Mostly short-term rehab stays
Most residents typically stay for a few weeks or months before returning home or moving on.
ADVANCED CARE OF ST JOSEPH
ADVANCED CARE OF ST JOSEPH is a Nursing Home in Missouri
ADVANCED CARE OF ST… is a Nursing Home in Missouri
ADVANCED CARE OF ST JOSEPH
ADVANCED CARE OF ST JOSEPH is a Nursing Home in Missouri
ADVANCED CARE OF ST… is a Nursing Home in Missouri
Advanced Care of St. Joseph is located in St. Joseph, MO. It offers skilled nursing, rehabilitation services, and independent living options. The facility is known for its personalized care and commitment to the well-being of its residents.
Quality ratings
Official CMS rating based on health inspections, staffing and quality measures.
Official CMS rating based on deficiencies found during state health inspections.
Official CMS rating based on nurse staffing hours per resident per day.
Official CMS rating based on clinical outcomes for residents.
Capacity and availability
Medium-capacity home
Offers a balance of services and community atmosphere.
Total beds
180
This home usually has availability
Lower occupancy suggests more openings may be available.
Occupancy rate
57.2%
Residents per day (avg)
141
Occupancy rate
57.2%
Residents per day (avg)
141
Who this home usually serves
Show admissions and discharges
TYPE OF STAY
Might be optimal for
Short stays
Recovery
Medicare-covered care
Breakdown by payment type
Medicare
64% of new residents, usually for short-term rehab.
Typical stay
19 days
Private pay
18% of new residents, often for short stays.
Typical stay
9 months
Medicaid
18% of new residents, often for long-term daily care.
Typical stay
2 years
Finances and operations
Proprietary home
Corporation
Home revenue
$5.6M
Profit
$721.9K
Proprietary home
Corporation
Home revenue
$5,550,590.00
Profit
$721,896.00
Payroll costs
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
$2.3M
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Other operating costs
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
$2.5M
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Total costs
$4.8M
180-bed community
A large-scale community that may provide a wide range of amenities, services, and structured programs.
About this community
Facility Type
SNF
Additional licensing details
CMS Certification Number:
265754
Certification type:
Medicare/Medicaid
County:
BUCHANAN
Ownership & operating entity
ADVANCED CARE OF ST JOSEPH is administrated by JANET MCCARTHY GREEN.
Owner name:
NORTH 18TH STREET HEALTHCARE LLC
Care Services
Nursing Services
Rehabilitation Services
Independent Living
Skilled Nursing
Licensed Nurses/CNAs
24-Hour Staffing
Amenities & Lifestyle
Programs & Activities
Specific Programs
About Us, Clinical Capabilities, Independent Living, Therapy Services, Community Partnerships, Careers, Contact Us
Operating Hours
Open 24 Hours/7 Days A Week
Comparison Chart
The information below is reported by the Missouri Department of Health and Senior Services, Division of Regulation and Licensure.Compare Nursing Homes around Missouri
Bertrand Nursing And Rehab Center
SNF
Nursing Home 24/7 care needed
AL
Assisted Living For seniors needing help with daily tasks but not full-time nursing.
Bertrand
60
No
5
CHANCE, DON
78.8%
$5,145,452.00
$2,268,233.00
44.1%
53.70
5/5
3.6515
5/5
3/5
2/5
-
APPLE RIDGE CARE CENTER
SNF
Nursing Home 24/7 care needed
AL
Assisted Living For seniors needing help with daily tasks but not full-time nursing.
MO 64096-9143
60
No
-
CHANDRA, RAM
71.8%
$3,702,299.00
$1,348,963.00
36.4%
43.30
2/5
3.5681
3/5
1/5
2/5
-
ADVANCED CARE OF ST JOSEPH
SNF
Nursing Home 24/7 care needed
AL
Assisted Living For seniors needing help with daily tasks but not full-time nursing.
