the home, in an assisted living facility or in a nursing home. This benefit is for those who live in a nursing home or are mentally or physically incapacitated, or require the regular attendance of another person or caregiver in at least two of the daily activities of living. To learn more about the eligibility requirements and to apply for these veteran benefits visit VeteransAid.org online.
In situations when costs aren't covered through other means, paying via private funds is an option. Sources of private funds for assisted living include retirement accounts and 401Ks, savings accounts, annuities and insurance plans (including life settlements), trusts and stock market investments. Home equity and bridge loans can also be used when transitioning to a nursing home or assisted living facility. Social Security can also be used as a means of paying for a nursing home, and this can be an ideal solution for those who are receiving most of their care through a nursing facility.
Additional Nursing Home Resources
- Tips for Choosing the Right Nursing Home
- How to Find Medicare Ratings for Nursing Homes
- The Difference Between Skilled Nursing and Nursing Home Care
- What is Nursing Home Care?
- How to Pay for Nursing Home Care
- Pet Friendly Assisted Living Facilities and Nursing Homes
Nursing Home Regulations
Nursing homes are state regulated by the Department of Health in conjunction with the U.S. Centers for Medicare and Medicaid Services (CMS). Subject to inspections called "surveys," nursing homes are evaluated for any violations or immediate threats to patient safety and satisfaction. Unsatisfactory surveys are remedied by the nursing home administrator by proposing a plan of correction. Failure to improve on any violation could induce fines, reappointing managers, or suspension of new resident admissions or a facility's license, or even revoke a facility's license. SNFs are subjected to even more comprehensive evaluations due to the medical staff and more acute care nature of the facility.