Skilled nursing facilities also known as nursing homes have changed dramatically over the past several decades. These changes have been driven by government regulations and consumer pressures. Today’s nursing homes are highly regulated, high-quality institutions for the care and treatment of older adults who have severe physical health and/or mental disabilities.
Skilled nursing facilities are normally the highest level of care for older adults outside of a hospital. Nursing homes provide custodial care, which includes getting in and out of bed, and aiding with feeding, bathing, and dressing. However, skilled nursing facilities differ from other senior care facilities in that they also provide an elevated level of medical care.
While nursing homes have traditionally been set up in a medically oriented design, with ease of patient care being the primary goal, some homes are now moving to a newer design model with smaller communities of 10 to 30 people within a home, private kitchens, communal areas, and continuity of staff.
Whether you and your family are facing a quick decision about a skilled nursing facility due to a recent event or have been coping with a worsening progressive disease such as Alzheimer’s or Parkinson’s, considering a skilled nursing facility is not an easy decision. Emotions such as guilt, sadness, frustration, and anger are normal.
The services nursing homes offer vary from facility to facility. Services often include:
Room and board
Monitoring of medication
Personal care (including dressing, bathing, and toilet assistance)
24-hour emergency care
Social and recreational activities
As you and your family evaluate your long-term care needs, it's important to consider financing options. Payment for nursing home care can be made through Medicare, Medicaid, private insurance, and personal funds. When evaluating nursing homes, it's important to ask the administrative staff what payment options they accept.
Here's a summary of some of the financing options.
• Medicare is a federal health insurance program providing health care benefits to all Americans age 65 and over. Insurance protection intended to cover major hospital care is provided without regard to income. Medicare will only provide 100 days of nursing care and only if a person requires skilled care and is referred by a doctor when discharged from the hospital. If a person needs custodial care alone, Medicare won't cover it. Medicare only pays for skilled care in a nursing facility that has a Medicare license.
• Medicaid is a joint federal/state health insurance program providing medical care benefits to low income Americans who meet certain requirements. Nursing home care is covered through Medicaid, but the requirements and covered services vary widely from state to state. To become eligible for Medicaid coverage, people usually must spend all their assets first. This means that they might pay for nursing home care out of pocket initially. Once their money runs out, Medicaid would kick in. It's best to work with a lawyer who specializes in elder law when determining Medicaid eligibility.
• Private long-term care insurance is a health insurance option that, if purchased, supplements Medicare coverage. Private long-term care insurance policies vary greatly. Each policy has its own eligibility requirements, restrictions, costs, and benefits.