Camden County Health Serv
20 N Woodbury Turnersville Rd, Blackwood, NJ 08012
Of the 12.7 million people who live in Pennsylvania, 18.7% are aged 65 and older. The Pennsylvania Health Care Association estimates that one out of four residents of the state is aged 60 or older. The state has 705 licensed nursing homes with more than 88,000 beds, and the average nursing home is over 91% occupied. Pennsylvania seniors have a number of options for their health care and long-term care needs. Two hospitals, University of Pennsylvania-Penn Presbyterian and UPMC Presbyterian Shadyside, are ranked among the top 25 in the nation for senior care, according to US News and World Report.
Nursing home care provides an elderly person with extensive medical intervention and help with daily living needs. The average cost for Pennsylvania nursing home care, according to the 2020 Genworth Cost of Care Survey, is $10,038 for a semiprivate room and $10,828 for a private room. This is significantly higher than the national averages of $7,756 for semiprivate rooms and $8,821 for private rooms.
This guide discusses options for nursing home care in Pennsylvania, resources for seniors who need care and ways to pay for that care.
Pennsylvania has a high average cost for nursing home care compared to national averages. The 2020 Genworth Cost of Care Survey found that seniors in Pennsylvania pay an average of $10,038 for a semiprivate room in a nursing home, compared to $7,756 for the national average. However, Pennsylvania is among the most affordable in the area compared to neighboring states. In West Virginia, seniors pay $11,376 on average for nursing home care. New Jersey seniors pay an average of $11,254, while in New York, the average cost increases to $12,319. Maryland has an average cost for care of $10,190, while Delaware’s average is $12,349 a month. Only Ohio is less, at $7,148.
The cost for nursing home care varies based on the amenities and services available at the facility as well as its location within the state. While the state average is $10,038, in the northern part of the state in Erie, the cost is about $900 less, at $9,186 a month. Williamsport in the central part of the state has a cost of $9,604. In Gettysburg, the cost is higher than the state average, at $10,889, and Harrisburg has an average of $10,311. Philadelphia is much more expensive, with a monthly cost of $11,285. The York area has an average cost of $10,291, while Pittsburgh has an average cost of $9,125.
Pennsylvania
$10038
Pittsburgh
$9125
Erie
$9186
Williamsport
$9604
York Area
$10291
Harrisburg
$10311
Gettysburg
$10889
Philadelphia
$11285
In addition to nursing home care, seniors in Pennsylvania have other care options. The average cost for nursing home care is the highest, at $10,038. Seniors who choose to move to assisted living, which doesn’t provide skilled nursing care, pay an average of $3,955 per month. Home care and home health care both cost an average of $4,576. Adult day care, which provides care and interaction during the day, is the cheapest, with an average of $1,517.
Nursing Home Care
$10038
Adult Day Care
$1517
Assisted Living Facility
$3955
Home Care
$4576
Home Health Care
$4576
Over three million Pennsylvanians are enrolled in Medicaid/CHIP, and this includes approximately 38% seniors and those with disabilities. For recipients residing in nursing homes, Medicaid pays the cost of room and board, meals, laundry and room cleaning as well as medication administration and other general nursing and support care services. Medicaid also covers the cost of on-site medical care, including medications and physician services.
Pennsylvania’s more than 700 nursing homes provide about 800,000 beds to Medicaid recipients, where care is delivered 24 hours a day in a hospital-like atmosphere. The Long-Term Care Services division of the Department of Human Services, the state’s Medicaid overseer, helps cover additional costs associated with nursing care, such as nonmedical transportation and personal care items. Seniors who require a nursing home level of care but wish to remain in their homes may qualify for Community HealthChoices.
All applicants must meet particular income and medical criteria in order to qualify for Medicaid services. The application can begin through a referral or completed online, on paper or in person at the local county assistance office. The process includes a screening interview, done face-to-face or over the phone, and a reporting of all incomes and assets.
Income limits are $32,904 yearly for individuals or two-family households where one person is applying. Limits are double that amount for two-family households where both members are applying. Assets are limited to $2,000 for single applicants or $4,000 for married couples, with the exception that, in two-person households where only one person is seeking Medicaid, the non-applicant can keep $148,620 in assets.
