Nursing home care can be one of the most expensive costs for the elderly. Most people don’t expect to have to stay in a nursing home. However, when you get, or a loved one gets sick, this unexpected expense can devastate your finances.<\/p>\n\n\n\n

The\ncost of nursing home care is expensive, but it’s because of the high cost of\nstaffing, medications, facility cost, and more. Nursing homes need to charge\nhigher rates to cover the cost of doing business as well as make a profit. <\/strong><\/p>\n\n\n\n

The insurance companies pay the nursing homes based on the fee schedule set by the nursing home. If they set the fee schedule too low, they stand to be reimbursed at a lower rate.<\/p>\n\n\n\n\n

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Prices\nof nursing homes have increased year after year. It doesn’t look like the price\nof nursing home stay is going to decrease in the near future. Rents for the\nhomes, staffing costs, and medication prices go up year after year.<\/p>\n\n\n\n
There\nare also ancillary charges that get passed onto the consumer. The homes provide\nhealth insurance and benefits to their employees. The cost of health insurance\nhas increased for many insurances by greater than 10% year after year. There is\nalso an increase in workman’s cost insurance and liability insurance.<\/p>\n\n\n\n
Some\nnursing homes have their rates set by the state. Mandated rates usually result\nin lower prices than other states that are not regulated.<\/p>\n\n\n\n
Why\ndoes it cost so much?<\/strong><\/h2>\n\n\n\n
There are many things that the nursing home must provide for the resident. The high cost of delivering care includes medications and medication management, housing costs, television, food\/beverage, 24\/7 nursing, CNA support, and so much more.<\/p>\n\n\n\n
There\nis also entertainment provided by the nursing home at no additional cost such\nas bingo, arts and crafts, and more. There are also movie nights and group\ndining events on holidays.<\/p>\n\n\n\n
When\nyou consider the price of staying at a hotel, the cost isn’t so extravagant.\nSome people have said, “I’ll just go stay on a cruise ship all year and\nhave access to a doctor, food, and a place to stay.” <\/p>\n\n\n\n
There\nis also the high cost of medications that are usually covered by medical\ninsurance. However, there are sometimes secondary insurance issues or lapses in\ncoverage. With a short term stay at a nursing home, the medications are considered\npart of a “bundle” package. The more medications you are prescribed,\nthe less the facility makes.<\/p>\n\n\n\n
According\nto the national conference of state\nlegislators<\/a>, “In 2018\nthe average annual premium for employer-based family coverage rose 5% to\n$19,616 for single coverage, premiums rose 3% to $6,896. Covered workers\ncontributed 18% of the cost for single coverage and 29% of the cost for family\ncoverage, on average, with considerable variation across firms.”<\/p>\n\n\n\n
According\nto Genworth financial<\/a>, Every day until 2030, 10,000 Baby Boomers will\nturn 65, and 7 out of 10 people will require long term care in their lifetime.\nIn Connecticut, the yearly cost of nursing home care is $152,388 for a\nsemiprivate room.<\/p>\n\n\n\n
Not\nonly is their nursing support, but you also have access to physical therapy,\noccupational therapy, dietary, speech therapy, advanced practice nurses, and\ndoctors while you are in the nursing home. <\/strong>Getting\naccess to care like this is possible but very challenging in the home setting. <\/p>\n\n\n\n
The\nprivate cost of having these services in your home can quickly add up to\nthousands of dollars when done similar to a nursing home level of care.<\/p>\n\n\n\n
With\nthe majority of the cost of nursing home stay going to cover the cost of the\nmedical staff, you can see how the pricing of staying at a nursing home won’t\nbe cheap.<\/p>\n\n\n\n
Some\nother ancillary things driving up the cost of care are placement agents that\ncan often charge the facilities a “referral fee.” These “finders\nfees” that are charged by the placement agency’s can range from\n$2000-$10,000. <\/p>\n\n\n\n
These\nplacement agencies are usually for assisted living facilities. However, some\nnursing homes use their services when the census is low with open beds. <\/p>\n\n\n\n
