Not Just Asset Protection: How Private Long Term Care Can Protect Against Abuse

By: Melissa Barnickel at Baygroup Insurance

It’s horrible in the abstract. Yet it’s even worse when it’s reported at a facility you know. The topic: elder abuse at the hands of professional caregivers.

Elder abuse is far from a new issue. So it wasn’t a surprise to hear that the Senate Finance Committee recently held a hearing, “Not Forgotten: Preventing Americans from Abuse and Neglect in Nursing Homes.”

Let that sink in. Why would the Senate finance committee be taking a look at this topic? It’s actually logical, once you remind yourself that the government is the source of the majority of nursing home revenue.  

The vast majority of care in nursing homes is paid by two government programs: either Medicaid or Medicare. Medicaid pays primarily for individuals receiving custodial long term carethe kind of care that can go on for years and years. Medicare pays primarily for post-hospital skilled care or rehab care, with a typical duration of days or weeks.

So, just as the feds could halt highway funds for states that don’t follow the rules, theoretically the feds could use the power of the purse to force nursing home reforms. So, periodically, Congress takes a look at things.

Committee chair Sen. Chuck Grassley (R-Iowa), started the hearing by saying that approximately one-third of residents in federally-funded nursing homes suffer harm, and that number has remained essentially unchanged for 20 years. Several experts cited low Medicaid reimbursement rates for nursing homes as a major factor. How? They keep operators from offering higher wages to recruit and keep quality workers. This can even impact private-pay patients, such as those paying their bill with personal funds or long term care insurance.

Harvard Medical School profession Dr. David Grabowski testified that the facilities most dependent on Medicaid for payments are also the ones where patient neglect and substandard care is found.

How does this matter to long term care policyholders? After all, many people who purchase long term care insurance do so specifically to pay for home care and assisted living care. They hope to avoid altogether extended care in a nursing home. However, there are many reasons why some percentage of even these people will end up receiving some nursing home care, such as: need for round-the-clock-care which may be difficult to line up in a home, complex medical needs that demand frequent specialized care, or safety concerns when a home can’t be properly adapted. All of these situations can make home care, or assisted living facility care, a problem.

I’ll speak plainly. None of us know what our need for care will look like. But if you do find yourself in the situation of needing care in a nursing home, your long term care insurance policy is like a golden ticket. Nursing home admissions professionals recognize that you have a rock-solid payment source (unlike other payment sources that may be transferred to shelter money from the nursing home), which, as unbalanced as the system may be, means you’ll receive red carpet treatment when searching for a nursing home.

And if the unthinkable happens, and you ever end up in a nursing home whose care is substandard, your policy can expedite your transfer to a better facility. After all, all facilities want private payers.

Situations change. Assets erode, can be subject to legal judgments, or the vagaries of ill-willed relatives. Make no mistake— one of the smartest moves anyone can make to ensure quality care throughout their lives is to have a long term care insurance policy in place when that care is needed. 

Contact Baygroup Insurance at or call us at 410-557-7907 for more information about long term care insurance and how it can help you get the best care possible.