Lucille has lived in her home for 33 years. Even after her husband died 3 years ago, she was able to manage on her own. Recently, she broke her hip and now needs a wheelchair to get around. At 82, she is no longer able to be on her own. Her children all have busy lives. How are they going to care for their mother?
There are many long-term care choices that Lucille's family might look into—one of them is a nursing home.
A nursing home, also known as a skilled nursing facility, is a place for people who don't need to be in a hospital but can no longer be cared for at home. Being admitted to a nursing home is based on medical need. Most nursing homes have aides and skilled nurses on hand 24 hours a day. Talk to the doctor to find out if a nursing home is the best choice.
Nursing homes can be:
Some nursing homes have visiting doctors who see their patients on site. Other nursing homes have patients visit the doctor's office. Nursing homes sometimes have separate areas called Special Care Units for people with serious memory problems, like dementia. When looking for a nursing home, it's important for families to think about special needs.
If you are looking for a nursing home here are some things to keep in mind:
The Centers for Medicare and Medicaid Services (CMS) asks each State to inspect any nursing home that gets money from the Government. Homes that don't pass inspection are not certified. Ask to see the current inspection report and certification of homes you are thinking about. Visit www.medicare.gov for more information.
People pay for nursing home care in many ways:
Many people believe Medicare will pay for long stays in a nursing home, but it doesn't. For example, Medicare will only cover the first 100 days in a skilled nursing home for someone who needs special care after leaving the hospital. State/Federal Medicaid programs may pay for long-term nursing home care, but there are many rules about qualifying. It is important to check with Medicare, Medicaid, and any private insurance company to find out the current rules.
When thinking about costs, keep in mind that there can be extra out-of-pocket charges for some supplies, personal care like hair appointments, laundry, and services that are outside routine care.
The rules about programs and benefits for nursing homes can change. Medicare has some helpful resources online. Visit www.medicare.gov for information about different care options. To learn more about the Medicaid program, see www.cms.hhs.gov/home/medicaid.asp.
You can find nursing homes in your area that are approved by the Centers for Medicare & Medicaid Services by visiting the Medicare website. You can also see summaries of recent inspection reports. Visit Nursing Home Compare at www.medicare.gov/NHCompare. The Nursing Home Checklist at the same website is a good guide to use when thinking about choosing a nursing home.
Many States have State Health Insurance Counseling and Assistance Programs (SHIP). These programs can help you choose the health insurance that is right for you and your family. Visit www.medicare.gov/Nursing/Payment.asp.
Each State also has a Long-Term Care Ombudsman office that helps people learn about long-term care. Your local office may be able to answer general questions about a specific nursing home. Also, once you are living in a nursing home, the Ombudsman can help solve problems you may have with a facility. The National Long-Term Care Ombudsman Resource Center has more information. Visit www.ltcombudsman.org.
A veteran in need of long-term care might be able to get help through the Department of Veterans Affairs (VA). Visit www.va.gov or call VA Health Care Benefits toll-free at 1-877-222-8387. You can also contact a VA medical center near you.
Here are some helpful resources:
AARP
601 E Street, NW
Washington, DC 20049
1-888-687-2277 (toll-free)
1-877-434-7598 (TTY/toll-free)
www.aarp.org
American Health Care Association
1201 L Street, NW
Washington, DC 20005
1-202-842-4444
www.ahca.org
Centers for Medicare & Medicaid Services
7500 Security Boulevard
Baltimore MD 21244-1850
1-800-633-4227 (toll-free)
www.medicare.gov
Department of Veterans Affairs
VA Benefits: 1- 800-827-1000 (toll-free)
1-800-829-4833 (TTY/toll-free)
www.va.gov
FirstGov for Seniors
www.seniors.gov
Leading Age
2519 Connecticut Avenue, NW
Washington, DC 20008
1-202-783-2242
www.leadingage.org
National Citizens' Coalition for Nursing Home Reform
1828 L Street, NW
Suite 801
Washington, DC 20036
1-202-332-2275
www.nccnhr.org
National Long-Term Care Ombudsman Resource Center
1828 L Street, NW
Suite 801
Washington, DC 20036
1-202-332-2275
www.ltcombudsman.org
For more information on health and aging, including the publication There's No Place like Home for Growing Old, contact:
National Institute on Aging
Information Center
PO Box 8057
Gaithersburg, MD 20898-8057
1-800-222-2225 (toll-free)
1-800-222-4225 (TTY/toll-free)
www.nia.nih.gov
www.nia.nih.gov/espanol
For information on Alzheimer's disease, contact:
Alzheimer's Disease Education and Referral Center (ADEAR)
PO Box 8250
Silver Spring, MD 20907-8250
1-800-438-4380 (toll-free)
www.nia.nih.gov/alzheimers
To sign up for regular email alerts about new publications and other information from the NIA, go to www.nia.nih.gov/health.
Visit NIHSeniorHealth (www.nihseniorhealth.gov), a senior-friendly website from the National Institute on Aging and the National Library of Medicine. This website has health information for older adults. Special features make it simple to use. For example, you can click on a button to have the text read out loud or to make the type larger.
National Institute on Aging
National Institutes of Health
U.S. Department of Health and Human Services
Publication Date: August 2009
Page Last Updated: May 1, 2012