Nursing homes are facilities that provide 24/7 skilled nursing care for those who need a higher level of care than provided by an assisted living facility but who do not need hospital-level care.
In addition to nursing care, they offer room and board, personal care, rehabilitation, therapies, and supervision. Nursing homes also provide short-term rehabilitation for patients who are recovering from a long-term illness or surgery.
Why Would I Need a Nursing Home?
As said above, a nursing home can be a permanent home or just a “rehab” home for those that are recovering from a surgery or major illness such as stroke, hip fractures, traumas, knee replacement and the like.
The goal for someone using a nursing home for rehab is to get well enough to return home and live as independently as possible.
The goal for permanent patients is to help improve their condition or maintain their current condition so that it doesn’t get worse.
Typical Nursing Home Services
No two nursing homes are alike but in general, a facility will offer the following services and amenities:
- The professional skills of registered nurses, licensed practical nurses, certified nursing assistants, administrative personnel, physical therapists, occupational therapists, dieticians and others
- Assistance with activities of daily living (ADLs) such as dressing, bathing, toileting, transfer, medication management, and meals
- Physical, occupational, respiratory and speech therapies
- Alzheimer’s and dementia care
- On-site activities such as bingo, cards, and hobbies
- 3 daily meals in a common dining area or in-room
- Dietary consultation
- Dental services
- Laboratory services
- X-ray services
- Pharmaceutical services
- Laundry services
- Exercise and fitness classes
- Field trips
- Family and pet visits
- Religious services
Nursing Home Stats
According to the most recent statistics from the American Health Care Association (AHCA):
- About 1.7 million certified beds in the U.S.
- About 1.4 million patients
- Nearly 16,000 nursing home facilities
- Residents need help with an average of 4 out of 5 ADLs
- Each patient receives on average 8 hrs. a week in staff care
Nursing Home Costs
Care costs vary depending on level of care needed, the facility amenities, and the geographic location.
According to Genworth Financial’s Cost of Care Survey, the U.S. average for a semi-private room in a nursing home is $5,870 a month. The average for a private room is $6,479 a month. By contrast, the average cost nationally for an assisted living facility is $3,261 a month.
Paying for a Nursing Home
There are four ways to pay for nursing home care: Medicaid, Medicare, out-of-pocket, and long-term care insurance.
Medicare usually pays for up to 100 days of care in a skilled nursing facility per benefit period.
- For the first 20 days of care, Medicare pays 100%.
- From days 21-100, you’re required to pay a co-payment (up to $128 a day).
Medicaid pays for certain nursing home care for those who meet certain income and asset requirements. Eligibility and benefits vary from state to state.
Long-term care insurance is another payment source. The cost of a policy is based on “the type and amount of services you choose to cover, how old you are when you buy the policy, and any optional benefits you choose, such as benefits that increase with inflation,” says the Department of Health and Human Services.
Paying out-of-pocket is the only option for some seniors. These funds typically come from the sale of the home, pensions and/or social security benefits.
Are Nursing Homes Regulated?
Yes. By a combination of state and federal laws: the U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services (CMS) and a state’s Department of Health.
Among the areas these two entities cover are:
- Certification, inspection and enforcement
- Complaint procedures
- Resident rights
- Admission, transfer and discharge rights
- Resident behavior
- Quality of life and care
- Staff services
- Physical environment
Nursing homes fill an essential role for seniors needing skilled nursing care or for those who just need to convalesce after surgery or illness. The quality and level of care vary from facility to facility. To begin searching for a nursing home in your area, use our advanced search at the top.
Nursing Homes can be a temporary facility during a recovering period or they can serve as permanent residences for people who are too sick or frail continue living at home. Most nursing homes have nursing aides and skilled nurses on hand 24 hours a day. Nursing homes fall in between hospice care and assisted living. Unlike a Hospice that deals with patients that have terminal health complications, most nursing homes are focused on maintaining or improving the health of the residents. In assisted living, the focus in on enjoying a stable life so there is no pressure to make a transition out of an assisted living facility.
In general, Medicare doesn’t cover long-term stays (over 100 days) in a nursing home and they generally like to see patients discharged in 3 days. Medicare does cover some skilled nursing and rehabilitative care after a hospital stay under the skilled nursing facility benefits. Most seniors who need the long-term support of a nursing home pay for their nursing home care (room and board) using the following their own personal resources or long-term medical care insurance. Long Term care at a nursing home or similar facility is very expensive, ranging $3000 to $20,000 per month.
Selecting a nursing home is such a complex task that Medicare.gov offers a 68 page Guide to selecting a nursing home at: http://www.medicare.gov/publications/pubs/pdf/02174.pdf
Many of the best nursing homes pride themselves on their ability to rehabilitate and discharge patients. Since short term stays in a nursing home are typically covered by Medicare and/or Medicaid, this can be a double edged sword. The facilities work hard to help patients return to their normal life but many discharged patients still need help with daily activities. Once discharged, their Medicare coverage ends. This leaves many under-funded seniors at the mercy of friends, family and non-profit organizations (like a subsidized religious institution) until they are fully ready for self supported living.