The employees at long term care facilities (LTCFs) have many unmet needs. They lack adequate compensation, work in cramped conditions, have to travel by public transportation, and often have competing family responsibilities. Additionally, many LTCFs do not provide health insurance or paid sick leave and may be lacking in personal protective equipment. Sadly, these conditions make it difficult for them to provide the care and attention that are needed.
Medicaid
Depending on the state, some states offer a wider variety of home and community-based services. Medicaid long-term care facilities may provide emergency response systems, homemaker services, adult day care, and home modifications. For those who do not qualify for Medicaid, there are other options, such as private pay or assisted living residences. Unlike Medicaid entitlements, however, these programs do not cover the cost of room and board. Medicaid recipients must apply and wait for a slot.
If you need long-term care, contact your state’s Area Agency on Aging or a qualified elder law attorney who is experienced in Medicaid planning in your state. Medicaid agencies may also provide information on Medicaid planning in your state. Further, Medicaid agencies provide information on Medicaid requirements in your state. Once you have contacted a Medicaid agent in your state, make sure you know the eligibility requirements for long-term care. In addition, make sure to contact the Medicaid office in your state.
Medicare
In the U.S., Medicare long-term care facilities can provide long-term care services to eligible beneficiaries. While Medicaid provides coverage for skilled nursing facilities, private insurance may cover some or all of the costs of such services. There are many types of facilities and their staffing levels can vary widely. Some facilities may be more expensive than others, so it is important to consider the quality of care and costs before deciding which one to use.
Original Medicare is the most common type of long-term care insurance, covering only a portion of the costs. Medicare Advantage is evolving to include long-term care benefits. In addition to private insurance, there are public assistance programs, such as government grants and non-profits. The Veteran’s Administration offers funding for the purchase of long-term care insurance. This type of policy covers varying amounts of long-term care costs, but it is not cheap.
In-home care
Long-term care can take many forms, from short-term recovery care to ongoing support in the person’s home. Most long-term care is provided in the person’s own home, by family members or hired caregivers. The services may involve personal care, such as cooking, cleaning, and transportation. A care provider may work in a private home or an assisted living community. Both types of services offer a variety of benefits to the recipient.
In-home caregivers may be hired privately or through a long-term care insurance policy. Home care providers should be licensed, bonded, and insured. Another option is the care-recipient’s income and assets. Family members are willing to pay for in-home care if their loved one prefers to remain in their home. Many people opt to have their loved one cared for by a private caregiver.
Nursing homes
A new program is in the works to improve the quality of nursing homes and long-term care facilities. The program will expand enforcement actions against low-performing facilities, based on desk reviews as well as on-site inspections. In July 2021, CMS will reverse a change made by the Trump Administration that reduced the penalty amount for harmful deficiencies and bad actors. CMS will explore the possibility of reducing penalty amounts to a per-day basis.
The COVID-19 pandemic will likely accelerate the trend of expanding HCBS and may lead to a fundamental re-conceptualization of nursing home care. The pandemic, however, will not eliminate nursing homes, the institutional model, or underfunding for the system. The authors of the policy brief Being Mortal: Improving Nursing Homes and Long-Term Care Facilities
Assisted living
Assisted living services are designed to provide assistance with activities of daily living, including personal hygiene, medication management, and housekeeping. Residents are encouraged to bring personal items, furniture, and other belongings, and staff members are available 24 hours a day. Assisted living facilities also offer 24-hour supervision. Depending on the level of care needed, assisted living facilities may include physical therapy, social programs, and activities. A resident’s medical and social needs will be assessed upon moving into the facility.
Seniors are more likely to develop a variety of health problems and injuries. As these conditions worsen, they may experience increasing feelings of loneliness and sadness. These feelings may lead them to withdraw from activities and friends. Assisted living communities can help them address these issues and foster self-sufficiency. Assisted living facilities are ideal for seniors whose physical and mental abilities make it difficult to perform daily activities on their own.