Nursing Homes in Connecticut
Aging in seniors often precipitates health issues younger adults rarely experience. These include chronic conditions, such as heart disease and diabetes, as well as cognitive impairment and reduced mobility. While many of these are often long-term issues, some are shorter-term, such as recovering from surgery. Nursing homes provide near-hospital levels of care for seniors with medical issues. They're staffed round-the-clock by licensed professionals, such as nurses and therapists, ensuring residents get the care they need when they need it.
The 2020 Census revealed 18% of Connecticut's 3.6 million residents are aged 65 and older. About 70% of this age group will require some type of long-term care and 35% of seniors overall typically spend at least one year in a nursing home. Connecticut has 208 nursing homes caring for just over 19,000 residents. In addition to medical care, the facilities provide common rooms and outdoor spaces for residents to socialize and relax. Seniors also have a choice of private or semiprivate living spaces.
This guide considers several financial assistance options that may be available to Connecticut seniors needing skilled nursing care, including Medicaid and Medicare. It also explains the laws and regulations governing nursing home care in the state.
Cost of Connecticut Nursing Homes
The average cost of nursing homes in Connecticut is $400 per day. This is higher than the national average which is $228 per day.
Can You Use Medicaid to Pay for Nursing Home Care in Connecticut?
Medicaid can pay for nursing home care in Connecticut under a program known as HUSKY C. As this is an entitlement program, approved seniors can access the benefits immediately, without having to join a waiting list. As of 2023, this accounts for 18,500 seniors because Medicaid covers the costs for 74% of the occupants in the state's 24,522 licensed nursing home beds.
The benefits of long-term care and nursing home care include:
- Medical care and monitoring from licensed professionals
- Assistance with activities of daily living, such as eating and dressing
- Safety and security with round-the-clock staffing
- The ability to socialize with other residents, which can be a key part of recuperation
- Respite for the senior's caregiver, who may feel comforted knowing their loved one is with professionals
Seniors at risk of needing nursing home care in Connecticut may qualify for Community First Choice or the Connecticut Home Care Program for Elders. Both are Medicaid waivers for people deemed at risk of needing nursing home care who can be cared for at home or in the community, including assisted living. As they're waivers and not entitlement programs, successful applicants may need to join a waiting list.
Eligibility for Medicaid in Connecticut
To ensure Medicaid helps the seniors who need it most, the State of Connecticut imposes strict rules relating to the finances of applicants. For example, a single applicant can't have an annual income exceeding $12,744 or assets greater than $1,600. Almost all income is counted, including pension payments and stock dividends, but Aid and Attendance payments are not. Countable assets include stocks, bonds and real estate that isn't the applicant's principal address. Non-countable assets include one car, personal belongings, and, most of the time, the person's primary home. If only one senior in a two-person household applies, only the applicant's income is counted. If both apply, the income and asset limits are $15,456 and $2,400, respectively.
|Income Limits*||Asset Limits|
** An unearned income disregard of $409 is included for a single applicant and a married couple where only one is the applicant. It's to help applicants qualify if their incomes are above the base limit of $653 (single person) or $879 (married couple), but they have other costs, such as high medical expenses.
Every applicant must present documents supporting their claim, including those that confirm their income and assets. But this isn't all, as they must also prove they're:
- A U.S. citizen or legal resident
- A Connecticut resident
- In need of skilled nursing care
Applying for Medicaid in Connecticut
There are four ways to apply for Medicaid from Connecticut's Department of Social Services.
- Online: The speediest way is through ConneCT
- By phone: Seniors should dial (855) 626-6632 if they prefer to use the phone
- In-Person: Families can make an appointment with the nearest DSS field office if they prefer face-to-face contact with someone who can help
- By mail: The senior or a loved one can complete a copy of Form W-1 LTC and mail it to the nearest DSS field office
What Information You Will Need
Applicants will typically be asked to provide:
- Proof of their U.S. citizenship status and Connecticut residency
- Social Security number
- Banks statements
- Health insurance policy numbers
- Proof of assets, such as retirement accounts
Note: Families should know the DSS looks back over the previous five years of an applicant's financial history to check if their assets weren't gifted or undersold in anticipation of an application for Medicaid.
Additional Medicaid Support & Resources in Connecticut
The most effective way to get help with Medicaid in Connecticut is through the local DSS office, but some circumstances may call for other options, such as if Medicaid is denied or the family prefers to research the subject themselves. The following table includes three resources that can help free of charge.
|American Council on Aging||Online Only||The American Council on Aging is an online resource for families that like to do their own research. Its content is written and maintained by specialists in Medicaid with an in-depth understanding of each state's programs, including Connecticut. The site also has useful tools, such as a spend down calculator.|
|Community Choices||(800) 994-9422||Every area of Connecticut is served by an Aging and Disability Resource Center, known in the state as "Community Choices". Each can refer families to local Medicaid specialists who can advise them about their options and assist with their applications.|
|Legal Aid Services||6Multiple Locations||Connecticut doesn't have a single free resource where seniors applying for Medicaid can get help, but there are multiple legal aid providers available locally. They can help seniors denied Medicaid and other government benefits.|
Can You Use Medicare to Pay for Nursing Home Care in Connecticut?
Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet a number of specific requirements. This benefit is available to beneficiaries who have been hospitalized for at least three days, excluding the date of discharge, so it's most valuable for those who are recovering from an injury, illness, or surgery.
Once seniors meet the hospitalization requirement, Medicare will pay for up to 100 days of skilled nursing per benefit period. The first 20 days are covered in full. Starting on day 21, beneficiaries must pay a daily coinsurance rate. After day 100, seniors are responsible for the entire cost.
What Does Medicare Cover?
Medicare covers a number of specific services, including:
- A semiprivate room
- Skilled nursing
- Physical therapy
- Occupational therapy
- Speech therapy
- Audiologist care
- Medical supplies
- Medical social services
- Nutritional counseling
- Ambulance transportation
What Isn't Covered by Medicare?
Medicare does not cover long-term custodial care that addresses seniors' day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.
For more information about Medicare and when it covers Nursing Home Care, read our Guide to Nursing Homes.
Medicare Support & Resources in Connecticut
It can be confusing and stressful trying to wade through the complexities of Medicare. Fortunately, there are organizations within Connecticut that can help answer families' questions and provide assistance with applications. Some can also advocate for seniors whose Medicare applications have been rejected. The following table includes three such organizations, with links to their websites, phone numbers and a short explanation of how they can help.
|Medicare Savings Program||(855) 626-6632||Connecticut's Medicare Savings Programs can help to cover Medicare Part B premiums, coinsurance and deductibles. To be eligible, the applicant must meet certain requirements regarding their income and assets. The three programs are Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB) and Qualified Individual (QI).|
|Center for Medicare Advocacy||(860) 456-7790||The Center for Medicare Advocacy is a nonprofit law organization dedicated to helping Connecticut seniors get access to Medicare. It has self-help packets for families who feel confident enough to argue their loved one's case themselves, but also provides direct legal representation for seniors struggling to obtain Medicare.|
|Connecticut Department of Area Agencies on Aging||(860) 424-5055||The state department can connect seniors to local agencies operating various programs to benefit residents aged 60 and older. These include trained counselors who can help them understand Medicare and its different plans, as well as guide them through the application process and advocate for them if Medicare is denied.|
Other Financial Assistance Options for Nursing Home Care in Connecticut
While Medicaid and Medicare are two of the most common programs used to pay for Nursing Home Care, there are other financial assistance options available, depending on your unique situation.
|How to Apply||How It Works|
|Aid and Attendance||Learn more and apply online at va.gov.||Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for skilled nursing care.|
|Reverse Mortgages||Learn more about your options and how to apply at ftc.gov.||If you own a home, you may be able to use a reverse mortgage to help pay for nursing care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. This type of funding can be especially useful for married couples when only one partner needs nursing care, as the other residents of the home may continue living there. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.|
|Long-Term Care (LTC) Insurance||Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.||Seniors who already have long-term care insurance may be covered for skilled nursing care. Most policies cover at least a portion of the cost of nursing home care, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not be eligible to sign up for a LTC insurance policy.|
Nursing Home Laws and Regulations in Connecticut
|Licensing Requirements||Nursing homes must be licensed by the Connecticut Department of Public Health. Licenses are valid for a year and contain crucial information, such as bed capacity and the administrator's name. Nursing homes must abide by the Regulations of Connecticut State Agencies to maintain their licenses.|
|Staffing Requirements||Staff qualified for their roles, such as licensed nurses and therapists, must be on-site 24/7. A minimum of one registered nurse must always be on-site and there must be sufficient staff to provide at least 0.47 hours of care per resident during awake hours.|
|Staff Training Requirements||All nursing aides must participate in at least 100 hours of state-approved training within 120 days of signing their work contracts. This must include at least 25 hours of clinical training.|
|Admission Restrictions||A senior must be certified as being in need of nursing home care by a physician before they can be admitted. A nursing home can only accept seniors deemed medically in need of the type of care it provides.|
|Care Planning Requirements||Every nursing home resident must receive a unique patient care plan based on their initial assessment. This must take place within 14 days of their admission and the care plan must be ready within seven days of the assessment.|
|Dietary and Nutritional Services Requirements||A nursing home must satisfy its residents' dietary needs. A dietetic supervisor should review meals and if one isn't available, the supervisor must consult one. A continuous dietary service must be delivered for at least 12 daytime hours and menus must be written and dated.|
|Specialized Rehabilitative Services||Connecticut's skilled nursing facilities must have a minimum of one physical therapy room. Other specialized services aren't required by law.|
|Medication and Pharmaceutical Services||Only licensed nursing personnel, physician assistants or health care practitioners can administer medications in nursing homes. A detailed record of the medications given to each resident must be maintained and there must be a locked room for safely storing medications.|
|Activities Requirements||Connecticut's skilled nursing facilities must have at least one therapeutic recreation room and a range of physically and mentally stimulating activities. These must be overseen by a staff member whose role involves directing therapeutic activities.|
|Infection Control Requirements||Facilities must have infection prevention plans developed and regularly reviewed by their infection control committees. The facility must have a daily surveillance program to prevent infections and stop them if they appear. The Department of Health must be informed if there's an outbreak.|
|Medicaid Coverage||Connecticut seniors whose incomes and assets are within the guidelines may qualify for Medicaid to pay their nursing home care costs. Medicaid can only issue payments to nursing homes on its approved list.|
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