Which payer funds nursing home post-acute care primarily?

• A. Medicare
• B. Medicaid
• C. Private insurance
• D. Out-of-pocket

Answer: (B)

When a patient moves to a nursing home for post-acute care, the main funding source for long-term or custodial nursing home needs is Medicaid, provided the individual is eligible. Medicare does cover short-term post-acute rehabilitation after a qualifying hospital stay, but this is limited to a finite number of days and mainly focuses on skilled services, with cost-sharing after a certain point. In contrast, Medicaid is designed to pay for long-term nursing home care for those who meet income and asset criteria, making it the predominant payer for ongoing nursing home stays. Private insurance can help in some cases, but most policies have caps and exclusions for custodial long-term care, and paying out-of-pocket for extended stays is usually not feasible.