Nursing Home: Hospital Discharge Planning:Financial

The cost of a nursing home or assisted living can be daunting.  If your loved one is in subacute rehab, medicare is paying for 100 days.  After that, you are responsible for payment.  During the time in rehab,  physical and occupational therapy will be given.  It will be a window to assess what the next step will be.  During this time, figuring out assets is critical.


If you have been involved with long term financial planning, you are ahead of the game.  The cost of nursing homes run from $5,000-8,000 a month.  Assisted living vary depending upon the services but also in the thousands monthly.  Most cost comes out of pocket and assets will have to be spent down.  The best advise I can give is contact an elder care attorney.  Be sure the attorney is actually certified as in elder care.  There are not a high per cent of attorneys who have taken and past the certification.  An elder care attorney will know state and federal laws related to taxes and estates. 
It is also helpful to have an accountant who can help organize accounts.  This person can be a neutral eye for all matters financial.  

You can also contact the Small Business Association or Better Business Bureau.  There are often retired lawyers who can help if the cost of a lawyer is too much.  It is important to get advise.

Check if there is long term care insurance.  Depending upon the policy, much of the cost  will be covered for the time listed.  However, it takes time to get this activated up to three months.  Once you know the possible outcome, contact the insurer.  

It will be important to get a clear picture of where the assets are located.  My husband used to joke that his Russian mother still hid things under the mattress as any good Russian should.  When the time came, we did look under the bed and luckily nothing was there.  Instead, her assets were spread out in multiple accounts and bank deposit boxes.  My sister-in-law spent several long days at the bank filling out paperwork and getting access.

The spend down of assets will most likely have to happen before medicaid will kick in. This means you will be paying out of pocket all your loved ones resources before you get state assistance.  

What I hear frequently from clients and friends is, “I tried to talk to my parents, loved one and couldn’t get anywhere”.  The majority of families find themselves in this situation.