Nursing Homes

What do Nursing Homes Provide?

Nursing homes are residential care facilities that provide long term care services. This includes custodial care and skilled nursing care. Nursing homes provide personal care services, provide recreational activities, social interaction, meals, medical care with physicians coming to see patients in the facility.

Pečovatelka hovoří v pokoji se seniorkou a její návštěvou

Over 1,400,000 Individuals Live in Nursing Homes in the United States

Studies have shown that over 70% of individuals who live to the age of 65 will need long term care at some point in their lives. Plan ahead, consider long term care insurance. If you are at the point where you are considering a nursing home, there are many things to consider.

Nursing home residents have dementia
Nursing home facilities have dementia units
Nursing Home Patients are women, many with dementia

When to Consider A Nursing Home?

When an individual needs more assistance than a family or friend can provide or when an individual is no longer safe living by themselves it may be time for long term care. On the continuum of long term care, nursing homes provided the most care.

How To Choose?

Delighted female relatives sitting together on wooden bench in park and browsing mobile phone while learning using

Consider the Individual’s Needs and Wants

Men and Women Sitting by Table

Talk to Family and Friends for Ideas and Concerns

Pečovatelka veze jídelní vozík

Visit the Facility with Question List

A window with blue glass and a table in front of it

Questions to Ask During Your Visit:

  • What is the Staffing Ratio (staff to patient ratio)?
  • What is the turnover of staff? How long have the Administrator, Director of Nursing, and Activities Directors been there?
  • How often do the doctors come to the facility? Who are they, and how long has the Medical Director been there?
  • What are example activities you do for the residents? Ask to see their activities calendar for this and last month.
  • Is there a place where residents can go outside safely?
  • How do residents get to medical appointments with specialists?
  • Is there a Memory Care Unit on site?
  • Has the facility had any state survey deficiencies? If so, what are they and what is the Administrator and leadership doing to fix the findings? Most facility will have minor findings which they will be working on.
  • Has there been any Immediate Jeopardy citations (Patient at risk) or Conditional Deficiency citations (Facility not following procedures outlined by the state)?
  • Ask to see the kitchen and dining room. Meet the chef.
  • Ask to meet the Activities Director and sit through an activity.
Elderly woman standing in garden
How Much Do Nursing Homes Cost?

Cost can be A Challenge For Nursing Home Residents

Nursing Homes provide two different types of services: skilled nursing care and custodial care. Medicare and most insurances will pay for skilled nursing care.

Skilled nursing care is care that is received after a hospitalization. The patient still needs some things done to get better but no longer needs to be in the hospital. This would include IV medications (antibiotics), wound care, nursing care, and rehab including physical, occupational and speech therapy.

Custodial Care is care for patients who do not need skilled care, but are not in a position to care for themselves. These patients usually lack the cognitive ability to care for themselves (advanced dementia) or are severely debilitated and bed-bound. These patients are unsafe to live by themselves and usually need assistance with activities of daily living (ADLs). Medicare and most insurances do not cover custodial care. Custodial care is is covered by state Medicaid Programs (you must qualify) and long term care insurances (must purchase a policy before need).

Cost breakdown if no insurance coverage (out of pocket)
  • Nursing Home Custodial Care can range from $6000 – $12000 a month depending on semiprivate vs private room.
  • If Medicaid is covering room and board, they will assume most of any social security or other monthly income that may be coming in.
  • There may be additional costs in addition to the room and board payments. ASK! Be very clear on what is covered and what the facility may charge for additional services in the future.
  • Patients in nursing home CANNOT receive home health services (this is skilled nursing and the nursing home can provide this service directly). However, patients may receive hospice services (if they qualify) in a nursing home which may help keep the patient comfortable and help with costs.