Nursing home residents struggle with a $40 allowance per month



Many people have problems living within their means, but what happens when your means is $40 a month?

That’s how much a person living in a nursing home and on Medicaid gets each month as a personal allowance.

“That is all the money a person has for clothing, shoes, a haircut, or perm … a birthday gift or card for a grandchild, a winter coat, a ticket to a Scrappers or Indians game,” said John Saulitis, the ombudsman for the National Long-Term Care Ombudsman Resource Center’s Region 11, which covers Ashtabula, Trumbull, Columbiana and Mahoning counties.

Saulitis said that allowance amount hasn’t changed for 14 years.

“We would like to see legislative action that would increase Ohio’s personal-needs allowance to $60 a month with an annual cost-of-living increase,” Saulitis said.

“I’m hoping to increase the amount of personal-needs allowance possibly next year [during the new term of the General Assembly],” said state Sen. Capri Cafaro of Liberty, D-32nd. The amount of the increase would have to be decided through the committee process.

At least 33 states get more than $40 a month, according to the National Long-Term Care Ombudsman Resource Center. For example, Texas, Kansas and New Mexico get at least $60 and more. Some states get more than $80 a month, including Arizona ($101) and Minnesota ($89). The lowest allowances, at $30, are in Alabama, Illinois, Missouri and Oregon.

Dr. Daniel J. Van Dussen, coordinator in gerontology at Youngstown State University, said it is difficult to live with such a small amount a month. “I would say almost every resident is in this situation. … Medicaid is paying for a significant amount of residents’ stay,” Van Dussen said. “If you don’t have any family who may be able to give out more money to help out, you are going to be penniless very quickly.”

Rachele Padavano, 46, a resident at Valley Renaissance Healthcare Center in Youngstown, said she and others wish they got a bit more each month.

“They would like to buy more personal things for themselves,” she said. “It doesn’t go far.”

Sometimes residents just want shampoo, perfume or body wash, but $40 doesn’t always allow for that, said Padavano, who has been a resident at the facility since March.

Some residents, as Van Dussen indicated, do have some outside financial support, which makes the $40 allowance easier to accept.

Ralph Ferrara, a resident at Maplecrest Nursing Home in Struthers, doesn’t have a problem with the allowance.

“I only need spending money if I want to go do something or go out to eat,” he said.

His nephew pays for activities the two do together, however.

Paul Petro, also a resident of Maplecrest, doesn’t have many expenses, either.

“I don’t spend any money. I get a haircut, and that’s it,” he said.

As a veteran of World War II, however, he receives $90 a month from the Veterans Administration, rather than the $40 allotment that Medicaid residents receive.

Debbie Folkwein, a nurse at ValleyCare Northside Medical Center, helps out her mother, who is a resident of Ivy Woods Manor, North Lima.

“My mother gets 24-hour-care from the nursing home. I also buy her clothes and food,” Folkwein said. “She only needs the money to get her hair done and [gifts for the] grandkids.”

Some of these nursing- home residents may not feel a financial pinch because of the activities and services offered at the facilities.

Theresa Sebastiano, director of nursing at Maplecrest, said most of her residents don’t complain about not having money.

The main reason residents need money is for haircuts or hair styling. “We really try to provide everything else,” she said.

Van Dussen said getting Medicaid to increase the allowance may be difficult.

“Generally, [nursing home cost] is the first or second budget item in any state government, right after education,” he said. “It is very expensive to house people in nursing homes, so the state is trying to get as much paid by the residents as they possibly can.”

There are 78,221 residents in the 956 nursing homes in Ohio. There are 25 facilities in Mahoning County, 19 in Trumbull, 14 in Columbiana, 40 in Summit, 8 in Portage, 11 in Medina and 40 in Stark. On average, the state allocates 10 percent of its yearly budget for nursing-home care. In 2010, that came to $2.67 billion; 2011, $2.68 billion; and in 2012, $2.44 billion.

One way the state may reduce this dependence on nursing homes is to help residents move out of the home and into their own home or apartment.

“If they move out the nursing homes and still have some assets, have income of any sort, then they have to live off of that,” Van Dussen said.

Not all the residents are fortunate to transition back to the community, however.

“One of the biggest problems is if you are paying all the money toward the nursing-home care, what happens when you get well and you can go home? How do you transition back to the community? You’ve sold your house and all the possessions. That is a very difficult issue,” he added.

To help with this, the Agency on Aging Inc. has Home Choice, a Medicaid-waiver program that is offered in conjunction with the Ohio Department of Job and Family Services. Basically, people who want to leave a nursing home and re-enter society are given $2,000, which can be used for deposits on apartments, first-month’s rent, furniture, etc.

This isn’t a viable choice for all nursing-home residents, however. For them, the challenge will be using their $40-a-month allowance wisely. is a collaborative effort among the Youngstown State University journalism program, Kent State University, University of Akron and professional media outlets including, WYSU-FM Radio and The Vindicator, The Beacon Journal and Rubber City Radio, both of Akron.

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