Spousal Protection Assisted Living And Nursing Homes
If you’re married, Medicaid spousal protection rules can help a healthy spouse continue to live at home instead of becoming impoverished to pay for the other spouse’s assisted living or nursing home care. More commonly, it’s nursing home care but applies to some assisted living situations. Here are Wisconsin’s spousal impoverishment regulations as an example.
You can continue to receive SSI. Check out the 2020 SSI and Spousal Impoverishment Standards here. The community spouse is the one who continues to live at home or otherwise in the community.
Nursing Home Vs Assisted Living: The Differences Matter
Many folks use the terms, nursing home and assisted living, interchangeably. This is understandable, especially since some assisted living facilities provide memory care or low-level nursing care. However, the distinction matters quite a bit, especially with regulations and cost.
Some quick background: Skilled nursing facilities and assisted living facilities are part of the many Continuing Care Retirement Communities across the United States. These communities offer a continuum of housing and care so residents can stay in the same place if their needs change or live near a spouse with different care needs. Of course, plenty of standalone skilled nursing facilities exist, as do standalone assisted living facilities.
State Medicaid programs for assisted living may require that participants meet what’s called a nursing home level of care. That doesn’t mean these folks need skilled nursing care around the clock. Rather, it typically means they cannot perform two of the activities of daily living . Criteria varies by state and program. For example, one state may require the inability to perform two ADLs, while just one ADL suffices in another state.
If you have second thoughts about entering a nursing home, chances are you mean assisted living and not skilled nursing. Check out the table below for a refresher on the differences.
Nursing Homes & Assisted Living Facilities
Many people who live in nursing homes and assisted living facilities enjoy regular visitors. Share your time and talents at a nursing home or assisted living facility by bringing companionship to someone.
Volunteers can help in many ways:
- Visiting with or reading to residents
- Helping the resident write a memory book for their family
- Taking residents for walks around the grounds
- Helping with holidays and special occasions
- Conducting prayer or religious activities
- Leading an exercise program
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Continuing Care Retirement Community
A Continuing Care Retirement Community is a residential community for adults that offers a range of housing options and varying levels of medical and personal care services. A CCRC is designed to meet a residents needs in a familiar setting as he/she grows older. People most often move into such a community when theyre healthy.
A CCRC resident has to sign a long-term contract that provides for housing, personal care, housekeeping, yard care and nursing care. This contract typically involves either an entry fee or buy-in fee in addition to monthly service charges, which may change according to the medical or personal care services required. Fees vary depending on whether the person owns or rents the living space, its size and location, the type of service plan chosen, and the current risk for needing intensive long-term care. Because the contracts are lifelong and fees vary, it is important to get financial and legal advice before signing.
Washington State does not license CCRCs.
Differences In Payment Accepted
The cost of senior care can be somewhat staggering, with a private room in a skilled nursing facility costing an average of $90,500 annually. Assisted living costs are slightly less, costing an average of $42,000 annually.
Medicare can help defray the cost for seniors to pay for skilled nursing care if the care is medically required for at least 3 days, but no more than 100 days if the facility the person chooses is a Medicare-certified skilled nursing facility. If you are unable to pay for nursing home services and have minimal assets, you may be eligible to pay for skilled nursing care through Medicaid.
When it comes to assisted living, neither Medicare Parts A or B offer coverage for comprehensive long-term care. Some states may offer some coverage through Medicaid programs but eligibility and coverage differ greatly between states. While payment options do vary in each state, residents in assisted living rely primarily on private pay options since most assisted living communities cannot legally accept public pay. Private pay options for assisted living include using veterans benefits, long-term care insurance, retirement savings, home equity loans, or reverse mortgages.
While the cost of senior care may seem daunting, with proper planning and guidance, many families find it is more affordable than it seems at first glance.
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Are There Other Options
If independent living is the goal, you may find it more appealing or more cost-effective to use home health aides or assistants to help care for an older adult at home.
Another increasingly popular option is shared housing, in which older adults live together or with a younger person. This may help keep down housing costs, while also staving off loneliness and isolation.
For people who want companionship but dont need extensive medical care, board-and-care homes may be an option.
Board-and-care homes are smaller residential settings where several older adults live in a single home with a caregiver on site.
How Much Do Assisted Living Communities Cost
Assisted living costs vary by community, location, and services offered. Generally, assisted living which provides additional amenities and care services costs more than independent senior apartments. However, the difference between assisted living and nursing home costs is significant, since assisted living communities dont offer full-time medical care.
The median cost of assisted living in the United States in 2020 was $4,300 per month, according to Genworths most recent Cost of Care Survey.
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In A Residential Facility
Sometimes its not possible to live by yourself or with your family. In those cases, assisted living or a nursing home might be right for you. These facilities are professionally staffed businesses that provide different levels of care, depending on what you need.
