Nursing home care is likely more
expensive than you think, which means you need to do your homework to find the
best deal.
Brian O'Connell Aug 29, 2019 4:54 PM EDT
The average total cost for a nursing home is
higher than you might think - way higher.
According to industry data, the average cost of
a nursing home residence according to Genworth's 2018 cost of care study, is $8,121
a month for a private room, and $7,148 a month for a semi-private room.
Both figures represent total costs for nursing
home care on a monthly basis, including room, board, fees, and ancillary
expenses charged by a nursing home (also called a skilled nursing facility.)
The factors that matter when calculating the
total cost of a nursing home stay rarely vary. The top of that list includes
the quality and location of the nursing home residence, how long the stay will
be the nursing home care recipient, and the number and quality of specific senior
home care services required by the recipient and his or her family.
Those extra charges could be for a wide menu of
services, including physical therapy, memory care, prescription drug purchase
and/or delivery, special meals based on dietary needs, and other critical
services a nursing home resident may need.
That's why an all-inclusive nursing home care
rate is advisable for seniors and their families. It gives you a total cost
estimate and you may get discounts on key services for paying for an
all-inclusive senior care center plan.
It's also worth noting that nursing home care on
all levels outpaces the U.S. rate of inflation, by an average of 3%-to-6%
annual cost growth rate for nursing homes versus the current U.S. inflation
rate of 1.8% through July, 2019.
Put that calculating factor into play and the
expected cost of annual nursing home care for a semi-private room rises to
$120,008 and the cost of a private room soars to $134,896 in 2028, according to
Genworth.
Here's how Genworth breaks down average nursing
home care costs on a daily, monthly, and annual basis:
|
|
Daily
|
Monthly
|
|
Yearly
|
|
Private Room
|
$275
|
$8,365
|
|
$100,375
|
|
Semi-Private Room
|
$245
|
$7,441
|
|
$89,297
|
Location Really Matters
While all of the above factors are important,
the location may be the biggest when calculating senior home care in the U.S.
in 2019.
For example, the state you reside in can add or
subtract the total average monthly nursing home cost in a significant way.
For example, the average monthly cost for a
nursing home residential experience in Oklahoma in 2018 stood at $5,293.
Compare that to a cost of over $29,000 for Alaska for the same private room.
Alaska is, however, a major outlier, given its relatively remote geographical
location and a lack of nursing home options. For instance, Connecticut clocks
in second among the most expensive U.S. states for nursing home care, at
$13,733.
For a deeper dive, here's a state-by-state list of nursing home
costs, as of 2018.
State Total Monthly Cost
for Private Room
Highest States by
Average Monthly Cost
1.
Alaska
- $29,291
2.
Connecticut
- $13,733
3.
Hawaii
- $13,657
4.
Massachusetts
- $12,775
5.
New
York - $12,189
6.
No.
Dakota - $11,690
7.
New
Jersey - $11,863
8.
Delaware
- $10,950
9.
Hampshire
- $11,102
10.
Virginia
- $11,072
Lowest States by Average
Monthly Cost
1.
Alabama
- $6,661
2.
Texas
- $6,540
3.
Iowa
- $6,479
4.
Utah
- $7,604
5.
Illinois
- $6,753
6.
Arkansas
- $5,986
7.
Kansas
- $5,865
8.
Missouri
- $5,543
9.
Louisiana
- $5,542
10.
Oklahoma
- $5,293
Comparative Costs
With the costs of nursing home care so high -
even for a semi-private room - U.S. seniors and their families may want to set
their sights lower and pay a more affordable rate of senior home care or
assisted living care even if that means foregoing the nursing home care
experience.
For example assisted-living costs, using the
same metrics as Genworth uses for its nursing home pricing estimates, comes in
at about half the cost of nursing home care.
In 2018, for example, Genworth pegs the cost of
assisted living on a nationwide basis as follows:
Daily - $132
Monthly - $4,000
Yearly - $48,000
There are two ways of looking at the costs of
nursing home care versus assisted living.
·
First, you're getting
more comprehensive care, including 24-hour medical services, from a nursing
home.
