- When considering options for long term care in a facility setting, most people know about assisted living facilities and nursing homes.
- There are, however, lesser known categories of facilities licensed by the State of New Jersey.
- One type of senior housing and care facility is a residential health care facility which is defined as a homelike setting that provides shelter, food, supervised health care and related services.
Alternatives to a Nursing Home
There are only a handful of licensed residential health care facilities in New Jersey. Meals are provided in a common dining area similar to an assisted living facility. Staff is present to provide some assistance as needed and in some cases to administer medication. Many of these care centers focus on higher functioning residents for whom living alone is no longer safe, although that is not necessarily the case with every residential health care facility.
Another type of licensed facility is a dementia care home which provides care in a group home type setting to residents in mid to later stages of dementia. These facilities are similar to assisted living residences except they are exclusively devoted to dementia or memory care assistance. They typically are locked units to prevent residents from wandering and leaving the building. The cost is more than the lowest level of assisted living care but less than the average nursing home.
Paying for these types of facilities/homes can be very different than paying for the costs of a nursing home or assisted living facility.
One way, however, does remain the same. Private paying – using your own savings – always works as long as you don’t run out of money. If you have a long term care policy, it can be a little trickier. A residential health care facility may not be covered under a long term care insurance policy for one of two reasons. They are:
Policies that cover the cost of a nursing home or assisted living facility will often define those facilities as providing substantial assistance with activities of daily living. Boarding homes, individual residences and independent living units won’t qualify for coverage. Whether a residential health care facility will be covered will also depend on what services it provides to residences and the frequency.
A second reason the insurance may not cover the cost is because residents may not meet the requirement of needing assistance with at least 2 of the activities of daily living. ADLs are defined as bathing, dressing, toileting, transferring, eating and continence. A residential health care facility catering to the needs of a healthier senior is likely to be covered.
Qualifying under a long term care insurance policy is less of an issue with a dementia care facility. That’s because the focus is on caring for residents already in more advanced stages of dementia. These residents are more likely to fall within the definition of an assisted living facility or nursing home. Additionally, the resident will be able to more easily meet the test of needing assistance with the activities of daily living.
Then there is Medicaid. Many dementia care facilities do not participate in the Medicaid program so choosing this type of facility is like choosing a nursing home that does not take Medicaid.
There are many choices and options when it comes to long term care facilities. To the untrained eye they may appear to be the same. A closer look, however, reveals important differences that play a meaningful role in coming to the right decision for your loved one.
To discuss your NJ elder law matter, please contact Fredrick P. Niemann, Esq. toll-free at (855) 376-5291 or email him at fniemann@hnlawfirm.com. Please ask us about our video conferencing consultations if you are unable to come to our office.
By Fredrick P. Niemann, Esq., of Hanlon Niemann & Wright, a Freehold Township, Monmouth County NJ Elder Law Attorney