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A Quick Look at Medicare, Medicaid, and Nursing Homes

Nursing Home CareMany people are surprised to discover that Medicare actually provides very limited coverage for nursing homes.

In theory, Medicare Part A covers up to 100 days of care in a skilled nursing facility for each spell of illness. However, this is true only if the nursing-home care follows at least a three-day admission to a hospital. Further, after 20 days, you must pay a copayment of $157 a day (although this may be covered by Medigap insurance).

In addition, the definition of “skilled nursing” and the other conditions for obtaining this coverage are quite stringent. As a result, very few nursing home residents actually receive the full 100 days of coverage. In fact, Medicare pays for less than a quarter of long-term care costs in the U.S.

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Can You Be Discharged From an Assisted Living Facility?

Assisted Living facilities provide long-term or permanent care for residents, however, occasionally they are confronted with a situation which requires them to discharge a resident or terminate the resident’s admission contract.

As a resident, you have rights which protect you from being discharged without cause. Assisted Living facilities are required to manage difficult situations and are prohibited from randomly discharging residents because they have a difficult personality or challenging health care need.

If you or someone you know is facing an assisted living discharge that you believe is unfair, it may be possible to fight it. The legal rules, however, are often unclear, and vary a great deal from location to location.

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