Nearly\n70 percent of today’s 65-year-olds will need long term care at some point\naccording to the US Department of Health and Human Services. With so many of\nuse potentially needing services, this means that many of us will need to find\na way to pay for services. <\/p>\n\n\n\n
Medicare\nwill pay for short term stays but not long term. Medicaid, on the other hand,\nwill provide long term care coverage, but only if you qualify.<\/p>\n\n\n\n
There\nis also long term care insurance, which can help you pay for your long term\ncare stay. According to Clark Howard<\/a>, there are different forms of long term insurance.<\/p>\n\n\n\n
Traditional stand-alone long-term care insurance<\/li>
Hybrid life\/long-term care products<\/li>
Life insurance with an acceleration rider<\/li>
Annuities with a long-term care rider<\/li><\/ul>\n\n\n\n
Your room at the nursing home:<\/strong><\/h2>\n\n\n\n
Most people who stay in a nursing home will have a roommate or two, depending on the facility. Fewer facilities have rooms with three to four people compared to the recent past. <\/p>\n\n\n\n
As nursing homes increased their competition of Medicare A beds, they shifted their model to either one roommate of single rooms.<\/p>\n\n\n\n
Most\nrooms will include a closet and a dresser that can usually often be locked for\nprivacy and security. You will also have a bed, which depending on the\nfacility, will vary from manual to electric. There are other bed options based\non your specific ailment (i.e., Air mattress).<\/p>\n\n\n\n
Some\nfacilities will provide a TV with cable, while others will charge you\nadditionally for cable TV. <\/p>\n\n\n\n
Many\nyounger residents bring in DVD or gaming systems to help pass the time. Gaming\nsystems and DVD players are not usually included in the cost of the stay.<\/p>\n\n\n\n
There isn’t a refrigerator in the rooms unless it is a higher-end nursing home. Not having a fridge isn’t an issue because there usually is a refrigerator on the floor that is shared by residents. Hopefully, nobody takes or eats your food and drink which happens from time to time.<\/p>\n\n\n\n
You will also want to make sure you have the ability to have a family be able to stay the night. Make sure there will be room for a lounge chair so that your family member can sleep over sometimes. If you want to learn more, check out the article “Do nursing homes allow overnight guests?<\/a>“<\/p>\n\n\n\n
Medical\nCare:<\/strong><\/h2>\n\n\n\n
With\nmost short-term stays, if you have Medicare and right secondary insurance, the\nbulk of your stay will be covered.<\/p>\n\n\n\n
Occasionally\nthere may be extra charges for medical services:<\/p>\n\n\n\n
Medications that are not covered by your insurance<\/li>
Requests for specific OTC remedies<\/li>
Vitamins and minerals not commonly prescribed in this setting<\/li>
Homeopathic remedies<\/li>
High-end medicines<\/li>
Extra physical therapy and occupational therapy after you have completed your regular therapy.<\/li><\/ol>\n\n\n\n\n
<\/div>\n\n\n\n\n
Many medical services are included\nwith your general stay under your Medicare insurance benefits such as physical\ntherapy, occupations therapy, speech therapy, dietary consultants, access to\nlicensed practical nurses, and registered nurses.<\/p>\n\n\n\n
There\nwill also be a medical director that oversees the care provided to the\nresidents. This medical director may or may not be assigned to you during your\nstay. You will be assigned an attending physician to oversee your medical care\nduring your stay.<\/p>\n\n\n\n
Additional\ncosts of medical care include:<\/p>\n\n\n\n
IV therapy (IV antibiotics and hydration)<\/a><\/li>
Laboratory and diagnostic testing<\/li>
Medications for treatment including many over the counter medications<\/li>
Tube feedings<\/li>
Oxygen therapy, along with suctioning in some facilities.<\/li><\/ul>\n\n\n\n
There\nis also the cost of personnel that provides medical care for the residents.\nEach facility is required to provide specific medical staff.<\/p>\n\n\n\n
Director of nurses: average salary per salary.com $109,358\/year<\/li>
A registered nurse who usually acts as a supervisor: $79,893\/year<\/li>
Licensed practical nurse: Multiple nurses on any given shift with average salary $48,722\/year<\/li>
Certified Nursing Assistants: $29,429\/year with multiple employees working each shift<\/li>
The Administrator of the nursing home: $115,050\/year per Salary.com<\/li>
