Braving the maze of Medicaid and nursing homes


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Having spent nearly three decades at the state Department of Public Welfare and 22 more years in senior consulting, Eugene J. Sauers has watched Medicare and Medicaid evolve from Day 1.

“I was there before Medicare, quite frankly,” he said. (Medicare became law in 1965, and took effect in 1966.)

Because of his expertise in Medicaid administration and Pennsylvania nursing homes, friends, colleagues and clients often came to him with questions.

“What happens to my house? What happens to my spouse? Are my kids responsible for my bills?” Mr. Sauers said. After he provides the answers, “everybody says to me, you ought to write a book about this.”

So he did, self-publishing “Medicaid, PA Nursing Homes and You” last year. With 80 pages of questions and answers, he said he hopes to bring clarity to what can be a confusing experience for Pennsylvania families.

It’s an experience many of us will have — once you reach the age of 65, there’s a better than two in five chance that you’ll spend at least a period of time in a nursing home. And as nursing home care can cost more than $10,000 a month, many people must rely on some kind of government assistance to help them pay the tab.

Medicaid is the primary form of assistance, as Medicare — the federal health insurance program for seniors — does not pay for long-term or custodial care, only daily skilled care or physical therapy (and even then, for a short period). Medicaid, the health and assistance program for the poor and disabled, is the primary payment vehicle for nursing homes, for those who qualify financially and medically.

Mr. Sauers said the “maze of endless rules and regulations” that send applicants from the state, to the federal government, to the county assistance office and back again can be frustrating for both the long-term-care patient as well as the kin who are helping the patient make decisions and navigate the system.

“People apply, they get told wrong information,” he said. The book, he hopes, will help correct some of those misconceptions, particularly those about home seizures and asset protection.

The book costs $24.95, and can be purchased by contacting the author by email at gene@medicaidandpanursinghomeinfo.com, or by mail at 14 Dahlia Lane, Levittown, PA 19055. For more information, visit www.medicaidandpanursinghomeinfo.com.


Bill Toland: btoland@post-gazette.com or 412-263-2625.

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