National Institute on Aging. What Is A Nursing Home?

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1 Natioal Istitute o Agig AgePage Nursig Homes: Makig The Right Choice Lucille has lived i her home for 33 years. Eve after her husbad died 3 years ago, she was able to maage o her ow. Recetly, she broke her hip ad ow eeds a wheelchair to get aroud. At 82, she is o loger able to be o her ow. Her childre all have busy lives. How are they goig to care for their mother? There are may log-term care choices that Lucille s family might look ito oe of them is a ursig home. What Is A Nursig Home? A ursig home, also kow as a skilled ursig facility, is a place for people who do t eed to be i a hospital but ca o loger be cared for at home. Beig admitted to a ursig home is based o medical eed. Most ursig homes have aides ad skilled

2 urses o had 24 hours a day. Talk to the doctor to fid out if a ursig home is the best choice. Nursig homes ca be: F Hospital-like. This type of ursig home is ofte set up like a hospital. Staff give medical care, as well as physical, speech, ad occupatioal therapy. There ca be urses statios o each floor. As a rule, oe or two people live i a room. A umber of ursig homes will let couples live together. Thigs that make a room special, like family photos, are ofte welcome. F Household-like. These facilities are desiged to be more like homes, ad the day-to-day routie is t fixed. Teams of staff ad residets try to create a eighborhood feel. Kitches are ofte ope to residets, decoratios give a sese of home, ad staff are ecouraged to develop relatioships with residets. Some ursig homes have visitig doctors who see their patiets o site. Other ursig homes have patiets visit the doctor s office. Nursig homes sometimes have separate areas called Special Care Uits for people with serious memory problems, like demetia. Whe lookig for a ursig home, it s importat for families to thik about special eeds. How Do You Choose? If you are lookig for a ursig home here are some thigs to keep i mid: F Look. What choices are i your area? Is there a place close to family ad frieds? What s importat to you ursig care, meals, a religious coectio, hospice care, or Special Care Uits for demetia care? F Ask. Talk with frieds, relatives, social workers, ad religious groups to fid out what places they suggest. Ask doctors which ursig homes they feel provide good care. F Call. Get i touch with each place o your list. Ask questios about how may people live there ad what it costs. Fid out about waitig lists. F Visit. Make plas to meet with the director ad the ursig director. The Medicare Nursig Home Checklist (see Resources That Ca Help) has a good list to use whe visitig. Some thigs to look for: Medicare ad Medicaid certificatio Hadicap access Strog odors (either bad or good) 2 3

3 May food choices Residets who look well cared for Eough staff for the umber of patiets F Talk. Do t be afraid to ask questios. Ask how log the director ad departmet heads (ursig, food, ad social services) have worked at the ursig home. If key staff chage a lot, that could mea there is a problem. F Visit agai. Make a secod visit without callig ahead. Try aother day of the week or time of day so you will meet other staff members ad see other activities. Stop by at mealtime. Do people seem to be ejoyig their food? F Uderstad. Oce you choose, carefully read the cotract. Check with your State Ombudsma (see Resources That Ca Help) for help makig sese of the cotract. Do Nursig Homes Have To Meet Stadards? The Ceters for Medicare ad Medicaid Services (CMS) asks each State to ispect ay ursig home that gets moey from the Govermet. Homes that do t pass ispectio are ot certified. Ask to see the curret ispectio report ad certificatio of homes you are thikig about. Visit for more iformatio. Payig For Nursig Home Care People pay for ursig home care i may ways: F Medicaid. This is a State/Federal program that provides health beefits to some people with low icomes. Cotact your couty family services departmet to see if you qualify. Oce you have met the requiremets of your State s Medicaid program, it ca take up to 90 days to be approved. F Private pay. Some people pay for log-term care with their ow savigs for as log as possible. Whe that is o loger possible, they may get help from Medicaid. If you thik you may eed to apply for Medicaid at some poit, make sure the ursig home accepts it. Not all homes do. F Log-term care isurace. Some people buy private log-term care isurace. It ca pay part of the costs for a ursig home or other log-term care. This type of isurace is sold by may differet compaies ad beefits 4 5

4 vary widely. Look carefully at several policies before makig a choice. May people believe Medicare will pay for log stays i a ursig home, but it does t. For example, Medicare will oly cover the first 100 days i a skilled ursig home for someoe who eeds special care after leavig the hospital. State/Federal Medicaid programs may pay for log-term ursig home care, but there are may rules about qualifyig. It is importat to check with Medicare, Medicaid, ad ay private isurace compay to fid out the curret rules. Whe thikig about costs, keep i mid that there ca be extra outof-pocket charges for some supplies, persoal care like hair appoitmets, laudry, ad services that are outside routie care. Resources That Ca Help The rules about programs ad beefits for ursig homes ca chage. Medicare has some helpful resources olie. Visit for iformatio about differet care optios. To lear more about the Medicaid program, see You ca fid ursig homes i your area that are approved by the Ceters for Medicare & Medicaid Services by visitig the Medicare website. You ca also see summaries of recet ispectio reports. Visit Nursig Home Compare at The Nursig Home Checklist at the same website is a good guide to use whe thikig about choosig a ursig home. May States have State Health Isurace Couselig ad Assistace Programs (SHIP). These programs ca help you choose the health isurace that is right for you ad your family. Visit Each State also has a Log-Term Care Ombudsma office that helps people lear about log-term care. Your local office may be able to aswer geeral questios about a specific ursig home. Also, oce you are livig i a ursig home, the Ombudsma ca help solve problems you may have with a facility. The Natioal Log-Term Care Ombudsma Resource Ceter has more iformatio. Visit A vetera i eed of log-term care might be able to get help through the Departmet of Veteras Affairs (VA). Visit or call VA Health Care Beefits toll-free at You ca also cotact a VA medical ceter ear you. 6 7

5 For More Iformatio Here are some helpful resources: AARP 601 E Street, NW Washigto, DC (toll-free) (TTY/toll-free) America Associatio of Homes ad Services for the Agig 2519 Coecticut Aveue, NW Washigto, DC America Health Care Associatio 1201 L Street, NW Washigto, DC Ceters for Medicare & Medicaid Services 7500 Security Boulevard Baltimore MD (toll-free) Departmet of Veteras Affairs VA Beefits: (toll-free) (TTY/toll-free) FirstGov for Seiors Natioal Citizes Coalitio for Nursig Home Reform 1828 L Street, NW Suite 801 Washigto, DC Natioal Log-Term Care Ombudsma Resource Ceter 1828 L Street, NW Suite 801 Washigto, DC For more iformatio o health ad agig, icludig the publicatio There s No Place like Home for Growig Old, cotact: Natioal Istitute o Agig Iformatio Ceter PO Box 8057 Gaithersburg, MD (toll-free) (TTY/toll-free)

6 For iformatio o Alzheimer s disease, cotact: Alzheimer s Disease Educatio ad Referral Ceter (ADEAR) PO Box 8250 Silver Sprig, MD (toll-free) To sig up for regular alerts about ew publicatios ad other iformatio from the NIA, go to Visit NIHSeiorHealth ( a seiorfriedly website from the Natioal Istitute o Agig ad the Natioal Library of Medicie. This website has health iformatio for older adults. Special features make it simple to use. For example, you ca click o a butto to have the text read out loud or to make the type larger. Natioal Istitutes of Health U.S. Departmet of Health ad Huma Services August

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