Pa Nursing Homes

Pat Howard: Nursing home plans move forward as events increase risk

Erie County Council is running more than two months behind its timetable for deciding whether to build a new county nursing home at a total cost of more than $60 million.

Council's consultant on the issue said waiting past May to commit would not leave enough time to plan, finance and build the home before the county's two existing homes fall out of compliance with federal sprinkler system mandates in 2013. Council has moved ahead on site selection in the meantime, however, and indications are that the votes will be there when needed.

Just last week council narrowed the focus to properties near the current Pleasant Ridge Manor homes in Millcreek and Girard townships. The county already owns the land.

What's worried me throughout the debate is that council members don't seem appropriately nervous about all the variables and risks that come with this decision. The dynamics have only gotten more volatile in recent months.

Because of the way Pleasant Ridge Manor is set up, with council also serving as its board, County Executive Barry Grossman gets no official say. But his voice carries, and he's used it to warn the public that things are less clear-cut than some council members depict them.

Grossman's latest attempt, on Friday, offered signs that he's watching the world around us more closely than his legislative counterparts. He's not making this stuff up.

All hell is breaking loose as the economy sputters and Washington, where adults are in short supply, lurches toward a reckoning over our collective addiction to using borrowed money to fund more government than we can afford or are willing to pay for. What Grossman's trying to tell us is that those events and circumstances have a direct bearing on the decision before County Council.

Pleasant Ridge Manor gets most of its money from Medicare and Medicaid reimbursements. While last week's deal to raise the federal debt ceiling kicked the really hard calls down the road (again), it committed to spending cuts on a scale that ultimately can't be achieved without including those massive health-care programs.

Chances are that whatever cuts emerge will include squeezing health-care providers. Those nursing homes and other providers most dependent on that money figure to get squeezed the hardest.

Supporters of building a new home -- instead of retrofitting one or both of the current facilities or, as Grossman advocates, getting the county out of the nursing home business -- have taken reassurance from the work of County Council's consultant. Complete HealthCare Resources studied the situation and used a series of assumptions and projections to conclude last December that the project could be financially viable.

Preparing for Nursing Home Expenses | Robert J. Kulas, P.A. ...

Making plans to go into a nursing home is not on the top of many people’s list of fun activities, however it is a necessity to think through the options. In this day and age, nursing home care can become a very expensive proposition if you have not planned properly earlier in life. The time to plan for nursing home care is when you are still in good enough health to research the options and understand the costs. Nursing home expenses can be shocking if you have never looked into the details of long-term care.

Medicare is a potential option for people who need nursing home care, but only under limited conditions. Medicare will pay a portion of nursing home costs for Medicare beneficiaries who need rehabilitation services or skilled nursing. In order to be covered, you have to receive services from a Medicare certified skilled nursing home only after qualifying with a hospital stay. That means that you have to be in the hospital for a certain period of time before entering the nursing home. Currently, that is for at least three days.

Another government program that can be of assistance is Medicaid. This is a state and federal program that will pay for most nursing home costs for individuals who have limited assets and income. The eligibility does vary from state to state, and Medicaid will only pay for care in a facility that is certified by the government to provide the services to Medicaid recipients.

In the end, you really don’t want the government in control of your nursing home care. Instead, it makes sense to plan your estate in such a way as to cover the expenses using long-term care insurance or your own personal resources. That is why you should work with an estate planning attorney early on to develop a plan that will allow you to have control over your care in those later years. Leaving things to chance is not a good plan as you may end up living in a place that is not a good choice for you simply because you cannot afford to stay anywhere else.

Robert J. Kulas, P.A. Attorneys at Law is a member of the American Academy of Estate Planning Attorneys .

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