·
Second, you're paying
significantly less for assisted-living care, which costs approximately 50% less
(depending on where you live) compared to nursing home care. If you're a senior
with a family able to pitch in for care needs, the price difference is hard to
ignore, as most Americans can hardly afford $8,000 or even $6,000 a month
for full-time nursing home care.
Home-based senior care has a quality of life
advantage built into the equation, as most seniors, if health allows, would
rather stay in the comfort and safety of their own home than have to live in a
nursing home or even spend time at an assisted care center.
Base costs for home care do come in much lower
than a nursing home or even assisted-living care, but there are plenty of
add-ons and caveats that can add to the cost of home-based senior care.
Let's start with basic costs for home care,
which is usually priced out at an hourly rate for agency-based care.
According to PayingforSeniorCare.com, hourly
rates vary for senior-based home health care, from $21 to $28 an hour depending on
where you live and services you require.
You may have to add more dollars to the home
care budget if the care provided goes beyond basic daily living needs, which
include meal preparation, medication help, companionship, hygiene assistance,
and occasional licensed medical care. Anything beyond that, like paying for
dementia care or other services related to a serious injury or illness, and be
prepared to pay a higher rate for senior home care.
The good news is that you can bring in a trusted
private caretaker into your home for up to 30% lower in prices and fees.
If that sounds like a viable option, make sure
to thoroughly vet any private caretaker and ask for references. Any red flags
on that front and be ready to pull the plug - any discount on home health care
services aren't worth the trouble if you have a problematic private home care
service provider under your roof.
Additionally, don't count on Medicare for full nursing home care
financial help. Uncle Sam may help pay for short-term medical care at a nursing
home, but usually does not pay the freight for traditional nursing home stays.
Is Nursing Home Care Tax
Deductible?
The short answer is yes, nursing home care and
most professional senior care costs can be tax-deductible as legitimate medical
expenses. That said, the IRS has (naturally) certain conditions where it's
allowed, as follows:
You can deduct the full cost of nursing home
care if you or your spouse or dependent resides in a nursing home care for
medical/health care reasons. In that scenario, you can deduct the whole cost of
nursing home care, including room, board, and meals.
The IRS is prickly about seniors opting for
nursing home care for non-medical reasons and doesn't allow for deductions for
seniors who reside in a nursing home for personal reasons (i.e., they like the
environment and the facility, and are there for reasons other than health
issues.)
That "medical versus personal" area is
a gray one in the eyes of the IRS, so it's best to work with a trusted
accountant or tax specialist to make sure you're making the correct call when
listing a nursing home expense as a deduction on your taxes.
Tips on Choosing the
Perfect Nursing Home
Now that you're more aware of the cost of a
nursing home, what are the best action steps to take to choose the right one
for yourself or for a loved one?
These strategies always stand the test of time
and should help you land the best care facility for your unique needs.
Ask Your Doctor or
Better Yet, Your Nurse
If you or a family member has a close
relationship with their physicians or have spent time in a hospital and care
clinic, take advantage of that proximity to knowledge and ask a doctor, nurse
or clinician for their "top votes" for nursing home care centers near
you.
Know Going in What
Your Priorities Are
What matters to you in a nursing home selection
process is a big issue and needs to be prioritized. If it's the location to
family, quality of the facility (i.e. cleanliness or access to regular medical
care), good meals, or access to favored religious services, that matter, then
say so upfront when you're visiting a home and vetting it.
Use the Community
Grapevine
Ask your friends, neighbors and co-workers if
they have any tips or inside knowledge on local nursing homes. Social media,
the Better Business Bureau, and even local law enforcement or community centers
are a good place to go fishing for solid nursing home information.
Visit the Center and Ask
Other Families and Residents Staying There
Besides asking for references, which should a be
a staple when you're vetting a nursing home, ask residents and their families
what they like and don't like about the facility. Anyone who spends regular
time at a nursing home should be a great source of information and red flags
concerning that facility. So make sure to ask around when you're on site.
Read Your Contract
Thoroughly
Once you've made up your mind and are ready to
sign on the dotted line, don't do so until you've read the nursing home
contract line. Have a trusted attorney do the same thing. If any issues stand
out, make sure to clear the air with the nursing homeowner or manager before
signing the document.
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