How Do I Pay for Assisted Living?

Dear Jaclyn,

I’ve been considering moving to an assisted living community for some time now. However, I have some questions about how I will pay for it. What are my options? Does Medicare cover assisted living?

James K.

Columbus, OH

Paying for Assisted Living

Dear James,

Many people have questions about how to pay for assisted living. To help clear things up, let’s go over some of the most common ways people cover the cost of an assisting living community.

Out of Pocket

Almost all assisted living communities are private-pay. Medicare and most private health insurance plans do not cover assisted living, so you will likely need to pay out of pocket if you live in an assisted living community.

However, there are some things that can help you pay for assisted living, which I’ll go over below.


Related: Ask the Expert: How Much Does Assisted Living Cost?



A few (though not many) assisted living communities accept the Ohio Medicaid assisted living waiver. For example, Whetstone, an assisted living community in Columbus, will accept the Medicaid waiver.

Here’s how it works: once a resident spends down their funds, they can apply for the assisted living waiver. However, they must first have completed two or more years of private pay before this option is available. If they are still a good fit for assisted living after that period, they can transition to the Medicaid waiver, which can help with the cost of assisted living.


Medicare will not pay for assisted living. However, there are some services you may receive while in assisted living that could be covered.

For example, Medicare Part B covers certain types of home health care. Say you needed physical or occupational therapy after a health setback and received services in your assisted living apartment. That would be covered by Medicare because your assisted living apartment is your home.

Long-Term Care Insurance

If you have long-term care insurance, most assisted living communities will accept it. Coverage varies by plan, but it typically covers a large portion of your cost. If you have long-term care insurance, I recommend you utilize it.

As I mentioned above, private health insurance plans do not usually cover the costs of assisted living. However, long-term care insurance is different from traditional health care insurance.

According to the U.S. Department of Health and Human Services, “unlike traditional health insurance, long-term care insurance is designed to cover long-term services and supports, including personal and custodial care in a variety of settings such as your home, a community organization or other facility.”

Veteran’s Benefits

If you are a veteran, your VA benefits can help cover the cost of assisted living through the aid and attendance pension. For eligibility and coverage questions, call the Veterans Affairs office about your VA benefits and health care.

This is a benefit that many veterans don’t realize they have. The best part is, it applies to spouses of veterans, too.


Related: Cost Comparison Worksheet: Assisted Living vs. Staying at Home


Financial Resources for Assisted Living

Many of our residents work with an attorney or financial advisor to sort out how they will pay for assisted living. We can provide referrals to elder law attorneys if you do not currently have one. An elder law attorney can help you with health care planning, financial planning (such as establishing a power of attorney) and more.

On our end, we collect your financial application and answer any questions you may have about costs and what’s included in assisted living.

We always go over your finances with you to ensure that you are a good fit and will be able to afford the cost of assisted living. This is a very important step of the process. At some other communities, you aren’t required to meet any financial obligations prior to moving in and when that’s the case, you run the risk of being asked to move out down the road due to financial issues.

If you have any more questions, feel free to contact us and we’ll be happy to help.

Jaclyn Spalding
Assisted Living Director
Whetstone Rehabilitation, Skilled Nursing & Assisted Living


Is the Medicare Observation Stay Costing You Money?

Dear Jessica,

My father was admitted to the hospital twice in one year for the same type of illness. The second bill was a little more than half the amount of the first one, but Medicare paid hardly any of it.

And although his doctor recommended he go to a rehabilitation center after the second hospital stay, his Medicare wouldn’t cover it.

It doesn’t make sense that my father receives the same treatment but is billed differently and Medicare pays differently. What is going on?



The Medicare Observation Stay

Dear Frank,

It sounds like your father’s second hospital visit was classified under the Medicare observation stay. In an effort to comply with Medicare laws and penalties on readmissions, hospitals are increasingly utilizing the observation stay classification.

What this means is that, because hospitals are penalized for repeat admissions, Medicare patients’ chances of being admitted to the hospital or kept for observation are not based on length of stay or illness, but on the hospital’s likelihood of incurring the penalty. This was verified by a Health and Human Services study, which notes:

“CMS (Centers for Medicare and Medicaid Services) and others have raised concerns about hospitals’ use of observation stays and short inpatient stays. They are concerned about beneficiaries spending long periods of time in observation stays without being admitted as inpatients. In particular, they are concerned that beneficiaries may pay more as outpatients than if they were admitted as inpatients. Moreover, beneficiaries who are not admitted as inpatients may not qualify under Medicare for skilled nursing facility (SNF) services following discharge from the hospital. In addition, CMS is concerned about improper payments for short inpatient stays when the beneficiaries should have been treated as outpatients.”

