There are a lot of myths and misconceptions about nursing homes. For example, one myth is that living in a nursing home is like living in a hospital, and another is that once you move into a nursing home, you can never leave. However, the reality of modern nursing homes is quite different.
In this guide, we’ll clear up the confusion and help you understand when and why a nursing home might be the right care choice for your loved one. We will clarify why a nursing home is NOT Assisted Living. We’ll cover what nursing homes are, how nursing homes compare to other types of senior living, like an assisted living facility, and how to find the best nursing home near you.
Nursing homes are not assisted living communities. Also, they are not skilled nursing facilities (SNF), which is usually only for temporary residents. Nursing Homes provide the highest level of health care out of any senior living option. Standard services at nursing home facilities include:
What differentiates nursing homes from other forms of senior living is that they are the only type of senior care facility licensed to provide medical care services, such as skilled nursing and rehabilitative therapy.
Nursing homes are designed to provide comprehensive care in a private or semi-private room. Residents aren’t confined to their beds and can freely move around and interact with each other. There are also common areas where entire families can come visit and spend time with their loved ones.
They are always commercially zoned and may or may not be on the same campus as an independent living community thereby creating what is often categorized as a CCRC (continuing care retirement community).
Nursing homes offer a range of different options, depending on the level of care your loved one needs and for how long.
For example, for short-term stays you will want to look for a Skilled Nursing Facility (SNF). These are perfect for short-term rehabilitative services, such as physical, occupational, and speech therapy- when a skilled care service is identified following a hospital stay and is typically covered by their Medicare benefit. They are geared toward seniors who temporarily need additional support after being discharged from a hospital and who will discharge to home or a home-like environment after their skilled service benefit needs have been met, usually less than 21 days.
There are also nursing homes that offer long-term, palliative care for seniors with ongoing medical conditions that require constant care and supervision. For example, perhaps your loved one needs daily specialized treatment for kidney disease or a heart condition that can’t be provided at home. Remember, assisted living communities do not provide this kind of medical care or rehabilitation.
Finally, there are nursing homes that focus on providing hospice care to ensure the comfort of seniors with terminal illnesses who are approaching the end of life.
These days, many people who are initially searching online for nursing homes in their area are actually a better fit for an assisted living community. But what is the difference?
Assisted living communities are for seniors who don’t need regular medical care, but do require assistance with activities of daily living (ADLs). Residents live in private apartments with senior-friendly features like bathroom grab bars, barrier-free doorways (to accommodate wheelchairs / walkers), and alert buttons. They receive assistance with ADLs, enjoy three daily meals (plus snacks), and can participate in a wide array of different community activities – such as book clubs, exercise classes, game nights, field trips, etc.
Many assisted living communities also include on-site amenities like a library, beauty salon, gardens or walking paths, gym, etc. Residents may keep their own car, but many often prefer to make use of the community’s transportation service/public transit to shop or attend medical appointments.
Nursing homes offer many of the same services and amenities as assisted living communities, but are for seniors who have more comprehensive care needs or need daily medical care and 24/7 supervision by licensed medical professionals.
As previously mentioned,nursing homes are the only form of senior living that can provide 24/7 medical services. Like memory care communities for residents with Alzheimer’s or other dementia related illnesses, many nursing homes also include increased safety measures for residents with memory issues / dementia.
The level of medical care provided in an assisted living facility versus a nursing home is also reflected in the price. According to the 2021 Genworth Cost of Care Survey, the national monthly median cost for assisted living is $4,429. Meanwhile, the national monthly median cost for a private room at a skilled nursing facility is $9.086.
It used to be that the term “nursing home” was interchangeable with “senior living.” However, in modern parlance, the two terms mean different things.
Senior living is a catchall phrase for living communities designed for seniors (ages 55+). It includes independent living, assisted living, continuing care retirement communities (CCRCs), memory care facilities, and yes – nursing homes.
As a whole, modern senior living communities use social-based models that focus on providing for the emotional, social, and physical needs of residents. In the case of nursing homes, they also include medical services.
Perhaps your loved one doesn’t want to have to stay in a skilled nursing facility after being discharged from the hospital. Or, other than needing daily medical care, they prefer to live independently in their own private residence. In such cases, they might be able to receive skilled nursing care right in their own home. Provided they have the financial means to do so, seniors and their families can hire licensed home health aides to help with various medical procedures, such as:
The national median cost of hiring a home health aide is currently $4,576 per month. Keep in mind that the types of home nursing care services that are available will vary depending on state laws, as well as the agency. Furthermore, custodial services – such as assistance with ADLs, cooking, cleaning, etc. – are separate from skilled nursing services and will cost extra.
With all the different types of senior care available, when is a nursing home a good option for your loved one? The first consideration is the level of care your loved one needs – specifically, do they only need assistance with activities of daily living, or do they require regular skilled nursing? If they don’t need skilled medical care, then you should look into senior living options like memory care or assisted living.