2022 Basic Medicaid Income Limits for Seniors in Pennsylvania
Household Size | Number of Applicants | Income Limits Per Year* | Asset Limits: Applicant(s)**** | Asset Limits: Non-Applicants |
---|---|---|---|---|
One Person | 1 | $32,904 | $2,000 | |
Two Person | 1 | $32,904** | $2,000 | $148,680 |
Two Person | 2 | $65,808*** | $4,000***** |
*Except for a $50/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient's monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
***Income is limited to $2,742 per month per spouse.
****In addition to the asset limits listed, Pennsylvania allows an extra $6,000 exemption. However, if an applicant has income more than $2,523/mo., the asset limit is $2,400 rather than the total asset limit of $8,000 ($2,000 plus $6,000 disregard).
*****Assets are limited to $2,000 per spouse
Applications are also required to be Pennsylvania residents and legal citizens of the United States.
Several options exist for those seniors seeking Medicaid benefits. Applications can be completed through COMPASS, by calling the Consumer Service Center for Health Care Coverage at (866) 550-4355 or by downloading and printing the paper application and bringing it to their local County Assistance Office. Before applying, seniors should ensure they meet all eligibility requirements, and have documents on-hand verifying all income and assets. Decisions are made within 30 calendar days from the date of submission but can take up to 45 days if insufficient information is provided. Â
Information You Will Need:
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The following list is a compilation of free resources for seniors and their family members to help them navigate the often complicated process of Medicaid application and eligibility.Â
Resource | Contact | Service |
---|---|---|
Area Agencies on Aging | (800) 753-8827 | An interconnected statewide network, Pennsylvania's Area Agencies on Aging provides a wide range of free supportive services and programs to elderly and their families. AAAs can help explain the Medicaid application process to families in more detail and provide referrals to local nonprofits who may be able to offer more specific information or counseling. |
American Council on Aging | Online Only | The American Council on Aging gives families greater detail about how to qualify for Medicaid, including how to spend down assets if a person is over the limits. The website also offers a free Medicaid eligibility screening test for seniors, to help them see whether they qualify for Medicaid and, if they don’t, what other options exist for long-term care financial support. |
Benefits.gov | (866) 550-4355 | A federal website, Benefits.gov, gives generalized information about Medicaid such as income limits and how to apply. Includes links to apply online and a toll-free number for answering general questions about Medicaid coverage in Pennsylvania. |
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:
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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.
While Medicare health insurance cannot cover the cost of nursing home care per se, it may be useful to utilize in the interim between nursing home placement and at-home or community care. The resources listed below are staffed by helpful advisors who can offer families information more specific to their individual needs and situations.
Program | Contact | Service |
---|---|---|
PA MEDI | (800) 783-7067 | In conjunction with local Area Agencies on Aging, PA MEDI offers free Medicare counseling services for families with a non-biased, objective view of how Medicare, long-term insurance, Medicaid and Medicare Supplemental Insurance compare. Counselors can explain what is and is not covered, give eligibility and enrollment requirements and provide information about financial assistance programs that may help pay for premiums, copays and prescription drugs. |
BenefitsCheckUp | (800) 794-6559 | BenefitsCheckUp is a free service facilitated by the National Council on Aging that helps families identify pertinent Medicare resources and other potential healthcare benefits. After completing a brief questionnaire that asks individuals to specify which benefits they’re interested in, BenefitsCheckUp provides a listing of services, including specific programs, referral centers and waivers that may be applicable. Families can then select the resources they are interested in, then answer a more detailed series of questions to get them connected with the specific resource. |
Medicare.gov | (800) 633-4227 | Providing a wide range of information about the Medicare program, Medicare.gov provides families with information ranging from basic details regarding costs and eligibility to specific characteristics of each Medicare plan. Assistance is available for finding providers, comparing procedure costs and filing claims or appeals. Individuals can call the toll-free number to speak with a representative, or use the chat box feature to get their questions answered in real time. |
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.
Name | 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. 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 able to use it to pay for skilled nursing care. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not typically be eligible to sign up for a LTC insurance policy. |
There are many resources in Pennsylvania that assist seniors in their retirement. Caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.
Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.
