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What Medicare Does and Does Not Pay For

Medicare covers short skilled nursing stays, home health and hospice. It does not pay for assisted living or custodial care, in any state.

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Short answer

Medicare does not pay for assisted living, memory care, or long-term custodial care anywhere in the country. It covers limited skilled nursing facility stays after a qualifying hospital admission, intermittent skilled home health, and hospice.

What Medicare covers

  • Skilled nursing facility care after a qualifying inpatient hospital stay, for a limited period, when skilled care is needed daily. This is rehabilitation, not long-term placement.
  • Home health that is intermittent and skilled — nursing visits, physical, occupational or speech therapy. Not a caregiver who stays with your parent.
  • Hospice — the hospice team, medications related to the terminal diagnosis, and equipment. Not room and board in a facility.
The observation status trap. A Medicare skilled nursing benefit requires a qualifying inpatient hospital admission. Time spent under “observation status” does not count, even if your parent slept two nights in a hospital bed. Ask the hospital directly whether your parent is admitted as an inpatient or under observation, and ask in writing.
What senior care costs. Ohio's 2024 CareScout medians: about $5,500/month for assisted living, $9,034/month for a semi-private nursing home room. Read the full explanation →

Questions families ask

What counts as reportable abuse or neglect of a senior in Ohio?

Physical abuse, emotional abuse, neglect, self-neglect and financial exploitation of an adult are all within Adult Protective Services' scope in Ohio. If you're unsure whether a specific concern qualifies, report it and let APS make that determination.

Is a facility licensing complaint the same thing as an APS report?

No. A facility licensing complaint about a specific community's compliance with state regulations goes to the Ohio Department of Health. A suspected case of abuse, neglect or exploitation of an individual goes to county Adult Protective Services.

Can I report elder financial exploitation even if I'm not sure money has actually been taken?

Yes. Financial exploitation is within Adult Protective Services' scope in Ohio, and a report based on reasonable concern -- unusual account activity, a new 'friend' pressuring for money, sudden changes to a will -- does not require proof before you make it.

What happens after I make an Adult Protective Services report in Ohio?

The county Job and Family Services department screens and, where appropriate, investigates the report. Specific procedures and timelines vary by county and by the nature of the concern -- contact your county's JFS office directly for details on what to expect.

What should I do if a hospital gives my parent a discharge date in 72 hours?

Get the discharge plan in writing, confirm whether your parent was admitted as inpatient or under observation status, ask which facilities have actually accepted the referral, and verify any facility's Ohio license before signing anything.

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