Massachusetts Skilled Nursing: How to pay for, Licensing and Questions to ask…
Plymouth is a coastal town in Massachusetts. It is the site of the first Pilgrim settlement, founded in 1620. Plymouth Rock, a boulder in Pilgrim Memorial State Park, marks the place where settlers are thought to have landed on shore. Plymouth County offers cranberry farms, beautiful nature walks and more. The town and county of Plymouth boasts some of the best whale watching, dining, shopping, and cultural activities in a quaint New England setting, much of it nestled along the seashore. It is a history lover’s paradise, a family friendly atmosphere, and easy walking as you take in breathtaking sunrises.
About Skilled Nursing in Plymouth
There are excellent facilities for healthcare in Massachusetts. This is an added bonus for the aging adults in the state. They’ve already got the most beautiful summers and autumns in the United States, a rich history going back to the origins of the country. About 18% of the population of Massachusetts is 65 years and older and may require care at some point. A Skilled Nursing facility is a state-licensed facility that provides a safe, therapeutic environment for individuals who require rehabilitative care. Skilled nursing in Massachusetts typically helps with the transition between a hospital and more permanent residence, which could be an assisted living or independent living community. Most often, skilled nursing is short-term acute care, but there may be long-term care services as well. Facilities are required to be licensed by the Division of Health Care Facility Licensure and Certification, the Department of Health Services. The two main certification requirements for a Skilled Nursing Facility (SNF) are The State Certification and Medicare certification and accreditation. State agencies perform inspections for certification and report findings to the Center for Medicare and Medicaid Services. Massachusetts is well-known for its high-quality healthcare.
Considerations when looking for care in Plymouth
Plymouth has 60,803 residents with over 50 skilled nursing facilities. The hottest month of the year in Plymouth is July, with an average high of 80°F and low of 63°F. The coldest month of the year in Plymouth is January, with an average low of 23°F and high of 38°F.
Skilled Nursing Facility Communities near Plymouth, Massachusetts
Wingate At Silver Lake
Kingston, Massachusetts 02364
Webster Park Rehabilitation And Healthcare Center
Rockland, Massachusetts 02370
Taunton, Massachusetts 02780
Tremont Health Care Center
Wareham, Massachusetts 02571
New Bedford, Massachusetts 02745
The Guardian Center
Brockton, Massachusetts 02301
St Joseph Manor Health Care Inc
Brockton, Massachusetts 02302
Southwood At Norwell Nursing Center
Norwell, Massachusetts 02061
Southshore Health Care Center
Rockland, Massachusetts 02370
Southeast Health Care Center
Easton, Massachusetts 02356
Cities Near Plymouth
- Boston – 40 miles north of Plymouth
- Middleborough – 15 miles west of Plymouth
- Plympton – 11 miles west of Plymouth
- Brockton – 24 miles north of Plymouth
Pricing and how to Pay for Skilled Nursing
Health care is not cheap in Massachusetts. Skilled nursing care is no exception. A double occupancy room is $12,800 / month; a single occupancy room is $13,750 / month. The national average cost for skilled nursing care is $325 / day. This may not include all supplies, medications, therapy or rehab. Private rooms are more expensive at $340 / day. A shared room averages out to $310 / day.
Paying for Senior Living and Care will vary depending on a few factors. For instance, the level of care needed; the income and savings of the resident; the state and location of the community; or if the resident is a veteran. In the United States there are over 400 programs that may offer some monetary relief for senior care, but often the majority of costs are covered by private funds and family assistance. These funds come from our Federal, State, and Local Governments.
It is important to take your time when exploring payment and coverage options.
Private pay – YES:
- Many families pay for assisted living with private funds.
- Private pay can be a combination of retirement funds, personal savings, and pension payments.
- Family members may contribute funds to pay for assisted living or other senior housing and care.
Medicare will TYPICALLY cover Skilled Nursing (SNF) care ONLY under these factors:
- People 65 years and older and individuals with end stage renal disease are eligible for Medicare benefits, no matter their income.
- Coverage is meant for people in need of short-term care.
- The person has Medicare Part A, and has available days left in their benefit period. The person has a qualified hospital stay. (3 consecutive midnights or more)
- The individual must enter SNF within 30 days of leaving the hospital.
- The person’s doctor has ordered inpatient services at a skilled nursing facility.
- The individual must need and receive the skilled care daily. The care provided must be care that the person can only receive in a SNF.
- The person needs skilled services because of an ongoing condition or a new condition that started while in a SNF for treatment of an ongoing condition.
- The skilled services must be reasonable and necessary for the treatment of the condition.
