Medi-Cal Planning | The Realities Of Long-Term Care

What Is Long Term Care?

Long-term care refers to the supervision and assistance that someone with a chronic illness or disability may need for an extended period of time. A person in need of long-term care usually requires assistance with activities of daily living such as eating, bathing, dressing, taking medication, and toileting. They may also require skilled nursing care, therapy, or rehabilitation services.

Likelihood of Needing Long-Term Care

The number of people who need long-term care rises every year. This is because we are living longer and because our population of persons age 65 and older is increasing. As we age, we are more likely to suffer from a chronic illness or disability that impairs our ability to perform activities of daily living. Currently, 60% of all Americans over the age of 65 need long-term care - that’s every 6 in 10 people. The percentage of women needing long-term care is even higher because they tend to live longer than men. 74% of nursing home residents age 65 and older are women.

The Cost of Long-Term Care

Long-term care is expensive. Many people have sold their homes and have spent their life savings in order to pay for long-term care. Here are some statistics on the cost of long-term care*:

• In California, the average cost of home care is more than $20,000/year.
• Nationwide, the average cost of care at a nursing home is $3,891/month or $46,692/year.
• In California, the average cost of care at a nursing home is over $50,000/year.
• The average length of stay in a nursing home ranges from 272 days to 781 days, depending on the type of nursing home one stays in. This means that you can expect to pay anywhere between $37,260 and $106,986 for your stay in a nursing home located in California.

Types of Long-Term Care Facilities

There are many types of facilities that provide long-term care. The amount or type of care that a patient receives depends on the kind of facility that he/she is staying at. For example, a skilled nursing facility provides both custodial care and skilled nursing care. But a residential care facility for the elderly provides only custodial care. Custodial care (or personal care) refers to assistance with activities of daily living such as bathing, dressing, toileting and eating. Skilled nursing care refers to care that must be given or supervised by registered nurses and rehabilitative staff such as injections, tube feeding and physical therapy.

The three main types of licensed facilities are skilled nursing facilities, intermediate care facilities and residential care facilities for the elderly. However, there are other facilities and/or programs to choose from, including:

• Adult Day Care
• Continuing Care Retirement Communities (CCRCs)
• Home Health Care
• Hospice Care Facilities
• Intermediate Care Facilities (ICF)
• Nursing Facilities (NF)
• Residential Care Facilities for the Elderly (RCFE)
• Respite Care Services
• Retirement Residences
• Skilled Nursing Facilities (SNF)
• Specialized Long-Term Care Facilities

New Nursing Home Admission Agreement Requirements

Effective January 2, 2006, all California nursing homes must use the new standard admission agreement established by the California Department of Health Services as a replacement for their own admission contracts. The standard admission agreement will help protect residents from the deceptive and illegal provisions contained in many nursing home admission contracts. The act establishing the standard admission agreement says it applies to all residents admitted on or after January 1, 2000. The standard admission agreement and background information about it are available on the California Advocates for Nursing Home Reform (CANHR) website at: http://www.canhr.org/newsroom/newdev_archive/past/AdmissionAgreement200507.html

According to the CANHR website, the standard admission agreement and the new regulations will benefit residents and their representatives by:

Clearly stating that a resident's representative assumes no personal financial liability when signing the agreement on behalf of a resident.

Fairly describing the resident's and nursing home's rights and obligations;

Prohibiting nursing homes from: (1) presenting an arbitration agreement as part of the Standard Admission Agreement; or (2) requiring residents or their representatives to sign an arbitration agreement or any other document as a condition of admission or continued stay. The top of any arbitration agreement must contain a prominent, bold-faced advisory alerting residents that they "shall not be required to sign this arbitration agreement as a condition of admission..."

All California nursing homes must use the standard agreement, including skilled nursing facilities (SNFs), intermediate care facilities (ICFs) and distinct part SNFs and ICFs.

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Contact the Kisner Law Firm today and start planning for tomorrow.

*Data sources include the CDC and Calpers.