Average Nursing Home Cost $91K/yr

[imoldernu]

Going up 4% per year.
My Way News - Elder care costs keep climbing; nursing home bill now $91K

For its report, Genworth surveyed 15,000 nursing homes, assisted living facilities and other providers across the country in January and February. It found wide differences from state to state. In Oklahoma, for instance, the median cost for a year in a nursing home came out to $60,225. In Connecticut, it was $158,775. Alaska had the highest costs by far, with one year at $281,415.
So, who pays the nursing-home bill? "A lot of people believe Medicare will step in and cover them, but that's just not true," said Bruce Chernoff, president and CEO of The Scan Foundation, a charitable organization. Medicare will cover some short visits for recovery after a surgery, for instance, but not long-term stays.
Often enough, experts say senior citizens wind up spending their savings until they hit their last $2,000, and at that point they can turn to Medicaid, the government's health insurance for the poor, to help cover the bill. As a result, Medicaid pays for more than half of the country's long-term care bill. That cost accounts for more than a quarter of Medicaid spending, according to the Kaiser Family Foundation.

Less expensive at home? Maybe not. Home healthcare rates here average $18/hour, which, for 24hr. care, works out to$157K/yr... and that does not include specialty care, food, special services and the medical expertise available in a nursing home.
As we live in a regular home in a full service CCRC, we get a chance to see the realities of aging in terms of how long patients spend in nursing home care. While the average time spent in a nursing home before death is said to be about 5 months, our experience tells us that many who suffer from dementia, live much longer. This is more clearly seen in communities like ours, where there is a separate facility for Alzheimer/dementia patients.

 

[Lakewood90712]

Going up 4% per year.
My Way News - Elder care costs keep climbing; nursing home bill now $91K


Less expensive at home? Maybe not. Home healthcare rates here average $18/hour, which, for 24hr. care, works out to$157K/yr... and that does not include specialty care, food, special services and the medical expertise available in a nursing home.
As we live in a regular home in a full service CCRC, we get a chance to see the realities of aging in terms of how long patients spend in nursing home care. While the average time spent in a nursing home before death is said to be about 5 months, our experience tells us that many who suffer from dementia, live much longer. This is more clearly seen in communities like ours, where there is a separate facility for Alzheimer/dementia patients.

About a year before my dad died, I seriously considered bringing him home , with 24 hour care. I got a quote from a service I had previously used for daytime care. The service stated they could provide coverage for $270 a day, by having 2 shifts and some of the time would have an off duty worker sleeping on site, and being on call , paid for the additional time only if needed. I don't think that would work today with a recent labor decision requiring such employees to be paid for the so called " on call" hours.

If I could roll back time, I would bring him home for his final years, regardless of cost ,and put off retirement. No matter how good A dementia care facility looks to someone not being locked inside, it's still a nightmare for the occupants , especially for those still having some awareness .

I was paying over 9K per mo for dad as a dementia resident at A Belmont Village location when he died. Cost went up 5-6% yr, during his stay.

In the rear view mirror, it would have been well worth it to keep working and pay the extra $ to bring him home .

P.S. Dad was at Belmont Village for about 5 years. Anyone wanting my opinion on this provider, feel free to contact me by pm to discuss offline.

 

[check6]

My 90 yr old mother had a stroke on Monday. Those numbers are scary.

 

[MichaelB]

From the same article

Less-intensive care remains much cheaper than staying at a nursing home, according to Genworth's survey. One year in in an assisted-living facility runs $43,200. A year of visits from an agency's home health aides runs $45,760.

Keeping in minds that the nursing home means the patient requires continuing medical care. Dementia patients can live in Assisted Living, which costs much less.

 

[Htown Harry]

[FONT=Verdana,Sans-serif]Caldwell [[/FONT][FONT=Verdana,Sans-serif][FONT=Verdana,Sans-serif]Joe Caldwell, director of long-term services at the National Council on Aging] [/FONT]described Genworth's survey as essentially a marketing pitch. "Of course they want people to see how much it costs, to sell long-term care insurance," he said. [/FONT]

Anyone aware of an alternative data source?

 

[iac1003]

Anyone aware of an alternative data source?

In all honesty you can just call nursing homes and ask for their day rates. The many I have consulted to for w*rk don't give much if any break for being a monthly or long-term resident. The average in the NY-NJ area when my mother was in a NH in 2007 was about $7-8K a month. I had already spent $100K for 1 year of in-home 24 hour care.


Sent from my iPhone using Early Retirement Forum

 

[jim584672]

In all honesty you can just call nursing homes and ask for their day rates. The many I have consulted to for w*rk don't give much if any break for being a monthly or long-term resident. The average in the NY-NJ area when my mother was in a NH in 2007 was about $7-8K a month. I had already spent $100K for 1 year of in-home 24 hour care.