Program Name | Phone Number | Description |
---|---|---|
Pennsylvania Area Agencies on Aging | Each Area Agency on Aging in Pennsylvania operates under the Pennsylvania Department of Aging. Services available to seniors include legal assistance, Medicare counseling and prescription assistance. They can also access information regarding financial exploitation, protective services and the long-term care ombudsman program. Additionally, seniors can receive help with housing and meals. The agency runs the Senior Community Service Employment Program, which is open to qualifying Pennsylvanians who are 55+. |
Cash assistance programs in Pennsylvania provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.
Program Name | Phone Number | Description |
---|---|---|
Pennsylvania Lifeline Program | 800-234-9473 | The LifeLine Program offers a discount on landline or mobile telephone service, ensuring that participants can stay in contact with loved ones. |
Whether living in their own home or in a senior living community, Pennsylvania seniors can find financial assistance from numerous local resources. These organizations help residents cover some of the costs associated with in-home or long-term care and connect them with other helpful community-based resources.
Program Name | Phone Number | Description |
---|---|---|
Pennsylvania Living Independence For the Elderly (LIFE) | LIFE (Living Independence for the Elderly) is a Pennsylvania care program that offers an extensive package of medical and supportive services to seniors aged 55 and older. Care services include dental, audiology, in-home care and medical transportation. To be eligible for LIFE, seniors must live in an area served by a LIFE provider and meet the standard of care needed for a nursing home. | |
Pennsylvania Nursing Home Transition Waiver | 800-753-8827 | The Nursing Home Transition waiver is designed for Medical Assistance enrollees who are living in nursing homes and want to transition back to their homes and communities. |
Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help Pennsylvania seniors afford the nutritious food they need.
Program Name | Phone Number | Description |
---|---|---|
Pennsylvania Meals on Wheels | Meals on Wheels provides free home meal deliveries to seniors through local volunteers. | |
Pennsylvania Department of Aging Senior Meals | 717-783-1550 | The Pennsylvania Department of Aging Senior Meals program provides congregate noontime lunches at over 500 different senior centers in the state. In addition to the congregate meal programs, the state can also provide home delivery of meals to homebound seniors. To participate in either program, adults must be 60 years of age or up, or married to an individual who meets the age requirement. While there's no charge for this service, donations are accepted. |
Pennsylvania Senior Food Box Program | 800-468-2433 | The Pennsylvania Senior Food Box Program provides supplemental shelf-stable foods to qualifying individuals aged 60 or older as a way to enhance their diets and overall nutrition. Boxes may contain pantry staples such as peanut butter, pasta, dry beans and canned fish. Pennsylvanians must fall within a specific income range to qualify. Individuals who have applied and are deemed eligible can receive the boxes via their local food bank. |
Due to the high cost of purchasing new medical equipment, several organizations in Pennsylvania collect lightly used medical devices such as wheelchairs, ramps and walkers and distribute them to local seniors and residents in need.
Program Name | Phone Number | Description |
---|---|---|
Pennsylvania Assistive Technology Foundation (PATF) | 484-674-0506 | This statewide nonprofit organization helps seniors access necessary assistive technology. It provides information about possible sources of financial assistance, including private and public grant programs. PATF also offers zero-interest loans of up to $7,000 for eligible seniors. These loans may be used to purchase assistive technologies, such as hearing aids and vision devices. |
Pennsylvania seniors who meet certain income criteria can apply to local resources to help them pay for prescription drugs. Eligible residents can also receive assistance through health insurance and other programs to access free or discounted medical services.
Program Name | Phone Number | Description |
---|---|---|
Pennsylvania Department of Aging's Health & Wellness Programs | 717-783-1550 | Pennsylvania's Department of Aging offers a robust selection of Health & Wellness Programs for older adults. Seniors can take various programs to benefit both their physical and mental health. Fitness programs focus on needs such as nutrition, strength, balance and fall prevention. Medication management and programs to help seniors cope with chronic illnesses or pain are also available. On the mental health side, seniors can work to prevent depression and make lifestyle changes to support wellness. |
Pennsylvania PACE and PACENET Prescription Assistance Programs | 800-225-7223 | These Prescription Assistance Programs give older Pennsylvanians access to low-cost prescription medications. Eligible seniors pay a small copay for each drug, reducing out-of-pocket medication costs. Alternatively, PACENET offers low-cost prescriptions to seniors who exceed the income limits for the regular PACE program. |
Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in Pennsylvania have different eligibility criteria and often assist retirees by providing grants or loans.
