Rossman PC Logo

Long Term Care Planning

What Is Long-Term Care Planning?

Long-term care planning is the planning done by an individual or couple with a skilled elder law attorney to prepare for the cost of longterm care.

Long-term care, especially skilled nursing careis incredibly expensive and, if not properly planned for, can wipe out a couple’s savings. Typically, Medicaid will not cover longterm care unless the individual requires skilled nursing care and requires assistance with two activities of daily living (ADL), which include the following:

  • Eating
  • Dressing
  • Bathing
  • Incontinence care
  • Toilet needs
  • Medication management
  • Mobility
senior grandmother

How is Nursing Home Care Paid For?

It is crucial to work with a skilled elder law attorney when attempting to secure Medicaid benefits to pay for skilled nursing home care. Timing is an important element in securing coverage and it is important it is done when the individual is discharged to a nursing facility on their Medicare days. This means that the planning is done in up to 100 days of skilled services or rehabilitation provided by the nursing facility. This will secure coverage for the period after Medicare no longer covers the stay and the benefits will be retroactive to the first day of the month in which Medicaid was applied.

However, qualification is complicated in and of itself, and a skilled elder law attorney will assist you in navigating Medicaid’s many complicated rules. It is a common misunderstanding of Medicaid that a person has to be destitute to be covered by Medicaid. This is simply not true, but it requires the guidance of an elder law attorney to be done correctly.

In regard to nursing home care, the situation is more complicated. So, it’s vital to meet with an elder care attorney before placing someone in any facility. An elder care attorney will help protect assets and explain Medicare/Medicaid rules. Public programs do cover some costs in certain situations. It’s important to understand what’s covered before entering a long-term care facility.

Who Provides Long-Term Care?

Typically, when a family member initially needs long-term care, the needs start out minimal and the care is provided for by a loving family member. Sometimes the family member is compensated, but oftentimes not. It is important if the family member is compensated, that the compensation follows the strict Medicaid rules regarding caregiving contracts; otherwise, this compensation can be viewed as a gift in the eyes of Medicaid which can result in the disabled individual needing Medicaid services to be penalized. This care typically helps disabled adults stay in their residence for months or even years prior to needing to be moved to a skilled nursing facility.

A family member is typically moved to a skilled nursing facility when the services required to assist the individual are required on a 24-hour basis or require a substantial amount of physical labor and exertion. Assisted living is typically the first option families explore, but is not covered under Medicaid, nor are memory care facilities.

Nursing homes provide more advanced care than assisted living centers. A nursing home may handle more complex healthcare conditions. A nursing home also may provide physical, speech, and occupational therapy.