At $3,000 to $10,000 a month, nursing homes are expensive, there's no doubt about that. In some cases, for some periods of time, nursing home care may be covered by Medicare. Some nursing homes also accept Medicaid. The finer details are complex; be sure to check out our guide to paying for nursing home care. Costs will vary based on location, the type and amount of care, and who the provider is. Some nursing homes will charge extra for additional services while others will have “all inclusive fees.”
The average cost of Nursing Homes across the country as of 2009 was: $219 per day for a private room and $198 per day for a semi-private room.
Note: If you expect Medicare or Medicaid to pay for your loved one's nursing home, make sure this is established ahead of time. It's illegal for a facility that participates in these programs to require a resident to pay privately for a period of time before accepting government-mandated coverage.
To be a certified Medicare/Medicaid provider, a nursing home must meet 150 requirements ranging from safe storage of food to protect residents from physical and mental abuse. The State Survey Agency performs an inspection to rate the nursing home on these requirements. Ask to see a copy of this inspection report.
Paying for nursing home care is a major concern for most people. If an individual enters a nursing home directly after being in the hospital, Medicare will often pay, but if a person goes to a nursing home from their own home, they usually have to pay for being in it. When personal financial resources are spent, many nursing home residents become eligible for Medicaid. It is regulated by both federal and state laws and provides funding that will pay most nursing home costs for people with limited income and assets. Eligibility for Medicaid varies by state and is provided only to persons in Medicaid-certified facilities. A Medicaid-certified nursing home must continue to provide care for a resident whose personal funds are spent while residing there. A nursing home that does not participate in the Medicaid program can discharge the resident. Some nursing homes try to avoid admitting residents who are currently or will soon become Medicaid recipients as they can charge private paying residents a higher fee than they would receive under the Medicaid program.
A skilled nursing facility, or SNF, provides round-the-clock medical supervision, in addition, to help with tasks of daily living, such as bathing, dressing, and toileting. Your loved one may need to be in a skilled nursing facility if he's on a respirator, requires regular physical or occupational therapy, is recovering from surgery, or has wounds that need ongoing medical care. A skilled nursing facility provides 24-hour staffing by licensed or registered nurses. The staff at most skilled nursing facilities includes a social services team and a rehabilitation team, in addition to nurses and care staff. Most skilled nursing facilities provide both short-term acute care and rehabilitation and long-term care. For example, the short-term stay would be one following hospitalization to repair a fractured hip which would require from 2 to 4 weeks for physical therapy. Long-term stay is usually for people who could no longer be safe in their home and who are expected to recover the ability to care for themselves.
Intermediate care facilities, as the name implies, are one step down from a skilled nursing facility in terms of the level of care. An intermediate care facility provides inpatient care for seniors who don't require continuous nursing care but do need nursing supervision and supportive care. If your loved one primarily needs some basic nursing services and ongoing help with activities of daily living, then an intermediate care nursing home rather than a skilled nursing facility may be the best choice. There are also specialized intermediate care facilities for the developmentally disabled. ICF provides custodial care for people who usually have mental or physical infirmity. It is not considered by the government to be a medical facility so it can receive no reimbursement under Medicare and it is usually receiving the bulk of its financing under Medicaid.
The term convalescent home is the name used by many nursing homes and skilled nursing facilities. The range of services provided by a convalescent home can vary from facility to facility, so if you're considering a particular convalescent home, compare it to other skilled nursing facilities in your area. Convalescent homes are usually Medicare-certified for skilled nursing care.