The result, as you experienced, is that patients’ stays are not covered by Medicare Part A, but instead are covered by Medicare Part B. You may have higher costs and co-pays, and Medicare will not pay for post-hospital rehabilitation services.

Fixing The Problem

On April 1, 2017, new rules were implemented. If your parent is in the hospital for more than 24 hours, he must be notified that his stay is classified as an observation stay. In addition, hospitals and physicians were instructed that all patients who are expected to need care for more than two midnights should be officially admitted.

Unfortunately, your father can’t appeal these charges, although there are other options if he received services after January 1, 2009.

The bottom line on this issue is to be sure to clarify your father’s hospital status and to question and appeal it if you feel it is being used inappropriately. The Center for Medicare Advocacy has a complimentary self-help packet that can assist you if you need it.

Give me a call at (614) 457-1100 or contact any of our care centers if you have additional questions.


Jessica Meadows
Clinical Nurse Liaison
Whetstone Rehabilitation Center, Skilled Nursing & Assisted Living

Staying in Touch with a Loved One

Dear Sheila:

My mother moved to an assisted living community right after Christmas. Now that she is unpacked and settled in I am trying to figure out how we can make her feel as if she is still connected to family and friends. I know she is worried that everyone will forget about her!

Do you have any ideas for me? I am trying to create a list to share with everyone who is important to my mom.

Kind Regards,


Staying Connected to a Loved One in Assisted Living

Dear Donna:

Good idea! I know many other seniors who make a move to an assisted living community share your mother’s fear.

A few ideas you and your family members might find to be helpful include:

  • Visitor Calendar: Set up a schedule of which visitors will drop by to see your mother each day of the week. Spreading out her visitors will help avoid having three people come to see her one day and no one other days. It can be something as simple as sending up a calendar in Google Drive or a private group on Facebook.

  • Video Chat: Technology makes it easy to have virtual “face-to-face” conversations. If your mother has a tablet device or a smartphone, it can be as easy as setting her up on Skype. This free platform will allow loved ones to chat with her from wherever they are, whether across town or across the country.

  • Decorate for each Season: Make a point of helping your mother change her décor each season. Doors can be especially fun to decorate together. She might enjoy spending time with you or a grandchild exploring decorating ideas on Pinterest, too.

  • Cards and Emails: Your mom may also enjoy receiving cards and emails from loved ones. Encourage friends and family to send her a handwritten note a few times a month. While email might not seem as personal, it is a great way to let your mother know you think of her often.

  • Community Events: As a life enrichment director, I know firsthand how much residents enjoy having loved ones join them for community events and activities. And these events allow residents the chance to show off the grandkids, so bring them along, too! Some assisted living communities post their monthly calendar online to make it easier for families to access. Or you can ask to be put on the list to have one sent to you by email or snail mail every month.

  • Furry Friends: If you have a furry friend your mom is fond of, bring them along on your visit. While you probably need to check with the staff at her community about restrictions, pets are usually welcome and well-received by all residents.

I hope this list is helpful to you, Donna! And best of luck to your mother as she makes this transition.


Sheila Walters, Assisted Living Life Enrichment Director


4 Ways to Manage Medication

Mistakes with medications send an estimated 700,000 older adults to the emergency department of a hospital each year, according to the Institute of Medicine. It is easy to understand why. 30% of seniors take five or more prescription medicines each day. 90% of adults over the age of 60 take at least one. Staying on track while juggling so many different medications can be a challenge.

