Las Vegas Sun

March 28, 2024

Program raises awareness of long-term care needs

The cost of a skilled-nursing home can be expensive, and many people are not prepared for the realities associated with long-term care.

That's why Nevada, Arkansas, Idaho, New Jersey and Virginia were selected for a national pilot program to raise awareness about long-term care planning, which includes home-health care, assisted-living and skilled-nursing centers.

Gov. Kenny Guinn launched the campaign in Nevada, in conjunction with the Division for Aging Services, to educate Nevadans about the importance of planning for future care needs.

"Nobody wants to think about that until you have to," said Carol Sala, administrator of the state Division for Aging Services. "Usually they come to us at the crisis point; an adult child saying my mom is in crisis and I need to find a place for her. When you're in a crisis is not the time to be planning."

When people are in a crisis they tend not to think as clearly, she said.

The Department of Health and Human Services created the initiative called "Own Your Own Future" that includes advertising and direct mailings about long-term care planning and how to obtain a free 28-page booklet and CD with planning hints for people ages 50 to 70. Nevadans can receive the planning kits, which include Nevada-specific resources, by calling (866) 752-6582.

The National Governors Association, the U.S. Administration on Aging and the National Conference of State Legislatures worked in conjunction with the Department of Health and Human Services.

The kits provide information on financing, long-term care insurance, wills, trusts and advanced directives, Sala said.

"It's critical that if you want control in what happens to you as you get older, you need to make some decisions now; both financial and your wishes about whether you want to go to a nursing home or group care," Sala said. "A lot of people think Medicare covers it, and it doesn't."

Paul Boyar, administrator of the Plaza Regency skilled-nursing center, said many of the people he encounters assume that their long-term care would be paid by Medicare or Medicaid even though that often is not the case.

Medicare covers the first 20 days at 100 percent for people who have been hospitalized for three days, are over 65 and have conditions that are improving, Boyar said. Then patients are expected to pay $114 a day and Medicare pays the rest, he said.

People need to plan for long-term care insurance whiile they are younger because the average patient is in a skilled-nursing home for one year and nine months and has bills that average about $5,000 per month, he said.

About 2 percent of Boyar's patients are covered by long-term care insurance, he said.

"You have life insurance, but you need to start thinking about long-term care insurance," he said. "That plan helps protect people's assets. You're not going to be able to rely on Medicaid. Medicaid is running out of money."

Medicaid is not easy to qualify for, which means it is not an option for most people, Sala said.

To be eligible for Medicaid, a person must earn no more than $1,737 per month in income and have no more than $2,000 in assets excluding one home and one automobile, Sala said.

Last fall the MetLife Mature Market Institute released a study that showed Las Vegas Valley skilled-nursing homes' rates increased an average of 10 percent in 2004 to $175 per day, or $63,875 per year, for a private room and the average semi-private room was $156 per day, or $56,950 per year.

Metlife, which sells insurance and financial services, estimated that Americans spend an average of 2.4 years in a skilled-nursing home.

Larry Harrison, an insurance broker in Las Vegas, said few people are seeking out long-term care policies despite the fact that many people would benefit from them.

"People who want to buy it are people who had to live it and had to take care of a parent or they have a spouse in the hospital," he said.

Insurance companies offer various long-term care polices that typically cover skilled-nursing care and some include coverage for assisted-living and home-health care. The prices vary by age, sex, health status and type of coverage.

Policies that do not include assisted-living and home-health care can have those services included as an addendum, Harrison said.

Insurance companies review seven daily activities before the long-term care policy is effective and those include bathing, eating and dressing.

It's important to ask how many of those activities must be affected before the policy is effective and whether it is the insurer's doctor or the patient's doctor that assesses the outcome, Harrison said.

Jack Fields, a Las Vegas estate lawyer, said people need to at least consider long-term care insurance and guardianship and discuss the proposals with a lawyer.

"The attorney is paid to give you advice and make good decisions," Fields said. "The insurance agent is there to sell you something."

Whether a person has a trust, will or living will, there needs to be clauses about how to handle long-term care and assets in those legal documents, he said.

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