Program Name | Phone Number | Description |
---|---|---|
Pennsylvania Weatherization Assistance Program (WAP) | Pennsylvania's Weatherization Assistance Program provides funds for increasing energy efficiency and reducing energy costs. Participants may qualify for minor repairs, attic or window insulation, caulking, heating/cooling system replacement or other weatherization services |
Many organizations offer free or low-cost legal services to Pennsylvania seniors. Older adults can access advice on issues such as estate planning, living wills and power of attorney. Some firms also act as long-term care ombudsmen, advocating for the rights of seniors in senior living communities.
Program Name | Phone Number | Description |
---|---|---|
Pennsylvania's Long-Term Care Ombudsman Program | 717-783-8975 | LTC ombudsmen fulfill several roles. They act as advocates for seniors in conflict with long-term care facilities. They investigate complaints of abuse and neglect made by seniors or caregivers, and when their investigations are complete, they attempt to negotiate a resolution between the senior and the facility. LTC ombudsmen also advise seniors on billing disputes and applying for Medicare or Medicaid. Ombudsmen can provide information on available resources and educate the broader community about the rights of seniors in LTC communities. |
Pennsylvania Health Law Project (PHLP) | 800-274-3258 | The Pennsylvania Health Law Project works with low-income individuals, including seniors and persons with disabilities, to help them access publicly funded healthcare services and ensure their rights are protected. The project can assist with issues related to managed care, Medicaid eligibility, access to Medicaid services and long-term services and supports. |
Pennsylvania SeniorLAW Center Access Services | 877-727-7529 | Pennsylvania seniors requiring help with civil law matters can turn to the SeniorLAW Center for assistance. The Center can provide direct representation on some issues and information on problems with housing, exploitation or abuse of seniors, powers of attorney, wills, advanced medical directives and many consumer issues. The Center cannot help with criminal matters, divorce cases or lawsuits. |
Pennsylvania Legal Aid Network | 717-236-9486 | PLAN helps low-income seniors gain access to free legal services throughout Pennsylvania. Residents can get help with age discrimination, unlawful evictions, bankruptcy and many other civil issues. Services may include legal education and court representation. To receive assistance, seniors must have an income that's 125% or lower than the poverty level. |
Senior centers in Pennsylvania bring together residents through recreational activities and events. Many also offer advice and support on senior issues, run wellness and nutrition programs, and connect older adults with other resources in the local area.
Program Name | Phone Number | Description |
---|---|---|
Pennsylvania Help at Home (OPTIONS) | 717-783-1550 | The Pennsylvania Options Program helps seniors 60+ in the state to obtain financial aid for their care needs, whether it's home help, Meals on Wheels or nursing home care. The senior's health and physical abilities are assessed. The program then looks at funding options to cover some or all of their care. |
Senior engagement resources and programs in Pennsylvania help older adults remain active and ensure they contribute to the community. Resources include wellness programs, volunteer opportunities, support groups and organizations that help residents connect with the community to live fulfilling lives.
Program Name | Phone Number | Description |
---|---|---|
Pennsylvania East Stroudsburg University Life Long Learner | 877-230-5547 | East Stroudsburg University is keeping seniors mentally sharp and connected to the local community by allowing them to enroll in courses tuition-free. The Life Long Learner initiative has been operating in the city since 1981, and accepts legal residents of Pennsylvania aged 60+ who are not employed full-time. Program participants receive free tuition as long as they are enrolled in no more than six credits (which is typically two courses) per semester and have a non-degree status. |
Pennsylvania West Chester University's Senior Citizen Program | 610-436-3541 | Located about 15 miles from Phoenixville, West Chester University offers lifelong learning opportunities for seniors. Retirees who are 60 years of age or older can sign up for tuition-free courses, as long as space is available. Possible areas of study include art history, economics and mathematics. Seniors may be responsible for other costs associated with their studies, such as textbooks. |
Social Security offices in Pennsylvania help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.
Program Name | Phone Number | Description |
---|---|---|
Pennsylvania Social Security | Social Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working. |
Seniors can apply for tax assistance from several Pennsylvania resources. Elderly residents and those with disabilities could be eligible for tax exemptions on medical expenses, reductions on property tax and other tax assistance programs.
