Planning for Long Term Care

Print Friendly, PDF & Email

Planning for Long Term Care (LTC) is the smart way to save time, money, and avoid unnecessary stress. LTC planning doesn’t have to be intimidating if you and your family approach it one step at a time. Use the following checklist can help you in your planning.
Start with CANHR’s website, In addition to nursing home and residential care information, it contains extensive information on many long-term care resources.

Healthcare Needs

  • Take the time to educate yourself. 
  • Determine the appropriate level of care.
    • In other words, where should the person needing LTC reside?  Should the person receiving care be at home, in a Residential Care Facility for the Elderly (RCFE), in a nursing home, or some other facility?
    • The person’s physician needs to be consultant.  He or she should give guidance as to the appropriate level of care. Physician’s orders are a prerequisite to nursing home admission.
  • Find appropriate long-term care facilities.
    • You can identify local RCFEs on CANHR’s website. Consult CANHR’s website or contact CANHR for additional information on RCFEs.
    • Consult CANHR’s Nursing Home Guide, to learn about nursing homes in your community. You can search for nursing homes by name, location, acceptance of Medicare/Medi-Cal, and specific medical need. CANHR’s Nursing Home Guide can also let you view the inspection record for each facility.

Financial Considerations

  • You need to have a complete financial picture.
    • Inventory all assets in the person’s estate: cash, investments, annuities, CDs, IRAs, and work-related pensions. If the person owns real property, determine value and the nature of ownership (sole ownership, joint tenancy, etc.). If the person has life insurance, determine the cash surrender value, if applicable. You also need to determine the person’s monthly income.
  • Understanding how to pay for LTC.
    • Medicare may cover up to 100 days of skilled nursing care. HMOs and other health plans may offer LTC coverage. Purchasing LTC insurance may also be an option. For questions about Medicare, HMOs, and LTC insurance, contact HICAP (Health Insurance Counseling and Advocacy Program) at 1-800-434-0222 or
    • Medi-Cal, California’s Medicaid program, can help cover the cost of care at home or in a nursing home. With very limited exceptions (see CANHR’s Fact Sheet on the Assisted Living Waiver Pilot Project), Medi-Cal does not cover the cost of RCFE care. The IHSS (In Home Supportive Services) program can help pay for a caregiver at home. CANHR provides extensive information about Medi-Cal and IHSS eligibility  (see CANHR’s Fact Sheet on IHSS) requirements.
    • In Calfornia in 2016 the average cost of nursing home care is about $8,189 per month.

Capacity Considerations

  • Determine the person’s mental capacity.
    • Can the person make his or own decisions? If the person’s mental capacity isn’t obvious, seek the opinion of a physician.
  • Obtain DPAs or a conservatorship.
    • If the person still has mental capacity, consider arranging for a Durable Power of Attorneys (DPA). A DPA ensures that someone can make legal decisions for a person in the case of incapacity. There are two main kinds of DPAs: the DPA for Finance and the DPA for Property (See CANHR’s Fact Sheet on DPA for Property), and the DPA for Healthcare, which is also called an Advanced Healthcare Directive (see CANHR’s Fact Sheet on DPA for Health Care).
    • If the person does not have mental capacity, a conservatorship may be necessary (see CANHR’s Fact Sheet on Conservatorship). A conservatorship is a procedure where a court appoints someone to manage the person’s affairs. Conservatorships can be costly; if at all possible, DPAs should be established before loss of capacity.
    • For guidance on DPA, Conservatorship, or Medi-Cal Estate Planning Talk to your attorney, or contact CANHR for a referral.

Legal Considerations

  • Time to get your estate plan in order
    • Planning for LTC is a chance to to work out your estate plan.  Make sure that any wills, trusts, and other legal documents are up-to-date and conform to your true wishes. CANHR staff can help answer questions about some of your financial options, but we cannot plan your estate.
    • If you wish to plan and protect your estate, CANHR can refer you to a qualified lawyer in your area. Call 800-474-1116 or visit CANHR’s website for the only State Bar certified Lawyer Referral Service in California specializing in long term care.