Across the U.S., hundreds of thousands of nursing home residents are locked in a wretched bind: Driven into poverty, forced to hand over all income and left to live on a Medicaid stipend as low as $30 a month.
Alex Morisey listens to music in his room at a nursing home in Philadelphia, on Wednesday, Feb. 15, 2023. For U.S. nursing home residents receiving Medicaid, all income is garnished and the person is left to rely on a small subsidy known as a personal needs allowance. The federal government hasn't changed the minimum rate, $30 monthly, since 1987. Pennsylvania’s allowance is $45.
In a long-term care system that subjects some of society’s frailest to daily indignities, Medicaid’s personal needs allowance, as the stipend is called, is among the most ubiquitous, yet least known. Had it been linked to inflation, it would be about $180 today. But Congress has raised the minimum rate only once, to $30, in 1987. It has remained there ever since.
“As soon as I get it, it’s gone,” says Chris Hackney, a 74-year-old resident of a nursing home in Durham, North Carolina, who spends his $30 monthly allowance on body wash, toothpaste, deodorant and some items his facility used to provide but has cut back on, wipes and diapers. “Think of the prices of everything that tripled and quadrupled. And the money hasn’t gone up any.”
But when her grandniece’s 2nd birthday came a few months after she arrived in the nursing home last year, she wanted to buy a doll but realized she couldn’t.Nursing home residents often must cede control of everything from how often they get a shower to what they eat.
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