Social workers: $51,852\/year average nationwide<\/li><\/ol>\n\n\n\n
These are just national averages,\nwith some staff making more and some less than the national average. Some of\nthe larger nursing homes have assistant administrators. <\/p>\n\n\n\n
Most\nof the homes have assistant directors of nursing with average yearly salaries\nof $74,781.<\/p>\n\n\n\n
There\nare other specialty roles in nursing homes, including infection control nurses,\nwound nurses, and other ancillary medical staff.<\/p>\n\n\n\n
All\nthis staffing is valuable to the care of the resident but drives up the total\ncost for the nursing home. <\/p>\n\n\n\n
Advanced\nPractice Nurses (APRNs):<\/strong><\/h2>\n\n\n\n
If you are lucky enough, you will\nhave access to Advanced Practice Registered Nurses, who are at the nursing home\nto provide medical care to the residents. APRNs work\ncollaboratively with the doctors to care for the sick residents. Advanced\npractice registered nurses are often in the facilities more often than\nattending physicians. <\/p>\n\n\n\n
They\nprovide many of the same services as the doctor. They work hand in hand with\nthe attending physician, keeping them aware of what is going on with their\nresidents. This team approach allows for increased care for the resident at no\nadditional charge to the nursing home. <\/p>\n\n\n\n
The\nAPRN’s services are billed through the patient’s insurance company. The doctors\nwill also charge the patient’s insurance when they see the patient for medical\nvisits. The doctors sometimes are paid a “stipend” to provide\nservices by the nursing home.<\/p>\n\n\n\n
There\nare cases when the nurse practitioner is employed by the nursing home to\nprovide medical services. When they are employed, it is an additional staffing\ncost that the nursing home will need to cover.  <\/p>\n\n\n\n
Due to the high salaries, APRNs are paid, most homes chose to use third-party companies such as InHouse Care LLC<\/a>. The APRN companies provide services at no additional cost to the nursing home.<\/p>\n\n\n\n
Non-medical\npersonnel:<\/strong><\/h2>\n\n\n\n
There will be costs to the nursing\nhome that they will need to pass on to their customers in the form of ancillary\npersonal. These are the people who cook the food, clean the facilities, provide\noperational support, billing personnel, admissions staff, liaisons to\nhospitals, front desk clerical staff, laundry workers, maintenance staff, and\nmore.<\/p>\n\n\n\n
Union\nfacilities:<\/strong><\/h2>\n\n\n\n
Not taking into account the level\nof care, facilities that have union workers will have higher labor costs when\ncompared to nonunion facilities. Unionization can result in higher per cost per\nday to the resident to cover the higher labor costs.<\/p>\n\n\n\n
Operating\nexpenses:<\/strong><\/h2>\n\n\n\n
There\nare high costs of turning on the lights, heating and cooling the facility and\nproviding electricity to the building. <\/p>\n\n\n\n
The\nmaintenance staff is continually repairing rooms, roofs, windows, and more. Not\nonly does this increase labor costs, but also the cost of materials to do the\nrepairs add to the price of running the business. <\/p>\n\n\n\n
Since\nnursing homes are commercial businesses, they often have to pay a premium to\nuse licensed plumbers, electricians, and other tradespeople.  <\/p>\n\n\n\n
Medical Supplies:<\/h2>\n\n\n\n
The\nprice of medical supplies has gone up year after year. The facilities need to\npurchase these supplies to provide care to the resident. These supplies include<\/p>\n\n\n\n
Wound dressings<\/li>
Syringes<\/li>
Diabetic testing supplies<\/li>
Wound cleaning supplies<\/li>
Eye drops<\/li>
Sharps containers (you would be amazed at how much it cost to handle medical waste and sharps)<\/li>
Adult undergarments<\/li>
Hoyer lifts<\/li>
Scales for weighing patients (rarely the cheap scales you buy at the local Walmart)<\/li>
IV supplies<\/li><\/ul>\n\n\n\n
Insurance\ncost:<\/strong><\/strong><\/h2>\n\n\n\n
Workman’s\ncompany insurance, health insurance, and liability insurance all drive up the\ncost of doing business. Workman’s comp and health insurance for the employees\nare a couple of the largest expenses to the nursing home.<\/p>\n\n\n\n
There\nare other types of insurance that many facilities pay for, such as cyber\ninsurance, medical director insurance, and more.<\/p>\n\n\n\n
