2006 State Report > Our Health > Long-Term Care > Nursing Facilities
Our Health: Nursing Facilities
While many people enter nursing facilities for brief stays, they are also important providers of long-term care for older adults with serious functional and cognitive disabilities, such as the inability to perform activities of daily living.
In 2003, there were 178 nursing facilities in South Carolina with 16,220 residents. The state's nursing facility occupancy rate was 88.6 percent. Just over three percent of the total population aged 65 and older in South Carolina were nursing facility residents, compared with four percent of the 65-plus population nationwide.
Medicaid was the primary payer for 71.5 percent of South Carolina nursing home residents in 2003. Total South Carolina DHHS Medicaid expenditures for nursing home services for recipients aged 65 and older were $372,652,561 in the 2003-2004 fiscal year.
The state's average Medicaid reimbursement per day for nursing facility care was $103 in 2002. To receive Medicaid payment for long-term care in a licensed nursing facility, an individual must be aged 65 or older, blind, or totally and permanently disabled. In addition, the person's gross monthly income must be below the Medicaid Cap of $1,737 (as of January 1, 2005), and the value of resources owned by the individual cannot exceed $2000 (after exclusions). If an individual's gross monthly income is greater than the Medicaid Cap but they meet other non-financial requirements, they may be able to establish an income trust to become eligible for Medicaid.
Medicare was the primary payer for 13.3 percent of South Carolina nursing home residents in 2003. However, Medicare does not pay for long-term nursing care, only for short-term skilled nursing care (up to 100 days) following a qualifying hospital stay. After 20 days of skilled nursing care, beneficiaries must pay a daily co-payment of $109.50. The state's average Medicare reimbursement per day for nursing facility care was $243 in 2002.
The remaining 15.1 percent of South Carolina nursing home residents in 2003 had other primary payers, including private insurance and out-of pocket payers. The average private pay rate per day for urban nursing facilities in the state was $125 in 2003.