29. Paying for a Nursing Home in New York City

Paying for a Nursing Home in New York City is one of the major issues and concerns.

How can I pay for nursing home care?

Nursing Home can be quite expensive especially Nursing Homes in New York City.  It can have a huge impact on your wallet and your financial situation.

There are many ways you can pay for nursing home care. Most people who enter nursing homes begin by paying for their care out-of-pocket.

As you use your resources (like bank accounts and stocks) over a period of time, you may eventually become eligible for Medicaid.

Medicare generally doesn’t cover long-term care stays (room and board) in a nursing home. Also, nursing home care isn’t covered by many types of health insurance. However, don’t drop your health care coverage (including Medicare) if you’re in a nursing home.

Even if it doesn’t cover nursing home care, you’ll need health coverage for hospital care, doctor services, and medical supplies while you’re in the nursing home.

There are several other ways you can pay for nursing home care:

You can use your personal money and savings to pay for nursing home care. Some insurance companies let you use your life insurance policy to pay for long-term care. Ask your insurance agent how this works.

If you qualify for Medicaid, you may be able to get help to pay for nursing home care costs. Not all nursing homes accept Medicaid payment.

Check with the nursing home to see if it accepts people with Medicaid, and if it has a Medicaid bed available. You may be eligible for Medicaid coverage in a nursing home even if you haven’t qualified for other Medicaid services in the past.

Sometimes you won’t be eligible for Medicaid until you’ve spent some of your personal resources on medical care. You may be moved to another room in the Medicaid-certified section of the nursing home when your care is paid by Medicaid. To get more information on Medicaid eligibility requirements in your state, call your Medicaid office.

There are many Important things to know about Medicaid,n and how it can affect you financially when choosing the right Nursing home especially in New York City.


Paying for care

You may have to pay out-of-pocket for nursing home care each month. The nursing home will bill Medicaid for the rest of the amount. How much you owe depends on your income and deductions.

Your home

The state can’t put a lien on your home if one of these is true:

There’s a reasonable chance you’ll return home after getting nursing home care.

You have a spouse or dependents living there

This means they can’t take, sell, or hold your property to recover benefits that are correctly paid for care while you’re living in a nursing home in this circumstance.

In most cases, after someone who gets Medicaid nursing home benefits passes away, the state must try to get whatever benefits it paid for that person back from their estate.



Your assets

Most people who are eligible for Medicaid have to reduce their assets first. There are rules about what’s counted as an asset and what isn’t when determining Medicaid eligibility.

Also, states are required to let married couples protect a certain amount of assets and income when one spouse is in an institution (like a nursing home) and one isn’t.

A spouse who isn’t in an institution may keep half of the couple’s joint assets, up to a maximum of $119,220 in 2016, as well as a monthly income allowance. For more information, call your Medicaid office. You can also call your local Area Agency on Aging to find out if your state has any legal services where you could get more information.

Transferring your assets

Transfers for less than fair market value may subject you to a penalty that Medicaid won’t pay for your nursing home care for a period of time. How long the period is depends on the value of the assets you gave away.

There are limited exceptions to this, especially if you have a spouse, or a blind or disabled child. Generally, giving away your assets can result in no payment for your nursing home care, sometimes for months or even years.
Long-term care insurance

This type of private insurance policy can help pay for many types of long-term care, including both skilled and non-skilled care. Long-term care insurance can vary widely. Some policies may cover only nursing home care. Others may include coverage for a whole range of services, like adult day care, assisted living, medical equipment, and informal home care.

If you have long-term care insurance, check your policy or call the insurance company to find out if the care you need is covered. If you’re shopping for long-term care insurance, find out which types of long-term care services and facilities the different policies cover.

Also, check to see if your coverage could be limited because of a pre-existing condition. Make sure you buy from a reliable company that’s licensed in your state.

Federal employees, members of the uniformed services, retirees, their spouses, and other qualified relatives may be able to buy long-term care insurance at discounted group rates.

2. How to Choose a Residential Care Facility

Finding the right Nursing Home within New York City for your loved ones can become a tedious and hard process.  With all the Nursing Homes around, it can be quite difficult to really find the right for your loved ones.  It can be time consuming not to mention frustrating, but we all know that we will do everything no matter what for someone that we love.