Program Name | Phone Number | Description |
---|---|---|
Pennsylvania Property Tax/Rent Rebate Program | 888-222-9190 | The Pennsylvania Department of Revenue offers a property tax abatement for senior homeowners and tenants. The maximum rebate ranges from $250 to $650 per year for homeowners. Renters receive a rebate of $500 to $650. |
Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. Pennsylvania retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices.
Program Name | Phone Number | Description |
---|---|---|
Pennsylvania ​Heating Assistance/Low-Income Home Energy Assistance Program (LIHEAP) | 866-857-7095 | LIHEAP offers cash grants to help low-income Pennsylvania residents pay their energy bills. The program also offers crisis grants to replace broken heating equipment, prevent service disconnection and address hazardous conditions. |
Pennsylvania retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.
Program Name | Phone Number | Description |
---|---|---|
Pennsylvania VA Benefits and Health Care | Veterans of the U.S. Armed Forces and their spouses are eligible for services through the Pennsylvania VA Benefits and Health Care program. This agency can ensure veterans have access to all eligible benefits, services and programs. The state operates six senior living facilities for veterans that offer personal care, memory care and skilled nursing services, as well as several VA medical centers and dozens of VA health care clinics. |
Topic | Rule |
---|---|
Licensing Requirements | All skilled nursing facilities must be licensed with the state of Pennsylvania’s Division of Nursing Care Facilities, Bureau of Quality Assurance, Department of Health. |
Staffing Requirements | Pennsylvania has a minimum 1:20 nursing staff-to-patient ratio. This means there must be one licensed nursing staff member for every 20 residents. In addition, at least two nursing service personnel must be on duty at all times. Finally, all SNFs must have a Director of Nursing who is an RN on staff for a minimum of 35 hours and four days per week.Any nursing home with 120 or more residents must have a full-time social worker on staff to plan activities. Smaller facilities must have a social worker to plan and document activities, but they don't have to be full-time staff members. |
Staff Training Requirements | Ongoing, coordinated education for all staff at SNFs in Pennsylvania is required by law. Employees also must have an orientation before starting their roles, and the orientation must include instruction on abuse and reporting. Annual service training on infections, fire, accident prevention, confidential information, psychosocial needs and abuse reporting is required. |
Admission Restrictions | Individuals can only be admitted to SNFs in Pennsylvania if the facilities can attend to their needs based on their physician’s recommendations and evaluation. |
Care Planning Requirements | All residents must have a care plan in place within seven days of admission. When possible, residents should participate in their care planning. |
Dietary and Nutritional Services Requirements | SNFs must provide menus at least two weeks in advance and keep records for 30 days. A full-time, qualified dietary services supervisor must plan the menus. If the facility doesn't employ a full-time dietitian, it must consult with one at appropriate times and frequency to ensure healthy meals. A diet manual must be approved by the dietitian and medical director and be available to attending physicians, nursing staff and dietetic personnel. |
Specialized Rehabilitative Services | Pennsylvania doesn't require SNFs to offer specialized rehabilitation services. However, if the SNF does, then the therapies in the resident’s care plan must start within seven days of admission. |
Medication and Pharmaceutical Services | SNFs must administer medications under the oversight of a pharmacist or licensed physician. All residents must have written physician's orders for medications they take. Medications and biologics can be administered by qualified nurses and licensed practitioners only. The facility must have a monthly pharmacy consultation for each resident to check medication profiles. All medication, including over-the-counter, must remain in the original container and carry the resident’s name on the label. |
Activities Requirements | Preserving physical and mental health is an important part of nursing home care. Pennsylvania requires all facilities to have activities that encourage physical, social and mental engagement. |
Infection Control | Nursing homes in Pennsylvania must take measures to prevent infections following current state and CDC standards for preventing the spread of communicable diseases. The state also requires that staff reports any reportable conditions to the Division of Nursing Care Facilities field office. |
Medicaid Coverage | Pennsylvania Medicaid covers nursing home care for qualified seniors. To qualify, an individual must be a U.S. citizen with a Social Security number, meet income and asset requirements and have a medical need for nursing home care based on a physician’s evaluation. |
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