MO 64505-1872
180
No
-
NORTH 18TH STREET CONSULTING LLC
57.2%
$5,504,210.00
$2,303,058.00
41.8%
141.10
1/5
2.1152
2/5
1/5
4/5
1
AMBERWOOD ESTATES NURSING AND REHABILITATION
SNF
Nursing Home 24/7 care needed
AL
Assisted Living For seniors needing help with daily tasks but not full-time nursing.
MO 63121-1407
115
No
-
BERMUDA DRIVE CONSULTING LLC
81.7%
$5,482,532.00
$3,052,207.00
55.7%
79.70
1/5
1.7169
2/5
1/5
2/5
4
Good Shepherd Care Community
AL
Assisted Living For seniors needing help with daily tasks but not full-time nursing.
HC
Hospice Care
IL
Independent Living For self-sufficient seniors seeking community and minimal assistance.
MC
Memory Care Specialized care for those with Memory Loss, Alzheimer's, or dementia, ensuring safety and support.
Concordia
-
No
38
-
-
-
-
-
-
-
-
-
-
-
-
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Staffing Data
Source: CMS Payroll-Based Journal (Q2 2025)
161
Total Staff
154
Employees
7
Contractors
41,832
Total Hours (Quarter)
57
Avg Staff/Day
8.1
Avg Shift (hrs)
Nursing Staff Breakdown
| Role ⓘ | Count ⓘ | Avg Shift (hrs) ⓘ | Uses Contractors? ⓘ |
|---|---|---|---|
| Registered Nurse | 15 | 8 | No |
| Licensed Practical Nurse | 13 | 10.1 | No |
| Certified Nursing Assistant | 55 | 7.7 | No |
Staff by Category
Administration ⓘ
2 staff
7.4hs shift avg
Nursing Staff ⓘ
127 staff
8.2hs shift avg
Physicians & Practitioners ⓘ
4 staff
8hs shift avg
Therapy Services ⓘ
13 staff
6.5hs shift avg
Activities & Recreation ⓘ
9 staff
6.9hs shift avg
Social Services ⓘ
2 staff
7.2hs shift avg
Dietary Services ⓘ
2 staff
7.3hs shift avg
Other Services ⓘ
2 staff
8hs shift avg
Contractor Analysis
2.1%
of total hours from contractors
869 contractor hours this quarter
Respiratory Therapy Technician: 1
Physical Therapy Assistant: 3
Qualified Social Worker: 1
Medical Director: 1
Occupational Therapy Assistant: 1
| Role ⓘ | Employees ⓘ | Contractors ⓘ | Total Staff ⓘ | Total Hours ⓘ | Days Worked ⓘ | % of Days ⓘ | Avg Shift (hrs) ⓘ |
|---|---|---|---|---|---|---|---|
| Certified Nursing Assistant | 55 | 0 | 55 | 14,825 | 91 | 100% | 7.7 |
| Nurse Aide in Training | 26 | 0 | 26 | 6,265 | 91 | 100% | 7.6 |
| Medication Aide/Technician | 16 | 0 | 16 | 4,660 | 91 | 100% | 10.2 |
| Licensed Practical Nurse | 13 | 0 | 13 | 4,146 | 91 | 100% | 10.1 |
| Registered Nurse | 15 | 0 | 15 | 3,417 | 91 | 100% | 8 |
| Therapeutic Recreation Specialist | 8 | 0 | 8 | 1,329 | 71 | 78% | 7 |
| Speech Language Pathologist | 2 | 0 | 2 | 1,000 | 65 | 71% | 8 |
| Clinical Nurse Specialist | 3 | 0 | 3 | 744 | 65 | 71% | 8 |
| Physical Therapy Assistant | 1 | 3 | 4 | 690 | 69 | 76% | 6.6 |
| Mental Health Service Worker | 2 | 0 | 2 | 648 | 64 | 70% | 8 |
| RN Director of Nursing | 2 | 0 | 2 | 552 | 56 | 62% | 8 |
| Dietitian | 1 | 0 | 1 | 539 | 65 | 71% | 8.3 |
| Administrator | 1 | 0 | 1 | 520 | 65 | 71% | 8 |
| Physical Therapy Aide | 1 | 0 | 1 | 501 | 69 | 76% | 7.3 |