If your loved one does need medical care, the next question is for how long? For example, have they been discharged from the hospital after extensive surgery? In that case, temporary admittance to a nursing facility or short-term respite stay in an assisted living facility focused on rehabilitative care can help ensure their full recovery.
Meanwhile, if they can still live independently, but need regular assistance to manage a chronic condition, a home health aid can be a good fit. However, if your loved one can no longer manage independently and needs daily palliative care, then moving them into a residential nursing home might be the best option to ensure their comfort and well-being.
You can take our senior needs assessment quiz to help you determine which types of senior living might be the best choice for your loved one’s care and lifestyle needs.
Compare Nursing Homes
You want to move your aging loved ones into a nursing home where they will feel happy, safe, and comfortable. As such, here are some key questions you should consider when you evaluate different living facilities:
Quality of Care
When touring different nursing homes, make sure to explore the facility, stay for lunch, and observe daily activities. Is the building well-maintained? Are the rooms comfortably sized? Do residents seem to be healthy, calm, and engaged? Do they receive personalized attention when they interact with staff members?
See if you can connect with any of the current residents (and their families) to hear about their experiences. Also, make sure to visit the appropriate state regulatory agency (most likely the health department) to look up the community and review their survey or inspection reports for issues that could impact your loved one. Finally, do a search online for reviews.
The cost of nursing home care will vary dramatically across the United States, depending on your location. Here is how the average monthly cost breaks down state by state:
The above numbers are just averages, and the actual price of specific nursing home facilities can vary widely — even within the same city.
When considering nursing home costs, a lot of seniors assume that Medicare will help them pay for care. However, this is not always the case, as Medicare coverage for skilled nursing depends on several factors, including the type of care and the duration of care.
For example, short-term skilled nursing care – such as following a stay in the hospital – is almost always covered by Medicare. Generally, the program will pay 100% of approved costs for the first 20 days and partially cover another 80 days of medically necessary skilled nursing care.
However, the rules are different for long-term residential nursing homes. While Medicare might help cover medical care, such as doctor services, prescription medications, and medical supplies that your loved one needs while living in a nursing home setting, custodial care services (i.e., assistance with ADLs) room & board, etc., are generally not included.
We recommend reading our nursing home cost guide [A/N: include a link when available] to learn more about the various factors that will influence the cost of nursing homes in your area, as well as different ways to finance nursing home care.
As you know, the gig economy has been booming over the past several years. If youre thinking of using your skills to take on a side gig, what should you do with the money youll make?Theres no one right answer for everyone, and the decisions you make should be based on your individual situation. And of course, you may simply need the extra income to support your lifestyle and pay the bills. But if you already have your cash flow in good shape, and you have some freedom with your gig money, consider these suggestions: Contribute more to your IRA. If you couldnt afford to contribute the maximum amount to your IRA, you may find it easier to do so when you have additional money coming in from a side gig. For the 2023 tax year, you can put in up to $6,500 to a traditional or Roth IRA, or $7,500 if youre 50 or older. (Starting in 2024, this extra $1,000 catch-up contribution amount may be indexed for inflation.) The amount you can contribute to a Roth IRA is reduced, and eventually eliminated, at certain income levels. Look for new investment opportunities. If youre already maxing out your IRA, you might be able to find other investment possibilities for your side gig money. For example, if you have young children, perhaps you could use some of the money to invest in a 529 education savings plan. A 529 plan offers potential tax advantages and can be used for college, qualified trade school programs, and possibly some K-12 expenses. Please keep in mind that potential tax advantages will vary from state to state. Build an emergency fund. Life is full of unexpected events and some can be quite expensive. What if you needed a major car repair or required a medical procedure that wasnt totally covered by your health insurance? Would you have the cash available to pay these bills? If not, would you be forced to dip into your IRA or 401(k)? This might not be a good move, as it could incur taxes and penalties, and deprive you of resources you might eventually need for retirement. Thats why you might want to use your gig earnings to help fund an emergency fund containing several months worth of living expenses, with the money kept in a liquid, low-risk account. To avoid being tempted to dip into your emergency fund, you may want to keep it separate from your daily spending accounts. Pay down debts. Most of us will always carry some debts, but we can usually find ways to include the bigger ones mortgage, car payments and so on into our monthly budgets. Its often the smaller debt payments, frequently associated with high-interest-rate credit cards, that cause us the most trouble, in terms of affecting our cash flow. If you can use some of your side gig money to pay down these types of debts, you could possibly ease some of the financial stress you might be feeling. And instead of directing money to pay for things you purchased in the past, you could use the funds to invest for your future.As weve seen, your side gig money could open several promising windows of opportunity so take a look through all of them. Chad Choate III, AAMS828 3rd Avenue WestBradenton, FL email@example.com This article was written by Edward Jones for use by your local Edward Jones Financial Advisor. Edward Jones, Member SIPC
