Pensacola Elder Law Blog

Assisted living facilities and nursing homes are long-term housing and care options for older adults. Although people sometimes use the terms assisted living and nursing home synonymously, they are distinct. Understanding the differences between assisted living and nursing homes is critical for those considering where to live as they age. This is because assisted living communities and nursing homes provide different types of care. While assisted living is appropriate for active older adults who need support with everyday tasks, nursing homes provide medical care to adults with significant health issues. What Is Assisted Living? Older adults who can no longer live on their own but do not require round-the-clock medical care can benefit from assisted living. While assisted living facilities can have nurses on staff, the primary focus is not on health care, but rather on supporting residents with daily life. Activities of daily living (ADLs) are six basic activities that healthy individuals can carry out on their own on a daily basis. Depending on an individual resident’s needs, an assisted living facility can provide aid with showering, dressing, preparing meals, completing household chores, and taking medication on time at the correct dose. While giving necessary support, assisted living communities maximize adults’ independence and autonomy. Residents typically live in private units similar to traditional apartments with kitchens that are part of larger communities offering opportunities to socialize with fellow residents. Units can have safety features tailored to older adults with mobility challenges, such as shower bars, widened doorways, safety rails, and enhanced lighting. Difference Between Assisted Living and Nursing Home Compared to assisted living, nursing homes may be the right fit for those with significant medical conditions requiring round-the-clock care. Nursing homes can offer more extensive health care services that are unavailable in many assisted living facilities. Therefore, nursing homes can be more appropriate for those with severe health needs. As they provide critical medical support, nursing homes can help people with mobility complications or cognitive challenges that limit their autonomy. For instance, a person diagnosed with severe dementia might do better in a nursing home than in an assisted living facility. Some nursing homes have specialized memory care units for those with dementia. Nursing home staff can also provide medical care and supervision as well as help with the six activities of daily living. Like assisted living facilities, nursing homes also offer help with daily living, such as bathing or help with medication management, and can adapt to individuals’ needs. For instance, showers and bathtubs may have safety bars, and doors may be wide enough to accommodate wheelchairs. Yet nursing homes offer residents less freedom and independence than assisted living communities. Those receiving care typically do not have their own kitchens and may share a room with another patient. What Are the Costs of Assisted Living Facilities and Nursing Homes? Assisted living facilities and nursing homes can constitute a significant expense for residents and their families. According to SeniorLiving.org , the median cost of assisted living in 2021 was $4,500 per month. Because of the higher level of medical care, nursing homes tend to be more expensive than assisted living. The average cost of a shared semi-private room in a nursing home in the state of Florida averages $10,809 per month. Individuals can pay for assisted living or nursing home fees out of pocket or through long-term care insurance. Medicaid coverage, however, does extend to nursing home fees. Though Medicaid does not pay for room and board at assisted living facilities, it includes the skilled nursing care and emergency response services that residents of assisted living facilities receive. Additional Resources Before selecting an assisted living facility or nursing home, research the community and ensure it is a good fit. Trusted Elder Law & Asset Protection provides placement assistance in assisted living or nursing home placement. Our private social worker can help match you or a loved one with a facility matching their needs and wants. Compare nursing homes that interest you. There are many publications and online guides that help you find an area assisted living or nursing home and the services they each provide. If you need an experienced Elder Law attorney, please contact elder law and asset protection attorney Erich M. Niederlehner, owner of Trusted Elder Law & Asset Protection located in Pensacola, Florida and serving all in Florida or Alabama. Our on staff private social worker can help you find the home that is a right fit for you. Visit our website at www.TrustedElderLaw.com or call us at 855-ELDER-FIRM. If you need help with Medicaid planning to qualify for long-term nursing home care, estate planning for all generations and ages, probate, placement assistance with a nursing home or assisted living facility or bankruptcy asset protection services please learn how Trusted Elder Law & Asset Protection can help you and your loved ones.

Many senior citizens may need the services of a nursing home or at-home care at some point in their life. You might assume that government assistance or health insurance will step in and cover the cost if you cannot afford these services. Unfortunately, neither health insurance nor Medicare covers long-term care. Because obtaining long-term care insurance can be very expensive, Medicaid could become your only option.  Medicaid coverage is not a given, however, if you have assets or recently transferred assets, Medicaid may determine you do not qualify for coverage until a certain amount of time has passed. If this happens, you and their family can face significant medical bills. If you cannot pay, nursing homes may take you to court to get reimbursed. What steps can you take to avoid this? First, before applying for Medicaid, get a better understanding of the timelines in your state – known as look-back periods – that can affect your eligibility. Then you can engage in proper Medicaid or asset protection planning in advance of these timeframes. A good age to begin planning is around age 65, although everyone’s situation is different. Individual states run Medicaid programs, and every state has different rules regarding Medicaid eligibility. They designed these programs as a payor of last resort — in other words, to qualify, you must meet strict requirements. There are two primary types of Medicaid benefits: home care and skilled nursing home care. Look-back Periods You must apply to your local Medicaid office to qualify for these benefits. As part of this process, the state will look at any money or property you may have transferred within a certain look-back period. In New York, for example, this period will soon be 30 months for home care and 60 months for skilled nursing care. These look-back periods can have serious consequences. If you have not engaged in appropriate asset protection planning, you may not qualify for home care or nursing home care for many months. The result is that many elderly individuals must then spend down their savings and liquidate their assets to pay privately for their home care before Medicaid starts covering anything. If a person no longer has resources and is subject to a disqualification penalty period, family members may have to step in and bear these costs on their own. So, what can you do? The answer is to plan as soon as is practical. Options to Explore Speaking with an elder law attorney can help you and your loved ones explore options available to avoid you or them being personally responsible for the costs of your care. Medicaid Asset Protection Trust — One common approach is placing assets in a Medicaid Asset Protection Trust. You may be able to use this to shelter various assets, such as stock accounts, savings, a home with unprotected equity, and much more. Pooled Income Trust — Another option you may explore is contributing income that exceeds Medicaid allowances to a Pooled Income Trust. This can allow you to qualify for Medicaid while diverting excess income to a trust that pays qualified expenses on your behalf. This will enable you to benefit from the income and not spend it on things Medicaid could have otherwise covered. Spousal Refusal — Your spouse may also have options that can help you qualify for Medicaid. One such option includes exercising a right of spousal refusal — a process available in some states by which we can remove the income and assets of your spouse from consideration in your Medicaid eligibility analysis. Finally, an attorney can help you understand if certain transfers are permissible under Medicaid rules without triggering a penalty period. Without proper planning, individuals with assets and income exceeding specific state-set thresholds would have to spend this income and their assets on their care or exempt items before they can receive Medicaid benefits. For help in planning, consult with an experienced Elder Law attorney, please contact elder law and asset protection attorney Erich M. Niederlehner, owner of Trusted Elder Law & Asset Protection located in Pensacola, Florida and serving all in Florida or Alabama. Visit our website at www.TrustedElderLaw.com or call us at 855-ELDER-FIRM. If you need help with Medicaid planning to qualify for long-term nursing home care, estate planning for all generations and ages, probate, placement assistance with a nursing home or assisted living facility or bankruptcy asset protection services please learn how Trusted Elder Law & Asset Protection.