Long Term Care Planning & Asset Preservation



 In Home Care: In general, most people start with supportive care so that they can remain at home. This care is private pay only. However, since you are  a war-time veteran it’s possible that you could receive extra compensation for care at home. If you employ a private caregiver, the average hourly cost is approximately $15 per hour. If you required a live-in caregiver, the cost is between $4,500 to $5,500 per month. Due to recent changes in regards to caregivers employed by agencies, using an agency has become prohibitively expensive in most cases.

 Residential Care Facilities for the Elderly (RCFE): These facilities serve persons 60 and older. They provide room, board, housekeeping, supervision, and personal care assistance with basic activities like personal hygiene, dressing, eating, and walking. Facilities usually centrally store and distribute medications for residents to self-administer.  Medication administration and supervision can usually be provided by the facility at an extra cost. 

 This level of care and supervision is for people who are unable to live by themselves but who do not need 24-hour nursing care. They are considered non-medical facilities and are not required to have nurses, certified nursing assistants or doctors on staff. Other terms used to refer to this level of care are assisted living facilities, board and care homes, and rest homes.   

 There are generally two subcategories of RCFEs: assisted living facilities and board and care homes.  Residents of assisted living facilities usually have their own units or apartment. In addition to having a support staff and providing meals, the facility can provide extra care. However, if there is a lot of need for assistance, the cost of this care can rapidly rise to the point of being unaffordable.  
 If an elder is especially frail or there is a diagnosis of dementia, you should consider looking at board and care facilities. These private homes typically consist of six residents with their own individual rooms and may be a more appropriate setting for someone with mobility issues and extra care needs.  The cost of board and care is generally more affordable than assisted living.  While this level of care is private pay only, the VA benefit can potentially utilized to pay for this type of care.

 Nursing homes (SNF): All nursing homes in California must be licensed by the California Department of Public Health (DPH) and meet California nursing home standards.  In addition to being licensed, nursing homes that choose to participate in the Medicare and Medi–Cal programs must be certified by the federal government in order to qualify for payments from these programs. Federally certified facilities must meet federal standards as well as the California requirements. Most California nursing homes are certified to participate in both Medicare and Medi–Cal. 

 Skilled Nursing Facilities (SNFs), are broadly defined as health care facilities that provides skilled nursing and supportive care to persons who need this type of care on an extended basis. If there is a need for rehabilitation or skilled care and there is a prior hospital stay, then the care is paid for by Medicare or a Medicare HMO (such as Kaiser) for up to 100 days of skilled care or rehabilitation. If the patient plateaus, shows a decline in  improvement, or the need for skilled or rehab care ceases, a nursing resident is considered to be receiving “custodial” care. This level of care is private pay or can be supported by the Medi-Cal program.  


•    Medi-Cal
•    In Home Support Services (IHSS)
•    VA Aid and Attendance Benefits
•    Medicare