Assisted Living Facility
If you choose to live in assisted living facility, you will usually have your own room or apartment. You can bring your things with you to make it feel like home. You will usually eat with others. Services might include:
- Help bathing or getting dressed.
- Someone to make sure you get your medicine.
- Employees checking on you to make sure you are doing OK.
- Assisted living residents have the same rights as everyone else. Learn about your rights in an assisted living facility .
Nursing Homes Vs Assisted Living Facilities: Breaking It Down
Choosing the right type of care for your loved one ensures that their needs are met without going over budget. Heres a breakdown of assisted living communities and nursing homes.
*Source: Genworth Cost of Care 2020
Nursing homes offer around-the-clock care to roughly 1.3 million residents in the U.S., according to the latest data from the Centers for Disease Control and Prevention . These facilities are staffed by professional nurses, like registered nurses and licensed practical nurses, and they follow a medical care model. The nurses work alongside a physician, who serves as the medical director of the nursing home. A nursing home is also staffed by an administrator and director of nursing. These staff members oversee and provide consultative input regarding the care that is provided in that facility.
Resources provided on site
Nursing homes provide on-site resources that assisted living facilities do not. This includes physical, speech and occupational therapy, as well as rehabilitation. These are required services in nursing homes, according to Heidi White, a professor of medicine at the Duke University School of Medicine in Durham, North Carolina.
Comparatively, assisted living facilities do not generally have that level of sophistication of professional services, especially from nurses and physicians, says White. Thats not to say they might have a registered nurse on staff, but its possible they dont.
Nursing homes and rehabilitation
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Assisted Living Vs Nursing Homes: Whats The Difference
Senior living communities come in many shapes and sizes, and theres no universal approach for aging loved ones. Many people think of senior living and nursing home as synonymous, but over the past 30 years the terms have grown apart, and nursing home isnt the senior care catch-all it used to be.
In fact, A Place for Mom surveyed 100 families who contacted us seeking nursing homes for their relatives. After consulting with our Senior Living Advisors, 89 of those families determined that a nursing home wasnt the right choice for their aging family member, and they selected a more social, communal senior living environment.
So whats the difference between assisted living and nursing homes, and which fits your loved ones needs? Learn more about the services, features, and costs of assisted living versus nursing homes to help find the best community for your aging relative.
Facts About Richmond Hill
Richmond Hill is also known as: Richmond Hill, and Canada.
And some of the notable people born here have been: Dylan Neal , Mag Ruffman , Jeff O’Neill , Pete Orr , and Michael Cammalleri .
Popular neighborhoods in Richmond Hill include: Gormley, Temperanceville, and Oak Ridges.
And featured attractions of Richmond Hill: Gormley, Ontario, Temperanceville, Ontario, Wilcox Lake, Oak Ridges, Ontario, and Richmond Hill Centre for the Performing Arts.
Richmond Hill is represented by Mayor Richmond Hill Town Council, MPPs Helena Jaczek ,, Governing Body Vito Spatafora, Brenda Hogg, Regional Councillors Costas Menegakis, and MPs Dave Barrow.
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Is A Nursing Home Your Only Choice
Make sure to read through the other residential care housing options included on this page. There may be other alternatives for care in a more residential environment including getting the care and services the person needs at home. Learn more about in-home services.
Adults receiving state-funds to pay for long term care services may also be eligible for the Nurse Delegation Program. With Nurse Delegation, a caregiver may be trained to help with certain nursing type care tasks in your home, Assisted Living Facility, or adult family home. Learn more about Nurse Delegation.
Who Benefits From A Nursing Home
Nursing homes are for those who:
- Can no longer care for themselves independently
- Are not mobile without assistance
- Need around-the-clock care due to chronic health conditions or deteriorating health
- Require extensive rehabilitation following an injury or major surgery
As you can see, theres quite a bit of difference between assisted living and a nursing home. If youd like to learn more about assisted living communities in your area, you can use the senior living locator tool to find those near you. If youre considering an assisted living community, use this assisted living checklist so youll know what to look for and what kinds of questions to ask.
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Who Can Benefit From Nursing Home Care
The higher level of care offered in a skilled nursing facility versus an assisted living community makes nursing homes an ideal choice for seniors who require significant medical care in addition to companionship, assistance with ADLs, and on-site amenities. A nursing home may fit the needs of elderly loved ones who require a greater level of care. These seniors may:
- Require constant care due to chronic conditions or deteriorating health
- Be unable to feed themselves independently
- Have significant mobility concerns
- Have experienced an injury or fall and need significant rehabilitation
- Have progressive conditions, like Parkinsons disease or MS
- Require regular injections for diabetes or other conditions
What Are Nursing Homes
Nursing homes, also called skilled nursing facilities, provide a wide range of health and personal care services. Their services focus on medical care more than most assisted living facilities. These services typically include nursing care, 24-hour supervision, three meals a day, and assistance with everyday activities. Rehabilitation services, such as physical, occupational, and speech therapy, are also available.