If you need to go to a nursing home after a hospital stay for example, the hospital staff can help you find one that will provide the kind of care that’s best for you. Most hospitals have social workers who can help you with these decisions. If you are looking for a nursing home, ask your doctor’s office for some recommendations. 

Once you know what choices you have, it’s a good idea to ask:

How do occupants spend their evenings?

Try not to be frightened by the horde of inhabitants revolving around the medical attendants’ station or watching individuals travel every which way through the front entryway. 

 A quality nursing home will have a day by day logbook of exercises in which your parent can take an interest. On the off chance that your parent is room-bound, exercises ought to be conveyed to his or her room.

How does the staff cooperate with each other?

Listen stealthily on the associates and attendants. “In the event that the staff is impolite to each other, will be inconsiderate to your parent,”. Additionally tune in for what music is on the radio or projects are on the TV. “The music ought to be for the customers who are there, so in case you’re hearing hip-jump or hard shake then you know the chairman hasn’t the faintest idea as how to manage old individuals,”.


Do you see wounding?

Try not to accept that any beat up stamp you see on your parent is an indication of mishandle. As individuals age, their skin turns out to be more delicate and certain medicines make the skin more touchy. In any case, a few wounds ought not be overlooked. “A finger-molded wound around the upper arm is an extremely suspicious harm,”.

Likewise search for imprint molded blemishes on the face or stomach or wounds on the back, regions which are probably not going to be wounded by a fall.

How does the home handle a fall?

Falls can occur under even the best of conditions, says Stang, yet it’s vital to watch how the staff responds to one. Did they check for wounds? Did they help your parent get up off the floor securely? Is it safe to say that he was or she checked later in the move for wounds that weren’t evident at to begin with, for example, a shut head damage that would make a man demonstration more befuddled than ordinary? What’s more, how could you get some answers concerning the fall? After any fall, the staff ought to call you instantly and meet with you to decide why the fall happened and whether any progressions ought to be made, (for example, a seat caution that alarms staff when your parent gets up, or a lower bed) to shield your parent from future falls.

Are there unexplained bedsores?

Bedsores are regularly unavoidable, particularly as a parent turns out to be more debilitated and slight. “My worry would be if my cherished one were fit for being up and around and hadn’t hinted at any rejecting sustenance, yet out of the blue he’s creating bed injuries. “That is the point at which I’d converse with the staff about, ‘Why aren’t you getting him up? Why is he investing such a great amount of energy similarly situated?’ “

On the off chance that your parent is bound to a bed, ask how frequently he or she is being pivoted. This ought to compare to the specialist’s requests, which can be each hour or two, and turns ought to be set apart on your parent’s medicinal graph.

Taking care of issues

In the event that you have issues with your cherished one’s care, your first discussion ought to be with the unit administrator for your parent’s floor. On the off chance that that discussion doesn’t resolve the issue, proceed up the line of charge. “On the off chance that it’s an issue that is relentless and it’s something that is reoccurring, then we have constantly urged family to compose a grievance frame or protestation shape.

The issue ought to then be tended to inside 48 hours. On the off chance that it’s not, converse with the nursing home director. Furthermore, on the off chance that you are as yet unsatisfied, record a protest with the state office that directs nursing homes.

The Right Match

A nursing home might check all your boxes, but at the end of the day, what makes a a place excellent on paper doesn’t necessarily make it the right match for the person who’s going to be living there.

“The better nursing homes are more likely to incorporate principles of resident-centered care, which places higher priority on resident preferences. “For example, it would be a good sign if the nursing home would be flexible enough to make breakfast available even if the resident were to wake up relatively late. On the other hand, it would be a red flag if the nursing home insisted on regimented wake-up times or seemed largely unfamiliar with the concept of resident preferences.”

The Bottom Line

After narrowing down your options using ratings and your local long-term care ombudsman, visit the homes with a strong sense of what you want. Don’t be swayed by a beautiful lobby or a flawless official tour; visit unannounced and ask staff about the things that matter to you. 

Due to the stress of moving from one facility to another and the potentially life-threatening consequences of choosing a poorly managed facility, it’s important to do the research thoroughly and pick the right nursing home the first time.