October Pension Report

Nursing home and assisted living coverage under chapter 41.26 RCW and associated costs.

Under RCW 41.26.030(b)(iii)(I), LEOFF 1 members are entitled to be reimbursed for, or have paid directly, “reasonable charges” for nursing home coverage.  Under Statewide practice, this includes other services such as assisted living, memory care, and in-home professional care.

Using the 2024 Washington State LEOFF Education Association (WSLEA) Comparison of Benefits chart (COB), which is available on the RFFOW website in the Membership Only Area under the post entitled Disability Board Policies, LEOFF 1 Disability Boards’ approach to how to determine “reasonable charges” are done in a wide variety of ways.  For example, according to the COB the following methods are used by 59 different jurisdictions:

1.     Average Only (18 jurisdictions) (meaning the Board Policy says it will pay “average in the area” without specifying how that average is determined).

2.     No Standard Identified (16 jurisdictions) (meaning the Board independently determines what is reasonable on a case-by-case basis).

3.     Genworth Corporation (10) (meaning using an online resource to show what the average costs are in a particular geographic area).

4.     Insurance (6) (meaning an amount paid by an established insurance company approved by the Board).

5.     Fixed Number (4) (meaning the Board Policy sets forth a fixed dollar amount).

6.     United States Health & Human Services (2) (meaning a government agency standard).

7.     Washington State Medicaid Services (1) (meaning a government agency standard).

8.     Metlife Market Survey (1) (meaning an independent company’s reported average).

9.     Panorama (1) (meaning an independent company’s reported average).

Fortunately, for those who are trying to determine what the “average” charge is in a given geographic area under number (1) above, or under number (2) above where you are looking for evidence of what the Board should approve, Genworth Financial provides an online resource to discover what the averages are across the State (which is specifically used by Boards referenced in number (3) above).  Therefore, even though 10 different jurisdictions specify Genworth as the source from which they determine average charges, it can be a good source for those individuals who are trying to research what the average charges are, in general, in their jurisdictions.

Genworth Financial is a leading provider of long-term care insurance, as well as other financial and insurance products designed to help individuals and families prepare for the future. One of the key services Genworth offers is its Cost of Care Survey, an annual report that provides comprehensive data on the costs of various long-term care options in different regions across the United States. This information helps individuals and families plan for the financial burden of nursing homes, assisted living, and in-home care.

Genworth's Cost of Care Survey breaks down the average costs of long-term care services at a national, state, and local level. They collect data by surveying thousands of care providers across the country, compiling detailed insights into nursing home, assisted living, and home heatlh care charges. This service is particularly helpful for those planning retirement, allowing them to understand the financial implications of care based on where they live or plan to move. Genworth makes this data available online, offering a tool that allows users to search for costs in their specific region.

For example, as of 2023 in Kitsap County, the average cost of a semi-private room in a nursing home is $12,547 per month, while a private room averages $13,840 per month. In King County, the average cost for a semi-private nursing home room is $12,167 per month, with private rooms averaging $13,688 per month. Assisted living facilities in these counties cost significantly less, averaging between approximately $6,000 and $8,000 monthly, depending on the level of care and amenities.

Genworth’s Cost of Care Survey is a valuable tool for families and financial planners alike, providing critical insights to help plan for the escalating costs of long-term care.

Link for Genworth Cost of Care Website: https://www.genworth.com/aging-and-you/finances/cost-of-care