Tips to Help Central Ohio Seniors Safely Manage their Medicine

Here are a few steps you can take to keep a senior loved one safe:

  • Utilize Technology: There are a variety of tools and technologies that make managing medications easier. From Text4Health programs to products like MedMinder that work off cellular technology, there are systems available to help keep your senior loved one safe.
  • Dispose of Old Meds: Another important tip is to quickly dispose of old medications and keep the medicine cabinet free for only those currently prescribed. Doing so can help prevent an older adult from accidentally taking the wrong medication or a previously prescribed dose of a current one. These tips from the Food and Drug Administration (FDA) will assist you in figuring out how to safely dispose of them.
  • Keep a Current Medication List: Maintaining a list of medications –both prescription and over-the-counter ones – is almost critical. Update it with every change their physician makes. Keep a copy in your purse and have your senior also keep one in their purse or wallet. Be sure to share the most recent list with all of their health care providers at each appointment.
  • Review Potential Side Effects: Because older adults metabolize medications differently than younger ones, it puts them at a much higher risk for adverse effects and even potential overdose. Take time to review the side effects and warnings before your senior family member begins taking any new prescription or over-the-counter medication.
  • Clear Labels: If your aging loved one takes their medication directly from the bottle and not from a pill box, make sure the label can be easily read. Most pharmacies offer large print labels to help keep seniors safe. If they are using a daily pillbox system, be sure to provide clearly written directions on which medications to take and at what times of day to take them.

Tip from the Expert

“One of the most important aspects in helping patients understand and manage their medications is developing a relationship with them. It is crucial to earn a patient’s trust so that you can become part of their healthcare team. Seniors sometimes take quite a few medications so it helpful to make sure they are keeping track of each medication and what it is used for. I also make sure I make them aware of specific drug interactions as well as interactions with over the counter medications. Patients also need to make sure they get rid of medication they are no longer taking so they do not confuse with a new one. The same can be said to not combine different medications in one bottle.” -Jennifer Peters,  PharmD, RPH

If you would like to learn more, Medication Safety for the Elderly: A Guide for Patients and Caregivers is a free download that may be of interest.

For other questions regarding how your senior can better manage their medication, please give us a call at 614.345.9500 or contact us today.

Aggression in Men with Alzheimer’s Disease

We know women outlive men for a variety of reasons. But if you visit a memory care program in an assisted living community, you will likely notice men make up what seems to be a disproportionate amount of the resident population. A new study on Alzheimer’s and men sheds light on why.

Looking at three years of admissions data from memory care programs across the country, researchers found men are 27% more likely to require a memory care program than women are. Men are moving to an Alzheimer’s or dementia community 14% faster than their women. As researchers dug a little deeper into the reasons why, they came up with two behaviors that seemed to trigger the move: wandering and aggression. Both can be hard for family caregivers to try to cope with and manage at home. Men exhibit higher numbers in both behaviors than women.

  • Men are 8% more likely to wander from home than women.
  • Men are 30% more likely to exhibit aggressive behavior with family members and caregivers.

Causes of Aggression and Wandering Among Older Adults with Alzheimer’s

Because so many issues related to Alzheimer’s disease continue to be a mystery, the exact reasons for aggression and wandering aren’t known. Alzheimer’s researchers do believe they understand some of the possible causes. They can include:

  1. Undiagnosed pain. Communication can be difficult for someone with Alzheimer’s disease. The loss of verbal skills makes it harder to know when they are in pain. Whether it is the pain of a chronic health condition like arthritis or a new problem like a bladder infection, it can be challenging to figure out the source of the pain when someone lives with dementia.
  2. Fatigue. Alzheimer’s patients can seemingly go for days without sleep. That behavior doesn’t mean they aren’t tired. Chronic fatigue is common as Alzheimer’s disease progresses. It can lead to aggression because the person is so exhausted and frustrated at their body’s inability to sleep.
  3. Medication interactions. As we age, our bodies process medications differently. It can mean an older adult requires less of a medication or develops a problem with one they have taken for many years.
  4. Overstimulation. People with Alzheimer’s disease have trouble processing information. A noisy or hectic environment can be too much for them. It can lead to aggression and wandering.
  5. Communication struggles. Just the very fact that they have lost their ability to communicate can cause great frustration. When someone with Alzheimer’s needs to use the restroom and they don’t know how to convey it, or if they are hungry and can’t figure out what to do about it, they may lash out in anger or wander off in search of a solution.

If you are caring for a central Ohio senior who is living with Alzheimer’s disease, we invite you to subscribe to our blog. We routinely share information and resources designed to be of help to adult children and family caregivers.


Can My Mom and Dad Stay Together?

Dear Sarah,

My mom and dad have been together for more than 40 years. Last year, Mom had a stroke, and now, she has difficulty walking, bathing, dressing and even eating.

Dad’s done a terrific job of taking care of her, but we can tell it’s becoming more and more difficult for him. He’s already told me he’s concerned he’ll fall while he’s trying to help her.

