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COVID-19 and Elder Care: Home vs. Nursing Home

COVID-19 and Elder Care: Home vs. Nursing Home

The COVID-19 pandemic has ravaged the nursing home industry. Almost 114,000 residents have died and more than 120 homes closed in 2020, with many more facilities facing bankruptcy and closure.

Many residents have been forced to leave, while other seniors and their families are understandably afraid to remain in or move into a nursing home. The alternative of in-home care, however, comes with its own challenges.

Generally, nursing homes are designed for individuals who require skilled nursing care, which can include assistance with their activities of daily living and/or supervision. Taking or keeping one out of a nursing home can be dangerous, depriving them of access to care as well as important social engagement.

If the individual is to live at home instead, they will need a caretaker, whether a family member or a hired professional. Other practicalities to consider are whether the home is safe and accessible for a walker or wheelchair, whether the living quarters and bathroom are on a different floor, and if the family has the ability to aid the individual with needed functions, keeping track of prescriptions and medications, etc.

To complicate things further, the eligibility criteria for community (in-home) care Medicaid assistance (“Community Medicaid”) in New York changed last October, making it harder to qualify.

Previously, applicants could have transferred their assets immediately before applying for community Medicaid without being penalized. However, starting on April 1, 2021, we expect that there will be a lookback period of 30 months. This means that any money, asset, or gift transferred in that timeframe will be visible to Medicaid and may incur a period of ineligibility (“penalty period”) or even disqualify from eligibility altogether.

As a result, families may find themselves forced to pay out of pocket for in-home care, which can be very costly. Medicare may cover part-time, short-term, or intermittent in-home health aide services, but there is usually a portion of the bill left to pay, and not all services or items are covered.

The COVID-19 pandemic has thrown into stark relief the importance of long-term care planning. If you or a loved one require medical assistance for in-home care, or may require it in the future, now is the time to create a plan for qualifying and for protecting your assets.


Lauren C. Block is an associate in the firm's Wills, Trusts, and Estates Practice. Her work focuses on Trust and Estate Planning, Trust and Estate Administration, and Elder Law. She can be reached at lblock@vmmlegal.com and 516.437.4385 x145.