Our mission is to advocate for dignity, quality of life, and quality of care for all residents in long term care facilities.

There is a great range in the levels of care available in long-term residential facilities. Care ranges from intensive 24-hour care for the seriously ill (which is called skilled nursing care) to long-term personal assistance and health monitoring with very little active nursing (often called custodial care). Some facilities provide only one level of care, while others provide several levels at the same location.

Skilled nursing facilities provide short-term, intensive medical care and monitoring for people recovering from acute illness or injury. Other facilities -- called nursing homes, board and care homes, sheltered care homes, or something similar -- provide custodial care, long-term room and board, and 24-hour assistance with personal care and other health care monitoring, but not intensive medical treatment or daily nursing.

Your task is to find a good and affordable nursing facility that provides not just care, but the right type of care. For someone with severe physical or mental limitations, it is crucial to find a facility that provides the kind of attention and care that meets the individual's specific needs. For people who need little or no actual nursing care, the task is to find a facility that provides physical, mental, and social stimulation rather than merely bed and board.

Nonhospital-based skilled nursing facilities (SNFs) provide a relatively high level of nursing and other medical care, as well as personal care and assistance, for people whose illnesses or impairments require close monitoring.

Around-the-clock nursing is available from licensed vocational or practical nurses, with at least one supervising registered nurse on duty at all times. In addition to nursing, most other prescribed medical services can be provided, including various rehabilitative therapies. An SNF is almost always for short-term recovery from a serious illness, injury, or surgery that required hospitalization. A few people may spend months in an SNF, but most stays last only days or weeks.

The cost of SNF care ranges from $200 to $500 per day. Medicare, Medicaid, and private insurance will pay for SNF care, but only up to specific coverage limits.

These are sometimes called "Assisted Living" or "Board and Care" facilities. These are non-medical facilities that provide a level of care that includes assistance with activities of daily living. These facilities are considerably less expensive than SNFs and, in addition to monitoring residents' physical conditions, may provide social, educational, and recreational activities. Because RCFEs do not provide extensive medical care, they are appropriate for people whose physical and mental conditions do not require constant attention or intervention.

The primary ways to pay for skilled nursing facility care are Medicare, Medigap and Managed Care, Medicaid, Long-term care insurance policies (LTCI), Veterans Benefits or private payment. Most skilled nursing care at a facility is covered initially by Medicare. After Medicare coverage stops, your options are LTCI, Medicaid, private payment or a combination thereof. Read a detailed description of all types of reimbursements.

Private Pay
Most people must pay privately for Residential Care Facilities for the Elderly (RCFE). Long-term care insurance only covers a very small percentage of people.

Medi-Cal
Medi-Cal does not pay for RCFE level care in California except in an experimental Assisted Living Waiver Pilot Project. However, residents might be eligible for Medi-Cal to pay for such items as health insurance premiums and deductibles, medical equipment or medications.

Assisted Living Waiver Pilot Project (ALWPP)
The Assisted Living Waiver Pilot Project is California’s experiment to use Medi-Cal funds to pay for persons who require nursing home level care to be in Residential Care facilities. The experiment is for a limited number of residents in three test counties: Los Angeles, Sacramento, and San Joaquin.

SSI
There is very limited public funding through Supplemental Security Income (SSI) for this level of care. Unfortunately, the SSI rate is so low that fewer and fewer facilities will accept persons on SSI.