Long Term Care

One of the greatest concerns of seniors and their families is the cost of long term care, especially the cost of nursing home care. Long term care refers to a range of services necessary to meet your personal needs. Most long term care is not medical care, but assistance with the basic personal tasks of everyday life or activities of daily living (ADL’s). This type of assistance is generally referred to as Custodial Care. Activities of Daily Living include:

  • bathing
  • dressing
  • grooming
  • eating
  • mobility
  • toileting

Long Term care can include:

  • in home health care
  • residence in an assisted-living facility
  • nursing home care

Long Term Care Planning Questionaire

Costs Of Long Term Care

All forms of long term care are expensive. In-home care organizations generally charge from $16 to $24 per hour depending on the extent of services needed. Care for 6 hours per day at $20 per hour will result in a monthly cost of $3,600. The average cost of a one bedroom apartment in an assisted living facility in the Cleveland area is $3,375 per month, and the average cost of a nursing home is $8,159 per month.* One year in a nursing home can easily consume over $95,000. About half of all elderly will spend some time in a nursing home before death. The median length of stay in a nursing home is 2 and ½ years.
*2017 Genworth Financial cost of care survey

Ohio Medicaid Guide


Medicare does not cover most long term care services. Medicare will cover only 100 days of a nursing home stay. The first 20 days are paid completely by Medicare. Days 21 through 100 require a co-pay of $167.50 per day. In order to qualify for Medicare coverage, a person must be hospitalized 3 full days prior to entering the nursing home. Medicare coverage will only apply if you require skilled nursing care. Custodial care does not qualify.


Medicaid is a joint program of the federal and state governments that will cover the long term care costs of those who have little or no money. Medicaid currently covers more than 60% of all nursing home residents. However, most seniors are forced to spend all of their money paying for their care before they can qualify for Medicaid. Medicaid’s financial standards are very strict:

  • A single person may own assets worth no more than $2,000.
  • The spouse of a Medicaid applicant may keep only one-half of the couple’s assets, up to a maximum of $123,600.

Many seniors attempt to qualify for Medicaid by gifting their assets to their children. However, any gifts given within the five years prior to submitting a Medicaid application will cause a penalty, disqualifying the applicant for long term care.

With proper legal planning, however, it is possible for a person to preserve a significant amount of assets for their family and still qualify for Medicaid.

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