February 5, 2004   Copyright © 2004, Greenwich Financial Management Inc., a registered investment advisor.  Securities offered exclusively through Purshe Kaplan Sterling Investments of Albany, NY, a NASD member firm.

 

 

Demystifying Insurance, Part 9:

The Cost of Long-Term Care

 

 

            To evaluate your need for long-term care insurance, you first need to get a handle on the costs.  Long-term care quotations in this article represent typical pricing, not recommendations.  Next week we will discuss Medicare and Medicaid as funding sources for long-term care, and the following week, private long-term care insurance.

 

The costs of long-term care are highest in the northeastern part of the United States, and particularly in Fairfield County and the New York metro area.  For the Waveny Care Center, in New Canaan, the cost is $310 per day ($113,150 per year) for a semi-private room and $340 per day ($124,100 per year) for a private room.  At the Nathaniel Witherell Home, which is owned by the Town of Greenwich, the cost (as of a scheduled March, 2004 increase) is $281 per day ($102,565 per year) semi-private and $320 per day ($116,800 per year) private.  These nursing home charges include full room and board, but do not include the costs of prescriptions or physician's services.  The annualized amounts illustrate how these daily rates add up.

 

There is a website, by the way, www.memberofthefamily.net, which reports on nursing homes with state survey violations.  

 

Home care with a visiting nurse or health aide service is often a desirable alternative to nursing home care.  Probably nearly everyone would prefer to be cared for at home if possible.  Moreover, one risk with institutional care, no matter how immaculate, is the possibility of infection from other patients or caregivers.  Greenwich Hospital Home Care (863-3883) gave the following quotations for at-home care: private nursing, $132.75 per visit; therapy, $158 per visit; care by a Certified Home Health Aide, $25 per hour, or for blocks of four hours or more, $20 per hour.  If you should need live-in care by a Certified Home Health Aide, a typical deal is to charge for about 10 hours per day at $20 per hour, the assumption being that the caregiver does not have to get up more that once or twice per night to attend to the patient.  You may also contact a nurse's registry, which is basically a referral business whose member/owners are nurses.  The Greenwich Nurse's Registry (869-4050) provides three levels of assistance, generally for a minimum of four hours of service per day (but with exceptions): Certified Nurse Aide, $16-$17 per hour; Licensed Practical Nurses, around $35 per hour; Registered Nurses, up to $50 per hour, depending on qualifications.  Patient Care (629-4780), in Greenwich, specializes in providing Certified Home Health Aides and can also provide Certified Nurse Aides.  The cost is about $21 per hour, or $200 per day, with no set minimum number of hours; Patient Care emphasizes that they have two Registered Nurses on duty all the time, for supervisory purposes.  Patient Care handles only private pay and private health insurance cases.  A companion company, Priority Care (203-840-8312), in Norwalk (among other places) handles Medicare and Medicaid cases.

 

For some, staying in Greenwich, or at least in the New York metropolitan area, is very important.  Family, friends, place of worship, social clubs, and trusted medical providers may be nearby.  These relationships can be of critical importance to wellness.  For others, and particularly for those facing economic pressure or uncertainty, relocation to a less expensive area may save hardship or preserve more estate value to pass on to children or charity.  Long-term care nursing facilities may cost 70% or less of the rates quoted above in certain parts of Pennsylvania, Western New York or Maine, for example, or farther afield, in some parts of the Midwest and South.  

 

A cost-saving and desirable alternative to nursing homes may be an assisted living or adult care facility.  These facilities typically require that patients can at least get dressed and eat with some assistance.  Dementia cases may be accepted, but not if at the "wandering" stage; incontinence may also be acceptable.  For example, the Bristol Home, in Buffalo, NY (a venerable establishment in an older urban neighborhood), which is non-profit and enjoys an endowment, offers private rooms for $62 (without bath) to $67 (with private bath) per day.  For more ambulatory and cognizant clients, assisted living facilities may offer apartments or townhouses adjacent to a center offering meals, recreation and full-time nursing staff.  

 

                       

Andy Szabo, CFA, is Managing Director of Greenwich Financial Management Inc., a Registered Investment Advisor, which advises individuals and companies on investments, insurance and employee benefits.  Questions or comments welcome by phone (203-531-2877) or e-mail: Szabo@GreenwichFinancial.com.