Sent from my iPhone using Early Retirement Forum

https://www.health.ny.gov/facilities/nursing/estimated_average_rates.htm

 

[MRG]

Anyone aware of an alternative data source?

I've seen prices from state sources listing average cost by county. This wss in PA., I'd guess all states have them. Sorry I don't recall the source, but it wasn't from insurance companys. More likely state agencies for elder care. Little Google time should pay off.

 

[braumeister]

Keeping in minds that the nursing home means the patient requires continuing medical care. Dementia patients can live in Assisted Living, which costs much less.

Very true, but assisted living with dementia care ("Memory care" is what they call it around here) costs considerably more than regular assisted living.

When my mom moved from one to the other, the monthly cost went up nearly 40%. Still less than a nursing home, but substantial.

 

[MichaelB]

Very true, but assisted living with dementia care ("Memory care" is what they call it around here) costs considerably more than regular assisted living.

When my mom moved from one to the other, the monthly cost went up nearly 40%. Still less than a nursing home, but substantial.

For sure, and I didn't mean to imply anything different. I'm looking at prices right now and see about the same difference you reference.

I think every article on LTC or nursing home costs in the US should carry this disclaimer

Average costs for LTC in the US are nothing more than a statistical calculation, in real life they range from much less to much more and depend on a while series of factors probably not understood or mentioned by the author of this article.

 

[Amethyst]

Basically, the only cheaper alternative to institutionalization is caregiving by a relative.

Which is sort of costly, for the relative, because they end up having no life.

Amethyst

 

[Lakewood90712]

The 2 alternatives I have seen, one being a large family (8 adult children) all living close by , conscripted to for care 24 hour care of parents ( one with a very bad stroke) .

The other is using under the table cash paid workers. Have seen this quite a bit
A min. wage worker ends up costing about double of the wage with workers comp insurance and employer payroll taxes included. Under the table employees, not only illegal, but IMO fraught with risk. Your homeowners workers comp will not cover this. Healthcare workers handling bedridden patients do get injured fairly often , and this puts all your assets at risk, in addition to civil or criminal action for evading tax and labor law. Just my opinion

The other posts on cost. Just assisted living , I'm seeing 4-5 k for very good facilities in the metro Los Angeles area. That being for ambulatory, non dementia residents.

 

[jim584672]

My mother had a case of dementia. It got so bad at the end that she had to be watched 24/7 for her own safety and those around her. I had no choice but to out her in a home. She had no real assets so Medicaid paid the huge bills.

The dementia units are filled with people who are out of their minds, literally. Horrible places where no one cares. Such a horrible situation for all involved.

 

[jim584672]

I don't see the point for saving for a nursing home since it will burn down any savings in a short time anyway. I think the better way would be to spend time on legal ways to protect assets and getting Medicaid to pay for the care.

A "Life Estate Deed" can protect a property title from Medicaid. Also a "Supplemental Needs Trust" can be used to get qualified for Medicaid, while allowing a person to keep the benefits of saved funds. A SNT pays for your expenses, any income you get goes to the Trust. This allows a person to lower their income and qualify.

 

[athena53]

I don't see the point for saving for a nursing home since it will burn down any savings in a short time anyway. I think the better way would be to spend time on legal ways to protect assets and getting Medicaid to pay for the care.

A "Life Estate Deed" can protect a property title from Medicaid. Also a "Supplemental Needs Trust" can be used to get qualified for Medicaid, while allowing a person to keep the benefits of saved funds. A SNT pays for your expenses, any income you get goes to the Trust. This allows a person to lower their income and qualify.

My guess is that as hordes of baby boomers whose LTC plan is "spend down/shelter assets and get Medicaid" start qualifying for Medicaid nursing home care, Medicaid will be under tremendous financial pressure and the reimbursement rates to Medicaid nursing homes will decrease (or not keep pace with inflation). I don't want to be in a Medicaid nursing home when that happens. My prediction is that you'll have a roof over your head and 3 meals a day but it won't be pretty. If my entire estate goes towards a decent nursing home with a swimming pool, a library, access to good dental care, etc. then it will be well-spent. My only son, bless him, agrees.

I'd say more but I don't want this moved to "Political"!

 

[jim584672]

My guess is that as hordes of baby boomers whose LTC plan is "spend down/shelter assets and get Medicaid" start qualifying for Medicaid nursing home care, Medicaid will be under tremendous financial pressure and the reimbursement rates to Medicaid nursing homes will decrease (or not keep pace with inflation). I don't want to be in a Medicaid nursing home when that happens. My prediction is that you'll have a roof over your head and 3 meals a day but it won't be pretty. If my entire estate goes towards a decent nursing home with a swimming pool, a library, access to good dental care, etc. then it will be well-spent. My only son, bless him, agrees.

