The aging process may bring challenges to an older parent’s physical and/or mental health. A variety of ailments can slow your parent down to the point where day to day living is difficult. As a son or daughter you try to step in to help, but there comes a point in time when you can no longer care for your parent by yourself. Now the painful decision of whether a skilled nursing facility is necessary.
The decision is painful for two reasons: 1) determining what to expect and 2) nursing home care is very expensive. Let’s examine each of these.
Dealing with Expectations
You have the right to expect that your parent receives around-the-clock nursing care. He or she should receive physical, occupational, and/or speech therapy. He or she should receive assistance with walking, eating, using the toilet, and bathing. All patient care, activities, and social services needs to managed and recorded. You should expect to be notified of any problems within a short time frame.
Dealing with Costs
The average cost of a private room in a skilled nursing facility is $192 per day or $70,080 per year according to the 2004 MetLife Survey. A semi-private room comes in at a whopping $169 per day or $61,685 a year. Costs increase approximately $4,000 per year.
Where you live is also a big factor on what you will pay for elder care in a skilled nursing facility. Alaska reported the highest costs at $561 per day or $204,765 per year while Shreveport, Louisiana’s figures were considerably lower at $99 per day, or $36,135 a year. These figures do not include the costs of physicians, hospital stays, or medications.
There are several options to pay these enormous costs.
Private Pay
Few middle-class families can shoulder the bills for a nursing care facility and maintain their own households.
Long-term care insurance
If your parent saw this day coming many years ago, he or she may have planned for this day by purchasing a long-term care insurance policy. These policies are purchased to support any costs not covered by Medicaid or Medicare. You will have many more options in your parent’s care if there is a long-term care insurance policy in place.
Medicaid (Medical in California)
Medicaid is a federal and state regulated program for low-income residents. Nearly half of nursing home residents have their costs paid for by Medicaid. This presents a challenge of finding available space.
Not every nursing home accepts Medicaid because individuals pay more than Medicaid pays. Skilled care facilities must meet federal standards but if Congress deregulates the nursing home industry.
Medicare
Medicare is a federal health program that pays for a limited number days of nursing care for Americans age 65 or older. This program will cover 20 days of nursing home care. If a patient is discharged from a Medicare-approved facility and enters a nursing care facility, Medicare will cover some of the costs for 21 to 100 days.
If your parent is not in need of medical care but still needs help with daily living, an assisted living facility that provides senior living help or elder care is an alternative.
Medicare Facts
Medicare is a government health care plan provided for Americans 65 years of age or older. A person is automatically enrolled when he or she turns 65. There are two main sections of Medicare: Part A and Part B.
Medicare Part A
Part A provides coverage for hospital stays, skilled nursing facilities, in-home health care, and hospice services. Seniors do not have to pay a premium for Part A.
Medicare Part A coverage for hospital stays and skilled nursing facilities includes a semi-private room, medications, nursing care, meals, and other supplies. Mental health facilities and services are also included in Part A. Skilled nursing facilities costs are covered for up to 100 days. Occupational, physical, and speech therapies are also provided for under Part A.
Home health care includes the above supplies and services plus home health aides, long-term medical supplies such as beds, wheel chairs and walkers, and social services.
Medicare Part B
Part B requires a monthly premium in 2009 of $96.40. This part of the plan must be chosen three months prior to turning 65 years old. There is a window of time each year between January 1 and March 31 to enroll in Part B.
Part B’s insurance coverage includes outpatient hospital services, physicians, laboratory services, and therapies excluded by Part A. Preventative health care exams are also included.