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Choosing right facility for aging loved ones

Assisted living or nursing home? How to know what's right for your family

JACKSONVILLE, Fla. – Nearly one million Americans live in assisted living facilities according to the Centers for Disease Control and Prevention.

A few months ago, 75-year-old June Holland became one of them when she moved into Brooks Bartram Lakes in Bartram Park.

She's found her rhythm at her new home, but she admitted she's surprised she loves the facility as much as she does.

June Holland, 75, is enjoying life in an assisted living facility.

When she moved in, she didn't think she'd like living in an assisted living facility.

June has Alzheimer's and was living with her daughter, who vowed to care for her, but soon realized her mother needed more. 

"There was a part at one time (where I said), 'No, I can do this. I can do this. She can stay with me,'" Jennifer Holland said. "And I wanted to do it. But at some point you realize that's not what's best for her."

Over 3 million Americans get care in skilled nursing facilities -- what are often called nursing homes.

And with an estimated 10,000 baby boomers turning 65 every day for the next 19 years, many more will be using some form of long-term care.

So what's the difference between an assisted living facility (ALF), like the one June lives in, and a skilled nursing facility?

The ALF offers a high degree of independence and varying levels of care.

When patients go to a skilled nursing facility, it's because they need more intense medical care.

Linda Levin runs the non-profit ElderSource, which serves the needs of seniors in seven local counties.

Linda Levin runs the nonprofit ElderSource -- an agency that serves the needs of seniors in seven local counties.

For anyone exploring long-term care, there are a number of things she said you'll want to check.

"I think we all need to be paying more attention," Levin said.

First, check that the facility has its licenses up-to-date and that it's appropriately staffed.

"They want to see that the staff are happy there. That they interact with each other well, with the residents well," Levin said. "They want to check for smells and odors. You shouldn't smell anything bad and you shouldn't be smelling too much bleach, because they may be covering up something."

Besides the quality of a facility, the cost varies, too.

The average cost of a nursing home, if you're paying out of pocket, is $90,000 a year.

For an ALF, the average cost is $30,000 a year, but if you've shopped around, like June and her family did, you know they can be much more expensive.

At a living facility like Bartram Lakes, the base rate starts at $3,600 a month. And if your loved one needs help with daily activities, it can get as high as $5,800 a month. Living in a memory-care unit is even higher.

So how do you pay for it?

For an assisted living facility, you pay out of pocket, or long-term care insurance covers the cost.

Or if you qualify, you can apply for Medicaid, and the government pays.

For skilled nursing facilities, you can also pay out of pocket, but one study from the Center on Budget and Policy Priorities found that Medicaid covers more than 60 percent of all nursing home residents.

If your loved one is discharged from the hospital and needs to go into a skilled nursing facility for rehab, Medicare will pick up all of that cost for the first 20 days.

After that you'll have to pay 20 percent of the cost.

Medicare's skilled nursing facility coverage ends after the first 100 days.

Medicare may pay for home health care if qualifying conditions are met. 

Jennifer Holland had to make the decision to move her mother into an assisted living facility and has been pleased with the result.


Jennifer Holland is thankful her mother had the foresight to purchase long-term care insurance, and even more thankful her mother is in a place where she's thriving.

"What we did was the best thing for her. She is so happy here," Jennifer Holland said. "That is the greatest comfort to know how much she loves it here."

Getting the appropriate care for someone you love can be a complex, confusing process.

ElderCare provides a hotline for you and can help you get started on a Medicaid waiver. If you qualify, you can even get care in your home.

The number to call is 904-391-6699. Out of area is 888-242-4464.

Or go to their website: myeldersource.org