- You must receive the care in a Medicare certified SNF.
Medicaid – MAYBE:
Medicaid can be a payer source if the patient needs both care and has a financial hardship based on the individual state criteria. Eligible participants include: low-income adults, elderly adults and people with disabilities. The program is funded jointly by each state and the federal government; and national guidelines are in place do decipher how states must spend Medicaid money, but with allowances toward the guidelines. Every state has their own individual Medicaid assistance program. Each state determines what levels of care will be covered by Medicaid, who is eligible, and how much the state will reimburse the care community.
- Skilled nursing falls under Medicaid’s Nursing Facility Services.
- People who are eligible for Medicaid must meet the state criteria for skilled nursing care.
- The state of residency must abide by federal law and regulations when setting their skilled nursing care requirements.
- The patient meets the state guidelines for income and asset limits.
If you are unsure whether you qualify for Medicaid, you should apply. You may be eligible depending on your household income, family size, age, disability and other factors.For a clearer understanding on coverage contact your State Health Insurance Assistance Program.
Long-term Care Insurance – MAYBE:
Long term care insurance is a great way to pay for assisted living, and planning ahead is important when considering how to pay for senior housing and care. Nearly 75% of people over the age of 65 will require long-term care and services at some point. Buying into long-term care insurance when a person is in their 50s and 60s is the most common time to do so.
- Long-term care insurance helps cover the costs of chronic medical conditions.
- Individuals and couples with the ability to pay into long-term care insurance have the advantage of a head start in allocating funds for senior care.
Veteran Aid and Assistance – MAYBE:
This benefit is available to some military veterans and surviving spouses who live in an assisted living community and those who have in-home care.
- There are specific guidelines, but a veteran may qualify for as much as $2,050 each month.
- A veteran with a sick spouse may be eligible for $1,600 per month.
- If a veteran has passed, their surviving spouse can qualify for $1,300 per month.
Questions to ask a skilled nursing facility
- Is the facility licensed?
- Has the facility’s license ever been revoked?
- Is the facility Medicare/Medicaid certified?
- What types of insurance is accepted?
- Are all specific medical needs able to be met?
- What services are offered?
- What is the rate for basic care?
- Are any reviews available to be seen by the public?
- Are protocols in place to ensure healthy, balanced meals?
- What if an individual has specific dietary restrictions, can they be met at the facility?
Additional questions and inquiries to ask skilled nursing facilities
- What should a new resident (patient) bring with them?
- What is the difference between skilled nursing and assisted living?
- What happens in case of an emergency?
- Can the family pet visit the resident?
- What is the level of privacy?
- What are the available social activities?
- What is the hours for family visits?
- Can patients request special meals for dietary needs?
- Are skilled nursing facilities connected to hospitals?
- How big are the rooms?
- What are the training requirements of skilled nurses?
Local Hospitals and Healthcare Providers in Plymouth
VA Boston Healthcare System
116 Long Pond Rd #4, Plymouth, MA 02360
Senior Behavioral Health Center
275 Sandwich St, Plymouth, MA 02360
Local Resources and Links – Massachusetts
Central Massachusetts Agency on Aging seeks to outreach to older persons and their caregivers, hoping to educate them on services and programs that are meant to serve and assist them to remain safely and securely in our communities.
Age Strong Commission As an AAA, the Commission provides funding to community partners to provide services to seniors in the neighborhoods. The Commission also provides direct services to seniors such as advocacy, information and referral, transportation, volunteer opportunities and cultural and social events.
Executive Office of Elder Affairs State Agency that contracts with local service providers.
Greater Springfield Senior Services, Inc. is an Area Agency on Aging (AAA) and Aging Services Access Point (ASAP) providing services to help preserve the independence, and quality of life of elders and disabled persons desiring to remain within their own.
Eldercare Locator This is a great resource to search for specific care in specific counties and cities. This database is a nationwide resource that connects older Americans and their caregivers with trustworthy local support resources. Connect with services such as meals, home care or transportation, or a caregiver education or respite from caregiving responsibilities. The Eldercare Locator is a public service of the Administration on Aging (AoA), an agency of the U.S. Administration for Community Living.
Medicare provides a search feature to find & compare providers near you, most senior housing and care providers are included on CareAvailability.com. Find & compare plans in your area. Determine if you qualify for premium savings
Medicaid offers information on how to apply for Medicaid, eligibility criteria, links to local state offices, and additional resources
The Alzheimer’s Association is the leading voluntary health organization in Alzheimer’s care, support, and research. Whether you are living with Alzheimer’s or caring for someone with the disease, information and resources are available.
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