Nursing Homes in Michigan
Seniors who increasingly struggle with day-to-day tasks, such as dressing, meal planning and taking medication, should consider transitioning to a nursing home. In Michigan, the cost of nursing home care averages $9,095 for a semiprivate room and $9,855 for a private room.
Nursing homes provide a secure environment with around-the-clock care and trained nursing staff who can assist with complex needs. There are also on-site medical facilities, physical therapies and social activity programs to enhance the quality of life for seniors. In addition, nursing homes offer specialized care for those with Alzheimer's or dementia, which cannot be done in a home environment. 18.1% of people in Michigan are older than 65, and 32,059 live in nursing homes. There are 434 nursing facilities spread across the state of Michigan, meaning seniors have various nursing home options available.
This guide provides useful information about nursing home costs in Michigan and a general overview of what Medicaid covers. Seniors and their families can benefit from the helpful resources and advice about financial aid in this guide.
Cost of Michigan Nursing Homes
The average cost of nursing homes in Michigan is $249 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 Michigan?
Michigan's Medicaid health care program—also known as Medical Assistance (MA)—offers funds to care for 3,034,700 individuals. The program can cover stays in nursing homes, but it's based on eligibility. To qualify, seniors must prove they have limited income and assets and medical conditions requiring care. The income of married spouses (non-applicants) is wavered and not considered during the application for eligibility.
Nursing homes vary regarding services and facilities, but most offer social programs, access to on-site medical care, assistance with basic tasks and medication management. The state of Michigan does offer Medicaid waivers for home-based services to ensure seniors remain comfortable in their home environment for as long as possible. For the in-home Medicaid waivers, there are limited numbers available.
Eligibility for Medicaid in Michigan
Seniors in Michigan must have limited income and assets to be eligible for Medicaid in nursing homes. In addition, assets need to be less than $2,000, and seniors have to be in need of medical care. Although a spouse's income isn't taken into consideration when it comes to eligibility, it cannot exceed a total of $3,715 per month. Applicants need to be 65 years and over to qualify.
| Income Limits* | Asset Limits | |
|---|---|---|
| Single Person | $30,276 | $2,000 |
| Two-Person Household | $30,276 | $3,000 |
* Per year
The requirements for eligibility are not only based on monetary factors but also include other qualifying criteria, such as the following:
- Seniors need to fall within the 133% poverty level
- They cannot be enrolled in other Medicaid programs
- Enrollees should be residents of Michigan
Applying for Medicaid in Michigan
Seniors can take advantage of the quick and easy online interactive tool to see if they qualify for Medicaid. Seniors who qualify can apply online. Seniors who aren't comfortable applying online can call the helpline at (855) 789-5610. Alternatively, seniors can speak with someone in person in their local Department of Human Services.
Information You Will Need:
- Birth certificate
- State ID card
- Documentation detailing income and expenses
- Proof of income and household bills
- Health insurance card
- Bank statements
- Paperwork regarding assets
- Social Security card and proof of citizenship
Additional Medicaid Support & Resources in Michigan
These resources and links, along with additional information about Medicaid, should make it easier for senior citizens to navigate the complicated area of Medicaid.
| Contact | Service | |
|---|---|---|
| Michigan Medicare Assistance Program | (800) 803-7174 | Beneficial information regarding Medicare eligibility guidelines and long-term care options in Michigan is provided in this informative online resource that is readily available to seniors. |
| Healthinsurance.org | (855) 276-4627 | This company helps senior citizens with their application processes. They are able to assist with redeterminations and renewals, in addition to providing a better understanding of the various options for long-term care. |
| National Academy of Elder Law Attorneys | (703) 942-5711 | NAELA is a network of attorneys with local centers in Michigan. They provide legal assistance to the elderly population and also counsel on matters pertaining to Medicaid. |
Can You Use Medicare to Pay for Nursing Home Care in Michigan?
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:
- Meals
- A semiprivate room
- Medications
- 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 Michigan
Medicare can provide financial assistance for nursing home care and offers some financial relief. It doesn't cover the full cost of long-term care and has no set duration. There are also waiver programs that allow Medicaid to cover in-home nursing costs.
| Contact | Service | |
|---|---|---|
| Michigan Department of Insurance and financial services | (877) 999-6442 | The Michigan Department of Insurance and financial services division of the state government assists seniors in determining their rights and provides information regarding where fraud should be reported. In addition to that, it discusses the benefits of Medicare. |
| Detroit Area Agency on Aging | (313) 446-4444 | The Detroit Area Agency on Aging provides free drug assistance and Medicare plan advice to seniors. Their educational resources aim to educate and assist seniors in making informed decisions about their health and well-being. |
| Michigan Area Agencies on Aging | (231) 947-8920 | Seniors who want to connect with regional agencies can contact Area Agencies on Aging, who will provide a list of services for older adults. There are a wealth of resources about how to enroll for Medicare and information about the various benefits. |
Other Financial Assistance Options for Nursing Home Care in Michigan
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 Michigan
| Licensing Requirements | Nursing homes, medical facilities and long-term hospital care units must be licensed by the Michigan Department of Licensing & Regulatory Affairs and renewed annually. If nursing homes undergo any change of ownership, a name change or an increase in capacity, they are required to renew their state license. |
| Staffing Requirements | A director of nursing is required in each facility. The director tailor-makes care plans for each resident and ensures a licensed nurse is on duty at all times. Nursing staff has to provide a minimum of 2.25 hours of care per patient per day. Skilled nurses are required to only fulfill nursing duties—they aren't to provide basic services such as cleaning and meal prep. |
| Staff Training Requirements | The nursing home director is required to be an experienced and qualified individual trained in aging care. It's up to the facility to vet staff and confirm that they are registered and licensed. |
| Admission Restrictions | Admission into nursing homes is at the discretion of the home. There are some rare medical conditions that the home may not be equipped to deal with, and they would thus be doing the individual a disservice by enrolling them. Individuals with communicable diseases such as Hepatitis and Tuberculosis would also be at risk of not being admitted. |
| Care Planning Requirements | Seniors can work with the nursing home director to develop a care plan tailored to their needs. Nursing homes are required to look after both seniors' mental and physical well-being. |
| Dietary and Nutritional Services Requirements | Seniors have a right to good nutrition and should never be malnourished. Nursing homes have to create a nutritious meal plan for seniors, taking into account various allergies and dietary requirements. |
| Specialized Rehabilitative Services | Nursing homes in Michigan legally don't have to provide speech therapy, physical therapy or any other rehabilitation service. However, if the word rehabilitation is in their name, these services must be provided. |
| Medication and Pharmaceutical Services | Doctors prescribe medication and nursing staff administer drugs based on the doctor's orders. Some residents can take their own medication, but permission would need to be granted from management. |
| Activities Requirements | Some nursing homes have an activities calendar for seniors that offers chair exercises, gentle yoga and stretch classes. Activities are not a legal requirement. The law states that seniors can socialize privately with guests and are free to enjoy off-site activities during the day. |
| Infection Control Requirements | Michigan has an infection control policy that all homes and medical institutions need to follow. Basic hygiene practices include cleaning and disinfecting medical equipment and surfaces. PPE equipment should be worn when dealing with blood and bodily fluids. |
| Medicaid Coverage | Seniors who are eligible for Medicaid can receive funding for nursing home care. There are also waiver programs that allow seniors to benefit from in-home health care services. |
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