Some people stay at a nursing home for a short time after being in the hospital. After they recover, they go home. However, most nursing home residents live there permanently because they have ongoing physical or mental conditions that require constant care and supervision.
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What Is Assisted Living
Assisted living consists of a residential community equipped to help people with daily life and routine self-maintenance when needed. Ranging in size from a few dozen to a few hundred residents, they often run like retirement communities with added healthcare support however, they don’t always provide extensive or round-the-clock medical care.
In assisted living, people typically have their own rooms or apartments. They can gather in common areas for dining or recreation. Most facilities include room and board, medication management, and housekeeping. They also provide bathing and bathroom help as needed, social and leisure activities, and emergency care. Different facilities offer different levels of service, benefits, and expertise. Some even combine with independent living residences to form hybrid communities, so you can move from one to the other more easily when needed.
Want to learn more about assisted living? Watch the video below. Jeff Hoyt, our editor-in-chief, will walk you through everything you need to know.
Residential Facilities Assisted Living And Nursing Homes
At some point, support from family, friends, and local programs may not be enough. People who require help full-time might move to a residential facility that provides many or all of the long-term care services they need.
Facility-based long-term care services include: board and care homes, assisted living facilities, nursing homes, and continuing care retirement communities.
Some facilities have only housing and housekeeping, but many also provide personal care and medical services. Many facilities offer special programs for people with Alzheimer’s disease and other types of dementia.
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How Do I Pay For Long
Many people think that Medicare will pay for their long-term care expenses, but this usually is not true. Instead, people have to rely on their savings, long-term care insurance or Medicaid to cover the costs.
And while Medicaid pays for the largest share of long-term care services, to qualify your income and assets must be below a certain level and you must meet the minimum state eligibility requirements. To find out if you might be eligible for Medicaid or to apply for benefits, visit the Your Texas Benefits website.
Note: Texas is required by federal law to have a Medicaid Estate Recovery Program. This means that if you received Medicaid long-term care services, the state of Texas has the right to ask for money back from your estate after you die. In some cases, the state may not ask for anything back, and the state will never ask for more money back than it paid for your services.
Who Can Benefit From Assisted Living
Assisted living communities are designed for seniors who wish to maintain independence as long as possible in a secure setting designed to fit their needs. Assisted living may be a good option for your aging loved one who fits the following descriptions:
- Needs minor nursing assistance or medication but doesnt require full-time medical care
- Needs help with daily activities like dressing and bathing
- Is interested in a maintenance-free lifestyle without lawn care or home repairs
- Desires an active life but doesnt have access to transportation
- Is looking for new friends or social activities
- Wants to pursue their passions, like golf, art, or religious studies, in a specially focused lifestyle community
- Is currently in good health but knows theyll need more help soon
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Assisted Living Vs Nursing Home: Whats The Right Choice For Mom Or Dad
Having an open and honest conversation with your mom or dad about their wants and needs is the best way to determine what the best choice is when it comes to senior living options.
Things to consider are: your parents mobility, their ability to take medications properly, interest and ability to prepare meals, how easily theyre able to maintain their own personal hygiene, whether or not theyre capable they are of using the bathroom without any assistance, and any specific medical issues that they are dealing with.
For seniors who want independent living but may not be safe to live completely alone or unsupervised, an assisted living facility might be a good choice. This kind of facility will offer your mom or dad a chance to continue enjoying a more autonomous lifestyle with their own private space while some of their basic daily tasks cleaning, preparing meals, doing laundry, etc. are taken care of for them.
Those who need more extensive care services, including full-spectrum medical care, may need to consider a nursing home. Your parent will have access to the level and type of care they require while having a chance to interact with others in the long-term care facility, enjoy a sense of community, and engage in recreational activities.
Do you have past experience handling a parent or older adults transition into an assisted living facility or a nursing home? Are you and your mom or dad starting to consider this new transition? Wed love to hear from you.
Choose The Right Care For Your Loved One
The care decisions you make will affect your loved one for the rest of their life. The right decision can potentially improve an entire familys quality of life by reducing bickering and restoring a sense of balance.
The move to residential care is never a one-size-fits-all decision. Instead, its important to review your loved ones needs, spend time touring each community, and ask many questions. When you find a community that feels welcoming and comfortable, act quickly, because many communities have long waiting lists.
Your loved one deserves a retirement of peace and support, no matter how their health shifts in the coming years. So take your time and make a decision that feels right for everyone.
In the meantime, learn more about assisted living by downloading our free resource, The Complete Guide to Assisted Living. Our experts compiled everything you need to know about this senior living option, including more details about care, cost, and benefits.
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