People often use the terms “nursing home” and “assisted living” as if they are interchangeable. While both provide professional care and social support for elderly people, there are important differences which seniors and their families should be aware of.  In this blog post, nursing home abuse attorney Brent Wieand will compare nursing homes and assisted living facilities on key points like medical care, age and health, average costs, and accepted methods of payment.

Overview: Key Similarities and Differences

Nursing homes are independent communities outside of the home setting.  While architectural styles can vary, most nursing homes are reminiscent of hospitals.  Rooms may be shared or private, generally utilize smaller beds, and include only basic features and amenities.

Nursing homes are geared toward older residents, typically at least 65 years of age, and provide around-the-clock care by staffing nurses and other medical personnel 24 hours a day.  Nursing homes offer in-home events and activities for residents, and may bring residents on occasional supervised outings.

Assisted living facilities rose to prominence as a response to the somewhat “industrial” or “institutional” setting found in most nursing homes.  While assisted living facilities are also set outside the home, they tend to be more private and personal than nursing homes.  Most residents live in private rooms, although dining is communal.

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Cost of Care and Types of Payment Accepted

Even with great insurance coverage, U.S. medical care is often a major expense.  Fortunately, as we covered in our blog post about Medicare and Medicaid coverage, many nursing homes do accept these forms of payment.  Better still, you automatically become eligible for Medicare simply by turning 65 years old, provided the following statements are true:

  • You are either a U.S. citizen or permanent legal resident.
  • Either your or your spouse has worked for at least 10 years, which is the usual amount of time it takes to accumulate 40 “work credits” under SSA guidelines.

Medicaid, which helps pay for “long-term care” like nursing home care, is available to low-income individuals who don’t have significant assets or financial resources.  Pennsylvania’s Medicaid program covers a wide variety of care costs under various waivers.  For example, if you’re 60 or older and meet certain medical standards, you may be covered by the Aging Waiver.

The Pennsylvania Health Care Association (PHCA) reports the following payment method statistics for in-state nursing homes:

  • 47% — Medicaid
  • 23% — Medicare
  • 23% — Out-of-pocket
  • 4% — Veterans’ benefits, state benefits
  • 3% — Private healthcare insurance

While the majority of Pennslyvania homes do accept Medicare and/or Medicaid, they are not necessarily required to by law.

The PHCA reports the following median costs in Pennsylvania:

  • Nursing Homes
    • Monthly — $8,957
    • Annual — $107,493
  • Assisted Living 
    • Monthly — $3,280
    • Annual — $39,360

Interestingly, Pennsylvania’s median cost for assisted living is several thousand dollars lower than the national median, while its median cost for nursing home care is nearly $20,000 higher than the national rate.

Assisted living is not covered by Medicare, but may be covered by Medicaid depending on your eligibility.

paying for nursing home care

Age, Health, and Medical Treatment

As mentioned above, nursing homes are geared toward clients who are advanced in age and/or suffer from severe medical problems.  For example, the CDC (Centers for Disease Control and Prevention) reports that in U.S. nursing homes in 2012, nearly 50% had a diagnosis of Alzheimer’s Disease, while about 49% had a diagnosis of depression.

Unlike nursing homes, assisted living facilities do not offer around-the-clock medical care, which helps to explain why their costs are so much lower.  Consequently, assisted living residents tend to be younger and healthier than nursing home residents, as they simply do not require the same degree of professional medical help.  If the health of an assisted living resident begins to deteriorate, it may be time to consider making the transition to a nursing home.  Assisted living facilities do not have the medical resources necessary to tend to patients with severe illnesses or injuries.

If you’re thinking about placing your parent or elderly loved one into a nursing home or assisted living facility, it’s very important to carefully consider all of the benefits and drawbacks before making a decision.  Talk to your loved one about his or her options, and be sure to take advantage of Medicare Compare, a free nursing home comparison service provided by the federal government.

With Medicare Compare, you can measure homes by criteria such as staff to resident ratios, the frequency of health and fire safety inspections, and federal fines for violations.  The Medicare Compare tool also allows users to explore nursing home alternatives, locate local resources, and compare individual physicians.

To set up a free and confidential consultation, call nursing home injury lawyer Brent Wieand today at (800) 481-5206.