By Attorney Tammy A. Weber, CELA*

Long-term care involves a variety of services related to your personal and health needs. The need for long-term care may arise suddenly because of an accident or medical event, or it may be a slow progression of disease, or normal aging. It is easier to consider these options and services when you are not experiencing a crisis, when you have more control and choice. Planning is optimal, but it can be difficult to predict how much long-term care you will need, if any. The options available to you will depend upon your physical, mental, and financial condition.

Skilled nursing facility or personal care home

Nursing facilities and personal care homes (also referred to as assisted living facilities) are residential options other than your home. The choice of one or the other depends upon the degree of assistance you need with things like managing your medications, getting from one place to another, showering or bathing, toileting and whether you can remember to do, or how to do, these things. If you need help with only one or two activities of daily living, then a personal care home may be right for you. The more help you need, the more likely a nursing facility is the safest place for you. For a list of considerations and tips, please read How to Shop for the Right Nursing Home.

Aging in place at home

Perhaps you only need a little assistance, and you would rather stay in your home. This is the option that most people choose if they can remain safe in that environment, have family and friends to support them, and there are resources to pay for this care.

There are limited benefits available through Pennsylvania’s Options, also known as Help at Home, for those age 60 or older who want to stay in their home and have an unmet need that impacts daily functioning. There are four services under this program: adult day services, care management, in-home meals, and personal care services. Some Area Agencies on Aging have supplemental services which may include emergent services, home health services, home modifications, home support, medical equipment, pest control, personal emergency response systems and specialized medical transportation. There are no income limits to participate in Help at Home; however, depending upon income, the individual may have to contribute toward the cost of the service on a sliding scale.

If you are income eligible (gross income that does not exceed $2,742.00 per month as of January 1, 2024) and resource eligible (fewer than $8,000.00 in available resources), then Community Health Choices Waiver may be an option. This program is also for individuals aged 60 and older who meet the level of care requirements for a skilled nursing facility. The available services may include community transition services, non-medical transportation services, participant-directed community supports, respite, service coordination, therapeutic and counseling services, nursing services, physical therapy, specialized medical equipment, home adaptations, nutritional consultation services, among others. There is no cap on the services that the participants receive, no cost-sharing and no contributions permitted.

Average cost and payment sources

The average cost of a Pennsylvania skilled nursing facility is $11,547.69 per month, or over $138,500.00 per year as of January 1, 2024. Personal care homes average about $3,800.00 per month based on location and the level of care needed.

Paying for long-term care can be done with savings, long-term care insurance (purchase it now), through the Veterans Aid and Attendance program if the applicant or spouse is a Veteran and meets certain requirements, or the Medicaid program. Gifts made five years prior to application may create a period of ineligibility for Medicaid, and gifts three years prior to application may create a period of ineligibility for Aid and Attendance.

It is worth the investment of time and a consultation fee to meet with a Certified Elder Law Attorney to unpack and understand the options available to you within your personal and unique circumstances.

Tammy A. Weber is a Certified Elder Law Attorney and the Managing Attorney of the law firm of Marshall, Parker & Weber, LLC with offices in Williamsport, Jersey Shore, and Plains.  For more information visit or call 1-800-401-4552. 

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