The Average Cost of Nursing Home Care Moves Upward in 2012

The cost of long-term care increased significantly, according to the 2012 MetLife Market Survey of Nursing Home, Assisted Living, Adult Day Services, and Home Care Costs. 

Private room nursing home rates jumped 3.8 percent to $90,520 a year or $248 a day, while assisted living facility costs rose 2.1 percent on average to $42,600 a year or $3,550 a month.

The average cost of homemaker/companions increased by 5.3 percent to $20 per hour. The news wasn't all about increases, however. The cost of adult day care services remained the same as last year at $70 per day and the average cost of home health aides remained at $21 per hour.

The survey also reports on the cost of a semi-private room in a nursing home, which increased 3.7 percent to $222 a day, or $81,030 a year.

Once again, the highest rates for a private nursing home room in 2012 were found in Alaska, where the average cost rose from $655 a day to $687 a day. This year the lowest rates were found in Oklahoma (with the exception of Oklahoma City and Tulsa) at an average of $147 a day for a private room. Texas (with the exception of Austin, Dallas/Ft. Worth, and Houston) had the lowest rate for a semi-private room at an average of $131 per day.

The cost of assisted living continues to be the highest in the Washington, D.C., area, at $5,933 a month (up from $5,757 a month in 2011) and the lowest in Arkansas (except for Little Rock) at $2,355 a month (up from $2,156 a month in 2011). Average home health care aide services ranged from a high of $32 an hour in Rochester, Minnesota (down from $34 an hour in 2011), to $13 an hour in the Shreveport area of Louisiana (down from $14 an hour in 2011). Adult day care services were highest in Vermont at an average of $141 a day and lowest in the Montgomery, Alabama, area, at $26 a day, both down from 2011.

For the full 2012 report, including listings of average long-term care costs in selected cities, as well as the original website for this article, click HERE.  


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The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in Rhode Island who specialize in wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits.

They also are Newport Rhode Island Divorce Lawyers, Attorneys, Mediators, and Arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and military family law.

Call them today at 401-841-5700 or visit them on the web at http://www.CounselFirst.com.

Book Review: Everyday Law for Seniors

Lawrence Frolik and Linda Whitton.

Everyday Law for Seniors. 

Paradigm Publishers. Boulder, CO. 2012. 189 pages.

 $24.95 from Amazon

Seniors confront many issues that require a basic understanding of the law, from financing long-term care to protecting themselves in the event of incapacity. This book provides a clearly written and concise guide to the range of legal options and rights available to seniors.

Written by two law professors and elder law experts, and part of a series of "Everyday Law" primers, Everyday Law for Seniors explains how those in their 60s and older can use the law to their best advantage. The book covers a wide variety of topics of interest to seniors, including age discrimination, Social Security, retirement benefits, Medicare and Medicaid, guardianships, powers of attorney, and elder abuse. In clear, understandable English, each chapter describes the law and gives seniors an overview of their legal rights and protections to help them make the best possible decisions.

The authors don't offer legal advice and the book is not meant as a substitute for a good lawyer. Instead, the straightforward information the book provides can help readers understand their options, ask good questions, and better comprehend any legal advice they receive.

You may find the original article, as well as links to order this book, on our newsletter HERE.


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The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in Rhode Island who specialize in wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits.

They also are Newport Rhode Island Divorce Lawyers, Attorneys, Mediators, and Arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and military family law.

Call them today at 401-841-5700 or visit them on the web at http://www.CounselFirst.com.

Losing the Forest for the Trees

Can't See the Forest Through the Trees?

This common quote means that if you are so engrossed in looking at individual trees, you might forget that each tree is one of thousands and thus lose sight of the big picture-the forest.

It is much the same in elderlaw. For example, if you focus on the rules of the VA in order to obtain Aid & Attendance Benefits, you can make a mistake and jeopardize your Medicaid eligibility in the future (if you should require assistance to remain in a nursing home).

In elder-law, the trees are Medicaid rules, estate & gift tax laws, income tax laws, VA Aid & Attendance rules, state Probate rules, state statutes and case law. The forest is the comprehensive view of a clients needs, goals, health, and desires or the estate plan of a client.

We saw an example this week. Our client's son and daughter had been advised to spend down their mothers assets by making gifts in the allowed annual amount of $13,000 so that she would qualify for Medicaid nursing home assistance in the future due to lack of assets.

Our clients advisors were confusing one tree (Medicaid allowable spend-down) with another tree (estate & gift tax law). Her gifts would disqualify her from receiving Medicaid assistance for five years from the date of the gifts due to the penalty period imposed by the Medicaid rules. Our client would never have had an estate tax issue because her assets would never reach $900,000, the approximate Rhode Island credit amount.

On the other hand, it was possible that she could run out of funds within the five years and need Medicaid assistance to remain in a nursing home but not be qualified for that assistance due to the penalty.

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The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in Rhode Island who specialize in wills and trusts, estate planning, guardianship, probate, and Veterans Aid and Attendance Benefits.

They also are Newport Rhode Island Divorce Lawyers, Attorneys, Mediators, and Arbitrators providing services for family law issues such as divorce, child custody and visitation, support, and military family law. 

Call them today at 401-841-5700 or visit them on the web at http://www.CounselFirst.com.

The CLASS Act Is “Dead on Arrival”

CLASS Act  News

The publication Special Needs Answers  reported that The Obama administration has suspended implementation of the CLASS Act, a proposed national long-term care insurance program that was part of the health reform law.