I'd say more but I don't want this moved to "Political"!

You say a "Medicaid nursing home" as if there are scores of non-Medicaid nursing around. This is simply not true. Almost all nursing homes accept Medicaid. If you want to pay the bill yourself fine, but you will get the same care as someone on Medicaid.

 

[razztazz]

You say a "Medicaid nursing home" as if there are scores of non-Medicaid nursing around. This is simply not true. Almost all nursing homes accept Medicaid. If you want to pay the bill yourself fine, but you will get the same care as someone on Medicaid.

Thanks for mentioning this. I've been holding back thus far. This is true. My mother finally decided to go into a nursing home. Private. Decent. More than decent, in fact. Not in the Mitt Romney Class but most here really aren't contemplating THAT level of care and balloons every day. She was completely spent down. They are collecting her SS and a small pension she has. The rest from DAY #1 was paid for by Medicaid. The end.

The moral of the story is, if you want to feel comfortable in this, try to privately find at least one or two years. Probably doable by most here. That will get you into almost any nursing home barring the tippy-top tier. IF you live past that and run out of beans Medicaid will cover it and you won't get "demoted" or wheeled out to the parking lot.

It's a pretty useless time of life to worry about spending money anyway. If there is a spouse involved, THAT will require some planning. Get divorced now.

 

[ERhoosier]

You say a "Medicaid nursing home" as if there are scores of non-Medicaid nursing around. This is simply not true. Almost all nursing homes accept Medicaid. If you want to pay the bill yourself fine, but you will get the same care as someone on Medicaid.

Sadly, I cannot agree- at least in the states I've lived and/or had NH contacts via relative & friends.
First- Many NH's are not accepting Medicaid, and folks can be forced out of their NH when their $$ runs out and Medicaid takes over. Feds try to put a positive spin on this by saying... "In many cases it is not necessary to transfer to another nursing home when payment source changes to Medicaid NF."
Nursing Facilities (NF) | Medicaid.gov
They could have phrased the situation differently and said in many cases it IS necessary to transfer when changing to Medicaid. Sure some NH will let a resident stay after switch to Medicaid, but seems that fewer are doing so with each passing year.
Second- There can be significant differences in the care actually received by Medicaid vs insured/self-paying patients. Note the list of services NOT covered by Medicaid. Some very important therapies (PT, OT, ST, etc.) are not covered by Medicaid. As in no $$ no service. Another noncovered "service" that I've seen with relatives/friends is the "specially prepared food", which can be a notable step up from the "generally prepared" NH fare. How does a NH resident on Medicaid pay for any of these "extras" after spending down most all their assets to meet eligibility

Fact is that there are many very valid reasons to get LT care insurance &/or set aside personal assets for one's potential NH care. Medicaid is a basic (often VERY basic) safety net, not a long term financial plan.

 

[SumDay]

Basically, the only cheaper alternative to institutionalization is caregiving by a relative.

Which is sort of costly, for the relative, because they end up having no life.

Or worse. I believe my mother's Alzheimer's greatly hastened my dad's death. He tried (and covered for her) for almost two years and by then the damage was done. Then, the thought of spending every dime he'd saved to put her in a nursing home truly took its toll. He died about a 1 year after he moved her out of their home. I was glad he was out of his misery. Their expenses went from $1200 a month to $8000 and he was a nervous wreck. He was either crying or in a rage.

Alzheimer's is truly the cruelest disease.

 

[Tadpole]

Question - I imagine that nursing homes, like mortgages lenders, get a full view of one's finances. What prevents them from setting the price at a level that tries to extract as much as possible, without being too obvious, before one dies? Does one customer know what another customer is charged for room, board and specific services?

 

[jim584672]

Sadly, I cannot agree- at least in the states I've lived and/or had NH contacts via relative & friends.
First- Many NH's are not accepting Medicaid, and folks can be forced out of their NH when their $$ runs out and Medicaid takes over. Feds try to put a positive spin on this by saying... "In many cases it is not necessary to transfer to another nursing home when payment source changes to Medicaid NF."
Nursing Facilities (NF) | Medicaid.gov
They could have phrased the situation differently and said in many cases it IS necessary to transfer when changing to Medicaid. Sure some NH will let a resident stay after switch to Medicaid, but seems that fewer are doing so with each passing year.
Second- There can be significant differences in the care actually received by Medicaid vs insured/self-paying patients. Note the list of services NOT covered by Medicaid. Some very important therapies (PT, OT, ST, etc.) are not covered by Medicaid. As in no $$ no service. Another noncovered "service" that I've seen with relatives/friends is the "specially prepared food", which can be a notable step up from the "generally prepared" NH fare. How does a NH resident on Medicaid pay for any of these "extras" after spending down most all their assets to meet eligibility

Fact is that there are many very valid reasons to get LT care insurance &/or set aside personal assets for one's potential NH care. Medicaid is a basic (often VERY basic) safety net, not a long term financial plan.

