Skilled Nursing & Assited Living

Skilled Nursing
Facilities that are primarily engaged in providing skilled nursing, rehabilitation and other related services for residents who require medical, nursing and/or rehabilitative care.

Assisted Living
Provides and/or arranges for a special combination of residential housing, assistance with activities of daily living as well as personalized supportive and healthcare services.

Independent/Retirement Living
These communities focus on companionship, organized social activities, assist residents with the instrumental activities of daily living and, in the event of a health related event, some personal care of a temporary nature.

Activities of Daily Living (ADLs)
Generally considered to include eating, bathing, dressing, getting to and using the bathroom, getting in or out of bed or chair and mobility.

Instrumental Activities of Daily Living (IADLs)
These may include preparing meals, doing housework and outside the facility shopping and health care appointments


Payment Options for Senior Housing

There are various ways to pay for senior housing and long-term care; some of the most frequently accessed sources are summarized below.
 Private Funds
 Medicare
 Long-Term Care Insurance
 Medicaid

Medicare
As defined in Title XVIII of the Social Security Act, Medicare ("Health Insurance for the Aged and Disabled") is a Federal health insurance program for the aged (65+) and certain disabled individuals (e.g., persons with end-stage renal disease (ESRD) who require dialysis or a kidney transplant), regardless of income.

Medicare is comprised of two parts, defined as follows:

Part A (Hospital Insurance): Provided automatically to individuals 65 and over who are entitled to Social Security, and to disabled persons who have received such benefits for at least 24 months. The health services covered under Part A are:

Inpatient Hospital Care: Includes coverage of the costs for most hospital services, including operating room, intensive care, laboratory tests, inpatient prescription drugs, X-rays, rehabilitation, long-term hospitalization, meals and semi-private room.

Skilled Nursing Facility (SNF) Care: Covered by Part A only if it follows within 30 days of a hospitalization of three or more days, and is certified as medically necessary. Medicare does generally not pay for long-term care in a nursing facility, and the number of SNF days provided is limited to 100 days, with a co-payment required for days 21 to 100.

Home Health Agency Care: Can be furnished by a home health agency at the residence of the beneficiary. Part A may also pay for some medical equipment and medical supplies.

Hospice Care: Provided to terminally ill individuals who have a life expectancy of six months or less, and who choose to forgo standard medical treatment.

Part B (Supplementary Medical Insurance)
Provided to almost all U.S. residents 65 or older, certain aliens 65 or over and disabled individuals entitled to Part A. Part B coverage requires payment of a monthly premium, and primarily covers physician services. Also covered by Part B are non-physician services, including diagnostic tests, ambulance services, clinical laboratory tests, flu vaccinations and some therapy services.


Long-Term Care Insurance
Long-term care insurance covers the cost of long-term care in certain types of care facilities, depending upon the policy. These policies are sold by private insurance companies though not all insurance firms offer this type. Premiums for Long-Term Care Insurance are based on the age of the person at the time of purchase, the benefit amount, the benefit time period, elimination or deductible and special options (i.e. inflation adjustment, non-forfeiture benefits and spousal discounts).


Medicaid
As defined in Title XIX of the Social Security Act, Medicaid is a joint Federal-State program which pays for medical services to eligible needy and vulnerable families and individuals. Medicaid is intended to pay for health and long-term care for persons with limited financial resources. Medicaid program varies from State to State. Skilled nursing facility care it covered under this program for those eligible. Several states, but not all, have established waiver programs to provide coverage in the assisted living facility,