There\nis also the price of the electronic health record (EHR) that is used by the\nfacility for documentation, medication management, and more. <\/p>\n\n\n\n
Many of the electronic health record systems cost thousands of dollars each month and increase labor costs for documentation time and effort.<\/p>\n\n\n\n
The cost of staying in a nursing home can be high<\/a> if you do not have insurance. Try to plan ahead when you are younger or not sick when it comes to planning for your future. <\/p>\n\n\n\n
Conclusion:<\/strong><\/strong><\/h2>\n\n\n\n
The\nprice of a nursing home stay appears on the surface to be expensive. However,\nwhen you take into account all the costs associated with running a nursing\nhome, you can see why the price is what it is, and probably should be higher.<\/p>\n\n\n\n
All\nbusinesses need to make a profit, and it has become harder and harder for\nnursing homes to make a profit. Insurance companies are not increasing\nreimbursement for medical care at the same rate of increases for other services.<\/p>\n\n\n\n
Many\nnursing homes are going out of business because of the low reimbursement rates\nthat state insurance pays. The reimbursement rates from state insurance barely\ncover the cost of room and board, never mind the price of medical care.<\/p>\n\n\n\n
The\nnursing homes need to charge higher rates to offset the services for which they\nare not reimbursed. <\/p>\n\n\n\n
Some\npeople’s insurances lapse, or they are not updated correctly, while other\nprivate pay residents don’t pay their bills. There are also incidents of\nresidents who\u2019s insurance is maxed out, and they refuse to leave. The facility\nnow needs to go through the process of getting them out of the facility. This\ncosts time and money spent on attorneys or staff following the legal process.<\/p>\n\n\n\n
Medicare\noffers limited coverage (up to 100 days per benefit period) for some\nbeneficiaries. If you are worried about the price of a stay at a nursing home\nwill deplete your resources, you should look into Long Term care insurance.\nThere are many options available to the public, and you will need to research\nyour options.<\/p>\n\n\n\n
Make\nsure to investigate payment options long before a major health event occurs. If\nyou wait too long, many of the options for coverage assistance will no longer\nbe available. There will be secondary insurances that can cover what Medicare\nwill not cover. <\/p>\n\n\n\n
They’re\nalso ways to protect your finances as you get older. You will need to speak\nwith a professional with knowledge of long-term care prior to making decisions.<\/p>\n\n\n\n
If\nyou or your spouse is a veteran, there are programs set up to assist you with\nfinancial aid if you qualify. Some companies will help you with getting support\nbut do your research to see if they are reputable companies.<\/p>\n\n\n\n
Finally,\nyou can always negotiate a reduced private pay rate with some nursing homes.\nEspecially if they do not have a waiting list or they have a low census. The\nnursing homes would rather have some money coming in to cover the operating\ncost and may be willing to come up with a fair rate for all.<\/p>\n\n\n\n\n
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References:<\/strong><\/h3>\n\n\n\nCarol Marak. Nursing Home Costs, Nursing Home Costs by\nState. https:\/\/www.skillednursingfacilities.org\/resources\/nursing-home-costs\/<\/a> Retrieved\nDecember 3, 2019<\/p>\n\n\n\n
Cost of\nCare. Find your path Forward, US Department of Health and Human Services.  https:\/\/longtermcare.acl.gov\/costs-how-to-pay\/costs-of-care.html<\/a> Retrieved\nDecember 3, 2019<\/p>\n\n\n\n
David\nLevine. (July 10, 2019) How to Pay for Nursing Home Costs. https:\/\/health.usnews.com\/best-nursing-homes\/articles\/how-to-pay-for-nursing-home-costs<\/a>.\nRetrieved December 3, 2019<\/p>\n\n\n\n
Maryalene\nLaPonsie<\/a>. (March 22, 2017). 5 scary facts about nursing home costs\n(and what to do about them). https:\/\/clark.com\/insurance\/facts-about-nursing-home-costs\/<\/a> Retrieved\nDecember 1, 2019<\/p>\n\n\n\n
Victoria Sackett,\u00a0 AARP<\/a>, (October 24, 2018). Nursing Home Costs Top $100,000 a Year, Survey: As charges skyrocket for long-term care facilities, increases in home-care costs are more moderate.\u00a0 https:\/\/www.aarp.org\/caregiving\/financial-legal\/info-2018\/nursing-home-costs-rising.html<\/a>\u00a0Retrieved December 3, 2019<\/p>\n\n\n\n \n $\"\"$