We’ve tried everything to help them stay in their homes. Right now, we have home health care aides coming in four hours a day (their minimum), and Mom doesn’t need that much. We’ve also contracted for someone to mow the lawn, shovel the snow, and do odd jobs. The costs are mounting, and I’m not sure Mom and Dad are any safer or happier.

They’ve never been separated, and we’re concerned about the effect on Dad if Mom went to a nursing home.

Can you help us?




Dear Joseph,

I can read in your letter the heartbreak you and your family are going through. Many families just like yours are struggling to find solutions to keep their parents together, healthy, and safe.

There is an alternative to a nursing home for your mother. Your parents can stay together in a private assisted living suite at Mill Run Assisted Living. Just like they do in their home, they can lock the doors when they want privacy, and they can come and go as they like.

Your mother can receive the care she needs when she needs it. For example, if she has difficulty getting up, bathing and dressing in the morning, one of our professional certified aides will come in—at a time of your parents’ choosing—to help her.

The aide will stay no longer than necessary to assure your mother’s comfort and safety—no minimums. However, if your mother needs more help, we can easily provide it. And, because we offer skilled nursing, our professional nurses are available 24 hours a day.

Mill Run is part of the MacIntosh Company, so we can help if your mother requires skilled nursing, rehabilitation, and memory care, too. Our goal is to find the best solution for your parents and you.

Mill Run Assisted Living provides more than daily care for your parents. Although there’s a kitchenette in the apartment, your parents don’t ever need to cook. They can enjoy nutritious meals specifically concocted to appeal to aging tastebuds in our dining room in the company of our vivacious, friendly residents. They can even get snacks and room service when they want.

In addition, they can both participate in activities, including classes such as painting and cooking. The barber shop and beauty salon are in the same building, as is the laundry. They can join other residents listening to live entertainment and performers, participating in learning events or visiting nearby attractions. They can schedule transportation to their doctor’s office if they’d like.


There are many other services we offer at Mill Run, but in the interest of brevity, I’d recommend you and your parents visit us here. You can call us at (614) 527-3000 for a tour or more information.


Sarah Dixon
Market Development Specialist

Ask the Expert: Delaying Assisted Living

Dear Sarah,

Our entire family knows my mother needs to move to assisted living. She forgets to take her medications, and she gets vertigo very easily. When I’ve asked her about bruises, she has no idea where she gets them. And even though she gets Meals on Wheels, I don’t think she’s eating right.


Does your parent need assisted living? Discover the signs here.


We’ve all considered whether she could move in with one of us, but those of us who still live in the Columbus area don’t have houses that are big enough or work too much.

The problem is that Mom doesn’t want to move. She still believes she can maintain and live in the house she shared with my father.

But, recently, she had a spell of vertigo and fell. Although she was just bruised, she could have easily broken a hip.

What should we do?



Consequences of Delaying a Move to Assisted Living

Dear Beth,

Many families like yours are struggling with this issue with their older loved ones. The most important advice I can convey to you is not to wait until there is a crisis that forces a move. Many residents tell us they wish they had moved sooner.

One of the fears older adults have about moving is fear of change, which they may voice by saying, “I don’t want to live with older people,” “How will I make friends?” and “How can I trust the staff?” Another is fear of abandonment. They are worried you won’t visit them or include them in family activities if they live somewhere else.

However, if you go along with your parent’s delaying tactics, they not only may suffer a debilitating illness or injury, their decline in physical well-being may mean they may be forced to move into a less-than-optimal assisted living community that is either farther away from family or not highly rated. Alternatively, they may no longer qualify for assisted living and miss out on assisted living amenities, such as social activities, entertainment, and learning opportunities.


Which is better for your parent—assisted living or staying in their house?


Assisted living centers safeguard your parent’s health and safety by providing emergency response systems, medication management, Americans with Disabilities Act (ADA)-compliant buildings, and on-site nursing.

If you’re interested in starting a conversation with your mother, our blog has tips to help. In addition, I’d recommend you bring your mother over to any of our central Ohio assisted living centers, such as Mill RunNew AlbanyPickaway, and Whetstone. She can meet residents and staff, visit an assisted living suite, participate in activities, and experience the carefree lifestyle. If she wants, she can even stay for a nutritious, restaurant-style meal (our chefs are the best!).

You can call the center closest to you, but if you have any questions for me, please call (614) 527-3000; I’d be delighted to help.


Sarah Dixon