The cost of nursing home care is outrageous and getting worse! A recent article in the New York Times provides a good illustration of this exponentially increasing cost.

The amount that the government pays a nursing home for caring for a Medicaid beneficiary is the floor. In accordance with the rates for 2015 that were released today, a nursing home in Long Island (Nassau and Suffolk) paid by Medicaid will receive $12,390 per resident per month. In New York City (Bronx, Brooklyn, Manhattan, Queens and Staten Island) the rate is $11,843, and in Duchess, Orange, Putnam, Rockland, Sullivan, Ulster and Westchester Counties the rate is $11,455.

The cost of privately paid for care is unregulated and increases exponentially from the rate the government pays. The private pay resident receives the same services (good or bad) as a Medicaid paid resident. In 2014, my clients were billed on average $16,000 per month for basic care and $17,000 or more for dementia care. (You can expect the rates to increase in 2015.)

The Medicaid and private pay rate includes only the cost of basic care. Residents pay extra for a private room, private nursing care, companionship care, hair dressing services, medical care (other than the routine monitoring and sick visits), and for most forms of 1:1 attention. Private insurance, Medicare or Medicaid pays for non-routine medical care and pharmaceuticals. Private nursing, decent laundry, companionship services are paid for out-of-pocket by the resident.

Sadly, I expect the cost of care to continue to rise in 2015 and beyond. In an effort to improve quality and control costs, the Patient Protection and Affordable Care Act (more commonly referred to as the Affordable Care Act) encourages development of cooperative care into “Accountable Care Organizations” but I am not hopeful. In fact, just like the HMO experiment of the 1990’s, I expect more dollars to be spent on bureaucracy and less on direct patient care. Call me a pessimist, but the health care system has been down this road before with little to show for it except higher costs.

Want to go bankrupt fast? Try being a resident in a nursing home!