When your mother needs care in a nursing home, there is a lot of pressure on you to get her care right. Mom took care of you for so long it is difficult to switch roles and realize that mom is the one who needs care now. Greatly adding to this pressure is the confusion that surrounds nursing home placement—choosing the correct facility, knowing your rights in the facility.
There is no nursing home in which you would want to live if given a choice. For instance, there are no healthy thirty-year-olds who are signing up to live in a nursing home. But for some people, living in a nursing home is necessary because the person needs care.
The United States government ranks nursing homes. If you visit Medicare.gov, there is a five-star ranking system for nursing homes, which rates nursing homes on health inspections, staffing, and quality measures, to obtain a composite score. While I believe this rating system to be of some value—I certainly would not place my mom in a one-star facility for instance—recent reports indicate that the nursing home reports much of the information to Medicare.gov, meaning that that ranking system is based primarily on self-reporting.
In my opinion, nothing can substitute for actually visiting the nursing home and seeing for yourself the happenings at the facility. How does the facility smell? Is the staff engaging the residents or are the residents clustered around the front door sitting in the wheelchairs. You can use Medicare.gov as a starting point to find nursing homes in your area and to see how those facilities rank, but nothing beats actually looking at the facilities.
I also do not think that someone else can refer you to a nursing home. Which nursing home will appeal to you is a personal choice. I have had clients tell me that they like nursing homes that I do not like and do not like nursing homes that I like. Once you find a nursing home that has a good rating on Medicare.gov and that appears good (it does not smell, the residents seem engaged), then the nursing home you like is a matter of taste.
I would recommend that you choose a nursing home for your mother that is close to your house. You will have to visit often and there will be issues with your family member’s care no matter how good the nursing home, so choosing a nursing home close to your house is a good idea.
Once your family member is secure in a good nursing home, how do you pay for the home? Nursing homes cost anywhere from $10,000 to $15,000 a month, so they are not inexpensive. Since long-term care can last a long-time, $15,000 a month (or $180,000 per year) can add up quickly.
When it comes to paying for a nursing home, the staff of the nursing home is an expert, and you are a neophyte. They are in business of running nursing homes. For you, this is a new, scary experience. This knowledge imbalance often leads to those with knowledge saying things that are less than truthful to those without knowledge because they can get away with saying those untruths.
There are primarily two ways to pay for a nursing home—privately ($15,000 a month or $180,000 a year) or with Medicaid benefits. Medicaid is a government program for needy individuals. I have qualified thousands of clients for Medicaid benefits. People who never thought they would qualify for this program have qualified.
Just about every nursing home in New Jersey accepts Medicaid as payment. Medicaid is payment in full for the nursing home. Nursing home are prohibited by law from treating Medicaid beneficiaries differently than privately paying residents. In most nursing homes, 45% to 100% of the residents are Medicaid beneficiaries.
Most every bed in a nursing home is Medicaid certified. Nursing home staff will often say, “We don’t have a Medicaid bed right now,” but the truth is, in most nursing homes, every bed is a nursing home bed. Nursing homes cannot require private payment for any length of time before the resident qualifies for Medicaid, and nursing homes cannot ask a family member to pay for their loved one’s care.