The CLASS Act is the first big part of the health overhaul to be killed. Health and Human Services Secretary Kathleen Sebelius described the intended program as a voluntary program wherein workers could pay premiums and would be eligible after years for a benefit that could help pay for long-term care services.

The theory sounded good: “CLASS would not only give Americans who knew they were likely to require long-term services and supports an affordable way to prepare for the future. It would also give young and middle-aged Americans a way to insure against the possibility that they would someday require this kind of care themselves. Because all benefits would be paid out of premiums, it wouldn't cost taxpayers a dime (emphasis supplied) and CLASS would provide relief for State and federal budgets, which currently … bridge the long-term care coverage gap with scarce Medicaid dollars.”

The Secretary and her analysts could not develop a program that would meet the program’s financial objectives: “When it became clear that most basic benefit plans wouldn't work, we looked at other possibilities. But …, we have not identified a way to make CLASS work at this time.” Speaking for myself and for others who work in the field, it is clear that our leaders and legislators do not understand the import of the laws they are proposing and passing and they try to accomplish things that are near impossible.

The cost of nursing home care and long-term care has risen dramatically in the past two years. How are legislators to structure a program that will predict the economic realities of long term care in the future?

I respectfully suggest that they are out of their league.

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The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in Rhode Island who specialize in Wills and Trusts, Estate Planning, Guardianship, Probate, and Veterans Aid and Attendance Benefits.

They also are Newport Rhode Island Divorce Lawyers, Attorneys, Mediators, and Arbitrators providing services for Family Law issues such as Divorce, Child Custody and Visitation, Support, and Military Family Law. 

Call them today at 401-841-5700 or visit them on the web at http://www.CounselFirst.com.

Ways to Help Your Parents or Spouse Discuss Long-Term Care Planning

This article was published on ElderLawAnswers.com and may have been included in our December newsletter. I thought it would be helpful for people as a starting place with regard to their elder parents and is worth reading if you missed it the first time!

Dad, Can We Talk? Answers to 9 Top Questions About Discussing Long-Term Care Planning

Last Updated: 7/27/2010 4:14:01 PM

Recently a reporter asked ElderLawAnswers founder and president, Harry S. Margolis, some questions for an article on talking with aging parents or other family members about sensitive issues such as wills, funeral arrangements, assisted living or medical treatment wishes. Here are the reporter's questions and Harry's answers.


1. At what point is it appropriate for grown children, spouses, caregivers or friends to attempt to discuss these issues with aging parents, relatives or friends?

The earlier the better, but every family is different, and raising these issues can be more or less uncomfortable depending on the family dynamics. Certainly, if there is an illness or medical emergency, that can serve as justification for beginning the discussion.


2. What's the best way to broach the subject?

Rather than focusing on the parent or other family member's current or possible future physical and mental decline, it often works better for the person starting the conversation to focus on his or her own concerns. She can say that she was meeting with her own estate planning attorney, which made her think about her parents situation. Or she can talk about how she is nervous about being able to care for her parents when and if the need comes up. Often parents won't take measures to protect themselves, but they never stop being parents and will respond to a call for help from a child.


3. Where's the best place to have such a discussion?

In the parent's home.


4. Should you seek legal counsel first before initiating a talk?

Not necessarily. A legal consultation would help the children or other family members know what issues to discuss and some of the available options. But the ultimate goal should be for the elder to consult himself or herself with an attorney with elder law experience.


5. Should it be one-on-one or should family members, friends or those with specific expertise in an area be part of the discussion?

That has to be determined on a case-by-case basis. We always encourage transparency so that all family members are in the loop. However, scheduling can be difficult and too many people involved can be overwhelming. In addition, depending on the circumstances, elder care and planning issues can take several meetings to resolve. Different people may be involved in different meetings depending on the issues being discussed at each.


6. What if your parent, spouse, etc., refuses to talk about these issues? How do you overcome this?

Follow the advice above. If it's a parent, the child may have to be patient and wait until an opportunity arises to bring the subject up again. Ultimately, it may be impossible to get the parent to participate in any planning. If it's a spouse, this is also true. However, a spouse may be able to take some planning steps on his or her own.


7. What steps can you legally take to prevent an elderly person from driving if they refuse to hand over their license or keys?

This depends on the state. In some states there are provisions for letting the registry of motor vehicles know of problem drivers. Where family pressure doesn't stop a senior from driving and dementia exists, some of our clients have been successful in disabling vehicles if the senior does not have the capacity to get it fixed.

8. What steps can you legally take if an elderly person such as a parent or spouse refuses to take care of issues dealing with a will, housing, medical treatment or related areas?

It depends on the parent or spouse's mental capacity. If they are incompetent, it is possible to go to court to be appointed conservator or guardian and to take over decisionmaking in these areas. Unfortunately, this can be an expensive, time-consuming and cumbersome process. (For more on guardianship and conservatorship, click here.)


9. What can seniors do in advance, to avoid becoming embroiled with grown children, relatives, or friends over these issues.

Plan ahead. All seniors should sit down with an elder law attorney to discuss their goals, concerns and hopes and to develop a plan to reach the goals, address the concerns and give their hopes the opportunity to become realities.


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The Law Offices of Jeremy W. Howe, LTD. are ElderLaw attorneys in Rhode Island who specialize in Wills and Trusts, Estate Planning, Guardianship, Probate, and Veterans Aid and Attendance Benefits.

They also are Newport Rhode Island Divorce Lawyers, Attorneys, Mediators, and Arbitrators providing services for Family Law issues such as Divorce, Child Custody and Visitation, Support, and Military Family Law. 

Call them today at 401-841-5700 or visit them on the web at http://www.CounselFirst.com.