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     Nursing home cost: “On average, an American turning 65 today will spend $138,000 on long-term costs.” – U.S. Health and Human Services.

For Mom, “worry” was as much a part of farm life as sweltering August days or March snowstorms.

She fretted about the weather, especially if it was shaping up to be a dry year.

Prices for wheat, assuming there was a crop to harvest, were a concern and the same held true for cattle.

In the final years of her life, Mom’s chief worry was whether she would have enough money in the bank to pay her monthly nursing home bill.

Her concern was valid. A recent report by South Dakota News Watch today places the average daily cost of care at $163.

Oddly, despite the high charge, a number of nursing homes in South Dakota have closed and two more are scheduled to be shuttered next month, according to the News Watch report. Moreover, another 17 now in receivership are at risk, as well.

Many experts blame a low reimbursement rate by Medicaid as the primary culprit. Medicaid, a federal/state program that pays for care for the poor, reimburses South Dakota nursing homes at a rate of $131 a day, producing a $32 daily deficit by some accounts.

Apart from the current crisis that is causing angst for seniors and their families, think of this: For the elderly who can find nursing home care, the out-of-pocket costs can be $70,000 a year or more. At that rate, it doesn’t take long to eat up a lifetime of savings, which was Mom’s concern for the time she was in the care center.

Since nursing home care is so costly, why the crisis? A key reason is that most residents are not self pay. Amazingly, two-thirds or more are covered by Medicaid, which means that private pay residents are required to pay a much higher cost to subsidize Medicaid residents. It’s an unfair system indeed that penalizes those who have saved all of their lives and then must underwrite those who did not, or who were unable to put something aside. In some cases, however, Medicaid recipients give away their assets so they can qualify for government care.

The nursing home crunch is puzzling for another reason: Most of the heavy lifting is done by lower paid employees. Nursing aides and others who do the hands-on work of patient care are not getting wealthy at $12 an hour.  Unfortunately, the News Watch story did not drill down into the expense side of the nursing home crisis, which would have shed needed light on the problem.

With a growing population of seniors in South Dakota, lawmakers have important work to do.

Jan. 9, 2019