Long-term care consists of skilled and non-skilled services and supports. Non-skilled services are often referred to as personal, or custodial, care. There is a big difference between skilled care and personal or custodial care in terms of who provides care, how care is initiated, the goal of care and how care is paid for.
|Variable||Skilled Care||Personal or Custodial Care|
|Provider||Physicians, nurses, physical, occupational, speech and respiratory therapists, medical social workers and other professionals||Certified nursing assistants, home health aides, homemakers, caregivers, family|
|Care Inititation||Must be ordered by a physician||Physician’s order is not necessary to initiate care unless it is included in an order for skilled care on a short-term basis|
|Goal of Care||Specific goals are established for improvement or maintenance of function; once these goals have been met, skilled care ends||Ongoing assistance with ADLs and IADLs to help the individual maintain the highest quality of life possible|
|Payer||Medical insurance, Medicare, Medicaid, Veteran’s Administration||Private pay, Medicaid, long term care insurance, Medicare*, veteran’s benefits and/or pension, some employer medical insurance plans|
Medicare and Personal or Custodial Care
Medicare is medical insurance for those over 65, the blind and the disabled. Personal, or custodial care, is non-medical care. Medicare does not cover ongoing custodial care but will cover some personal care on a short-term basis when ordered by a physician in conjunction with skilled care or under hospice care.