As a self-pay patient you could afford extras, since you would not qualify for Medicaid due to having too many assets. Most patients come in as self-pay or self-insured to start off. Once they have "spent-down" to under Medicaid limits Medicaid takes over.

So the question is - are the uncovered services in a nursing home, that you pay for, worth the hundreds of thousands of dollars needed to pay for them? I think I would eat slop if I knew hundreds of thousands would be going to my heirs (with a proper estate plan) as a result.

 

[rodi]

You say a "Medicaid nursing home" as if there are scores of non-Medicaid nursing around. This is simply not true. Almost all nursing homes accept Medicaid. If you want to pay the bill yourself fine, but you will get the same care as someone on Medicaid.

I will take issue with this.

I think this varies quite a bit. I've done a lot of talking to facility directors at nursing home facilities in 3 states in trying to come up with a plan for my FIL (who has since passed) and now for my MIL. One of the questions I ask when I'm asking questions about pricing, staff levels, what is included, and availability, is "do you accept medicaid".

I would put the figure at about 50/50. This is for the San Diego area, the Lexington area, and the Philadelphia area. (All have family nearby so are possible areas.) Several that took medicaid, eventually, required that you show you would be able to pay full freight for at least 2 years before accepting you as a client... they wouldn't kick you out when you ran out of money and went on medicaid - but they didn't want the lower medicaid rate from the get-go.

For the ones that said they didn't take medicaid at all I asked what happens when a long term resident runs out of money... the answer was variations of "we contact the family and if that doesn't work, we find a facility that takes medicaid and arrange a transfer." In other words - they turf the resident from what has become their home.

One facility we've looked at closely is a continuing care community. They charge a higher monthly rent up front but the rent/cost doesn't go up as you move from independent to assisted to nursing. They do not take medicaid at all. They do a full financial analysis of your assets before accepting you as a resident. It's very nice (I know a few residents there in independent apartments). I can see the attraction if you have a pension that will cover most or all of the high monthly rate.

 

[athena53]

Question - I imagine that nursing homes, like mortgages lenders, get a full view of one's finances. What prevents them from setting the price at a level that tries to extract as much as possible, without being too obvious, before one dies? Does one customer know what another customer is charged for room, board and specific services?

If I were shopping for a nursing home I'd do it in the opposite order. You tell me what it will cost to stay here and if I choose your place, I will furnish proof that I have the means to pay the bill.

Someone mentioned that most nursing homes take Medicaid plus non-Medicaid patients, which is true, but my aspiration, if I decide I don't want to live on my own, is to move into a continuing care community. This is an Erickson community. You don't like the one you're in, our your kids moved to AZ and took the grandkids with them? That's OK- you can move to the one in AZ. One near me sends out a newsletter and I still remember the article about a group of ladies in their 90s working on a prairie grass restoration project, with help from other residents who were building bird houses in the workshop.

I'm guessing they don't take a lot of Medicaid residents.

 

[MRG]

Question - I imagine that nursing homes, like mortgages lenders, get a full view of one's finances. What prevents them from setting the price at a level that tries to extract as much as possible, without being too obvious, before one dies? Does one customer know what another customer is charged for room, board and specific services?

With both parents the prices were published up front. Obviously there were add ons that also had prices listed.

If everyone isn't suffering from severe dementia many talk about prices, food quality, lack of ice cream with birthday cake. Many with severe dementia will join in too, it's hard to tell if they really understand.
It'd be tough to hide any major differences, but this years "Better call Saul" made a point about overcharges to SRs. in a home.

Someone already said how cruel dementia is, so sad.

 

[braumeister]

When my mom was in the memory care assisted living place (last year and a half of her life), I noticed that nearly everyone there was so engrossed in their own private world that they didn't seem to even notice what anyone else was doing.

It was a pretty nice place ($5,500 a month in 2010, fairly low cost part of the country). Staff was professional and caring (I visited at least twice a week).

So my observation (N=1) is that the folks in these places are not as stressed by the environment as the rest of us are. My mom, for example, never had any complaints about it -- she enjoyed the attention and the opportunity to interact (as much as she could) with others. Actually an improvement (from her perspective) from her former abode in a retirement community where everyone had their own apartment and mostly hibernated there.

Just another thought that might be comforting.