Nursing Homes
What is a Nursing Home?
A nursing home is a public or private residential facility that provides a high level of long term personal or nursing care for persons who are unable to safely care for themselves in a community setting. These state licensed facilities offer the most extensive care a person can receive outside of a hospital setting. Supervision of the residents is provided 24 hours a day, seven days a week. Services can include skilled care such as rehabilitation therapies and medical monitoring as well as custodial care including assistance with bathing, dressing, and eating. Staff may include registered nurses, licensed practical nurses, nursing assistants, physical, occupational, and respiratory therapists, and recreation/activity directors. The types of nursing homes include:
- Intermediate Care Facilities (ICF) are for those that are elderly, not acutely ill or have a disability. The level of care is more of a custodial nature and not as intense as care provided in a hospital or a Skilled Nursing Facility. ICFs may also specialize in serving individuals with special needs such as those with Alzheimer’s disease or Developmental Disabilities.
- Skilled Nursing Facilities (SNF) are Medicare certified and provide skilled care requiring doctor’s orders (physical, occupational, and respiratory therapies, and medical monitoring) or rehabilitation on a daily (seven days a week) basis while recovering from an accident, surgery, or illness.
Who Needs Nursing Home Care?
A person who:
- can no longer live alone due to functional and/or cognitive impairments;
- needs 24-hour care and/or supervision;
- can no longer perform, without considerable assistance, at least three activities of daily living (bathing, dressing, eating, transferring, etc.);
- needs monitoring or overall care management due to cognitive, behavioral health, or functional impairment(s);
- cannot perceive and react appropriately to an emergency and get to safety without significant human assistance;
- needs routine or restorative nursing care;
- passes the detailed screening required by federal law for nursing home admission;
- needs skilled care or rehabilitation on a daily (seven days a week) basis while recovering from an accident, surgery, or illness
What Types of Accommodations are Offered?
Facilities may offer private rooms, semi-private rooms, or wards housing three or more persons. Normally, common areas, activity rooms, and a dining room are part of the design. Many homes have secure outdoor space and room for social activities. Some nursing homes have separate and/or secured units designed to meet the needs of persons with dementia or residents who may wander.
Empowerline can provide you with a listing of nursing homes.
How Much Does a Nursing Home Cost?
The state median cost of a nursing home in Georgia is $6,222 (semi-private room) to $6,707 (private room) per month and includes room, board, routine nursing care, general toiletries (soap, shampoo, tissue, etc.), and laundry. There may be additional charges for prescription medications, therapies, personal laundry, and incontinence supplies.
Persons who need nursing home care, but do not have the resources to pay for it, may be eligible for Medicaid, which can pay for extended stays in facilities enrolled as Medicaid providers. Medicaid, which was created to serve persons with low incomes and limited resources, has strict eligibility criteria that must be met which the individual states establish based on federal minimum standards. In Georgia, the “look-back” period is five (5) years. Applicants must provide financial records for this period of time which will be reviewed by the Georgia Department of Community Health to ensure assets were not transferred out of the applicant’s name for the purpose of becoming eligible for Medicaid.
Medicare will pay for up to 20 days in a Medicare-certified nursing home for skilled nursing or rehabilitative care under certain circumstances. There must be a three-day hospital stay directly preceding the nursing home admission. From the 21st day to the 100th day, the patient is responsible for a co-payment. Co-payments may change each year. Contact the GeorgiaCares Program at 1-866-552-4464, option 4 for the current amount. From the 101st day onward, the patient is responsible for the full cost, should skilled rehabilitative care still be needed.
The patient should apply for Medicaid if he or she anticipates an extended stay beyond Medicare-covered days, meets eligibility requirements, and does not have sufficient income and resources to meet nursing home expenses. Contact the GeorgiaCares Program at 1-866-552-4464, option 1 for additional information on Nursing Home Medicaid.
Under some circumstances, the Department of Veterans Affairs pays for nursing home care for veterans. Contact the Department of Veterans Affairs at 1-800-827-1000 for a ruling on a case-by-case basis.
Additional Nursing Home Information
Prospective nursing home residents or their family members may contact the Long-term Care Ombudsman Program for more information on nursing homes. Long-term care ombudsmen serve as advocates for people who live in long-term care facilities. One ombudsman role is to investigate and attempt to resolve complaints on behalf of nursing home residents.
They also conduct routine monitoring visits at every nursing home in the state. The information contained in the most recent survey report should be posted in a public place in the nursing home. Call 404-657-5327 for more information. The Department of Community Health, Healthcare Facility Regulation Division, is the regulatory agency that conducts the routine monitoring visits and receives and investigates complaints regarding nursing homes. To get more information
or to file a complaint, you may call 404-657-5700.
Individuals of any age who reside in a nursing facility, intermediate care facility for the developmentally disabled, or
behavioral healthcare institution and who receive Medicaid benefits, will be subject to the Medicaid Estate Recovery.
If you have any questions, please call the Estate Recovery office at 770-916-0328.
Empowerline: Your source for information about services for
older persons, individuals with disabilities, and caregivers.
Call Empowerline at (404) 463-3333 whenever you need help finding services for older persons,
individuals with disabilities, and caregivers in metro Atlanta, or visit www.empowerline.org.
Empowerline is a program of the Atlanta Regional Commission, the designated Area Agency on Aging for the 10-county Atlanta region.