Managing the Cost of Skilled Nursing Care

Dear Averi:

My aging mother needs more help than I can provide for her. In my conversations with various continuing care retirement communities, I think that skilled nursing would probably be the best option. What do I need to do? Any advice would be helpful.

Sincerely,

Dora

Dear Dora,

You have provided a great service by caring for your mother until now. It is not uncommon for a family member to transition the care of a loved one to healthcare professionals to ensure that they receive proper care and support. First, you will need to find a center that provides the level of care that your mother needs. Having her admitted involves the following steps:

Medical Records

The process begins with clinical information. Your mother’s primary care physician can give her a physical and provide you with a copy of her medical history, medications, and notes from home healthcare service providers, if applicable.

Level of Care Evaluation

The center will review your mother’s clinical information to determine whether her condition requires skilled nursing or long-term care.

Financial

Medicare

If your mother has recently been hospitalized for 3 or more nights, Medicare may cover the cost of skilled nursing.

Medicaid

Although Medicaid does not pay for skilled nursing care, it does cover room and board for long-term care if a Level of Care analysis is done before admission.

Managed-Care Insurance

Therapy notes need to be evaluated by the insurance company before her admission to a skilled nursing center can be approved. Like Medicare, most managed-care insurance companies will only pay if skilled care is necessary and will not cover long-term care expenses.

Long-Term Care Insurance

Each policy is different but many long-term care insurance policies help cover room and board for an older adult. We can help review your mother’s policy to see if it covers long-term care.

Self-Pay

If your mother does not have insurance coverage for skilled nursing or rehab care, you will need to arrange for payment from private resources. A deposit check may be required at admission.

I know this transition can be difficult. If you have any questions, please feel free to call me directly. I will be glad to walk you through the process!

Sincerely,

Averi Bruce
Admissions Director