Its been a bumpy year for the financial markets which means that some of your investments may have underperformed or lost value. Can you use these losses to your advantage?Its possible. If you have some investments that have lost value, you could sell them to offset taxable capital gains from other investments. If your losses exceed gains for the year, you could use the remaining losses to offset up to $3,000 of ordinary income. And any amount over $3,000 can be carried forward to offset gains in future years. This tax-loss harvesting can be advantageous if you plan to sell investments that youve held in taxable accounts for years and that have grown significantly in value. And you might receive some gains even if you take no action yourself. For example, when you own mutual funds, the fund manager can decide to sell stocks or other investments within the funds portfolio and then pay you a portion of the proceeds. These payments, known as capital gains distributions, are taxable to you whether you take them as cash or reinvest them back into the fund. Still, despite the possible tax benefits of selling investments whose price has fallen, you need to consider carefully whether such a move is in your best interest. If an investment has a clear place in your holdings, and it offers good business fundamentals and favorable prospects, you might not want to sell it just because its value has dropped. On the other hand, if the investments youre thinking of selling are quite similar to others you own, it might make sense to sell, take the tax loss and then use the proceeds of the sale to purchase new investments that can help fill any gaps in your portfolio. If you do sell an investment and reinvest the funds, youll want to be sure your new investment is different in nature from the one you sold. Otherwise, you could risk triggering the wash sale rule, which states that if you sell an investment at a loss and buy the same or a substantially identical investment within 30 days before or after the sale, the loss is generally disallowed for income tax purposes.Heres one more point to keep in mind about tax-loss harvesting: Youll need to take into account just how long youve held the investments youre considering selling. Thats because long-term losses are first applied against long-term gains, while short-term losses are first applied against short-term gains. (Long-term is defined as more than a year; short-term is one year or less.) If you have excess losses in one category, you can then apply them to gains of either type. Long-term capital gains are taxed at 0%, 15% or 20%, depending on your income, while short-term gains are taxed at your ordinary income tax rate. So, from a tax perspective, taking short-term losses could provide greater benefits if your tax rate is higher than the highest capital gains rate.Youll want to contact your tax advisor to determine whether tax-loss harvesting is appropriate for your situation and youll need to do it soon because the deadline is Dec. 31. But whether you pursue this technique this year or not, you may want to keep it in mind for the future because youll always have investment tax issues to consider. Chad Choate III, AAMS828 3rd Avenue WestBradenton, FL firstname.lastname@example.org This article was written by Edward Jones for use by your local Edward Jones Financial Advisor.Edward Jones, Member SIPC
As you go through life, youll have various financial goals and to achieve them, youll need to invest. But just recognizing the need to invest is not as useful as matching specific types of accounts or investments with specific goals. How can you make these connections?Lets look at some common goals and how they could possibly be met with appropriate accounts and investments: Saving for a down payment on a house When youre saving for a down payment, you want a certain amount of money available at a certain time so, for this goal, you wont want to take too much risk. Consequently, you might consider investing in certificates of deposit (CDs), which will pay you regular interest payments and return your principal when the CDs mature. CDs are issued in a range of maturities, from one month to 10 years. Other vehicles you might consider are money market accounts or other cash equivalents. Saving for a childs education If you have children, and youd like to help them pay for some form of higher education, you may want to consider a 529 education savings plan. Any earnings growth in a 529 plan is federally tax free, provided the withdrawals are used for qualified education expenses, and you may also receive state tax benefits. A 529 plan can be used for college, approved trade school programs, student loan repayments and some K-12 costs. And if the child youve named as a beneficiary chooses not to continue their education, and doesnt need the money in a 529 plan, you can generally switch beneficiaries to another immediate family member. Saving for retirement This is the one goal that will remain consistent throughout your working years after all, you could spend two or even three decades in retirement, so youll need to accumulate as many financial resources as you can to pay for those years. Fortunately, you likely have access to several good retirement-savings vehicles. If you work for a business, you might have a 401(k) plan, which offers you the chance to put away money on a tax-deferred basis. (If you have a Roth option in your 401(k), your withdrawals can be tax free, although, unlike a traditional 401(k), your contributions wont lower your taxable income.) If you work for a public school or a nonprofit organization, you may be able to participate in a 403(b) plan, which is quite similar to a 401(k), and the same is true if you work for a state or local government, where you might have a 457(b) plan. And even if you invest in any of these plans, you can probably also contribute to an IRA, which gives you another chance to invest on a tax-deferred basis (or tax-free basis, if youre eligible for a Roth IRA). Try to take full advantage of whatever retirement plans are available to you.Here's one final point to keep in mind: While some investments and accounts are appropriate for certain goals, they may not necessarily be suitable for your individual situation so keep all your options in mind and take the steps that are right for you. Chad Choate III, AAMS828 3rd Avenue WestBradenton, FL email@example.com This article was written by Edward Jones for use by your local Edward Jones Financial Advisor. Edward Jones, Member SIPC