By Angie Reinke, Galeon administrator
One of the toughest conversations we have at Galeon tend to be about the cost of care and how someone can pay for this type of care. There are multiple ways that we receive payment for care.
Cost of care can range from $338 to $560 a day at Galeon. The State of Minnesota determines the rate based off of required assessments that our RN case managers complete. Galeon has no control over how much we charge.
Medicare Part A: Medicare Part A or Medicare Advantage Plans will cover stays in nursing homes for rehabilitation or other skilled needs as long as you meet the necessary criteria. Some of the criteria may include a three-day overnight stay (observation days do not count toward this criterion). There is a maximum of 100 days but you need to be at a skilled level of care. A skilled level of care means you need the assistance of a registered nurse or therapist. If the resident meets their rehab goals or maintains a certain level, Medicare coverage will not continue. We have seen someone use as little as a few days and others with more complicated diagnosis use 100 days. If someone comes to the nursing home for only custodial care, which means help with medications, bathing, grooming, dressing, etc., you will not qualify for a Medicare benefit.
Medicaid: To qualify for Medicaid, a person would have to meet their state’s level of criteria and financial eligibility. The applicants tend to have very little for assets and little cash on hand to use for the cost of care. There is a lookback of five years to see if any assets were transferred, which may count against eligibility. Depending on your length of stay or if you pass away in a nursing home, the state may require you to put your home up for sale or place a lien on the property and will seek funds from the sale of the home. The nursing home has no involvement with the sale of the home. This is all regulated by the state.
Private pay status: The resident will pay the nursing home from their own private funds. The state sets the rates for all residents in nursing homes and are equal to rate those on Medical Assistance.
Long term care insurance: Long term care insurance is a policy that the individual has typically taken out long before needing to enter a nursing home. Long term care insurance will typically pay a portion of the daily rate. Not all policies are the same. When a resident enters the nursing home either they or a loved one makes a call to the company to notify them of the event that led them to a needed stay at the nursing home. The company will then let Galeon know what they will pay toward the stay and what criteria are needed for them to make payments toward the cost of care.
This is a very small look at some forms of payments at Galeon and how they work. If you ever have any questions regarding planning for a nursing home stay please call with questions and we would be happy to help you out.
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Osakis Voices is a rotating column written by community leaders who share their thoughts in their field of expertise.