| Other Dietary Services Staff | 1 | 0 | 1 | 470 | 73 | 80% | 6.4 |
| Nurse Practitioner | 1 | 0 | 1 | 464 | 58 | 64% | 8 |
| Qualified Social Worker | 1 | 1 | 2 | 454 | 63 | 69% | 7.2 |
| Respiratory Therapy Technician | 3 | 1 | 4 | 362 | 62 | 68% | 4.4 |
| Occupational Therapy Aide | 1 | 0 | 1 | 124 | 26 | 29% | 4.8 |
| Occupational Therapy Assistant | 0 | 1 | 1 | 61 | 14 | 15% | 4.4 |
| Medical Director | 0 | 1 | 1 | 59 | 13 | 14% | 4.5 |
| Qualified Activities Professional | 1 | 0 | 1 | 5 | 2 | 2% | 2.3 |
Health Inspection History
Source: CMS Health Citations (Feb 2022 – Aug 2025)
13
Inspections
50
Total Citations
0
Critical (J-L)
2
Serious (G-I)
3.85
Citations/Inspection
Aug 2025
Last Inspection
Citation Severity Distribution
What do these levels mean?
Top Deficiency Categories
Quality of Life & Care
11
22% of total
Resident Rights
9
18% of total
Pharmacy Services
6
12% of total
Abuse, Neglect & Exploitation
3
6% of total
Infection Control
2
4% of total
Administration
2
4% of total
Citation Sources
Standard Inspections
31
Complaint Investigations
25
State Comparison (MO)
Citations
50
Missouri average: 36.5
Critical Citations
0
Missouri average: 0.7
Recent Citations (Last 3 Years)
| Date | Severity ? | Category | Tag | Status |
|---|---|---|---|---|
| Aug 27, 2025 | D | Quality of Care | F0690 | Corrected |
| Jul 03, 2025 | E | Infection Control | F0880 | Corrected |
| Jul 03, 2025 | E | Nutrition | F0804 | Corrected |
| Jul 03, 2025 | E | Nutrition | F0812 | Corrected |
| Jul 03, 2025 | E | Pharmacy | F0759 | Corrected |
| Jul 03, 2025 | E | Pharmacy | F0760 | Corrected |
| Jul 03, 2025 | E | Pharmacy | F0761 | Corrected |
| Jul 03, 2025 | E | Quality of Care | F0677 | Corrected |
| Jul 03, 2025 | G | Quality of Care | F0684 | Corrected |
| Jul 03, 2025 | D | Quality of Care | F0685 | Corrected |
| Jul 03, 2025 | D | Quality of Care | F0690 | Corrected |
| Jul 03, 2025 | E | Quality of Care | F0695 | Corrected |
| Jul 03, 2025 | D | Quality of Care | F0697 | Corrected |
| Jul 03, 2025 | E | Care Planning | F0657 | Corrected |
| Jul 03, 2025 | E | Care Planning | F0842 | Corrected |
| Jul 03, 2025 | E | Resident Rights | F0550 | Corrected |
| Jul 03, 2025 | E | Resident Rights | F0565 | Corrected |
| Jul 03, 2025 | E | Resident Rights | F0585 | Corrected |
| Dec 12, 2024 | D | Care Planning | F0658 | Corrected |
| Jul 03, 2024 | E | Care Planning | F0658 | Corrected |
| Jul 03, 2024 | B | Resident Rights | F0568 | Corrected |
| Jun 20, 2024 | F | Environmental | F0925 | Corrected |
| Jun 20, 2024 | E | Infection Control | F0880 | Corrected |
| Jun 20, 2024 | C | Nursing Services | F0732 | Corrected |
| Jun 20, 2024 | F | Nutrition | F0812 | Corrected |
| Jun 20, 2024 | D | Pharmacy | F0758 | Corrected |
| Jun 20, 2024 | D | Pharmacy | F0761 | Corrected |
| Jun 20, 2024 | E | Quality of Care | F0695 | Corrected |
| Jun 20, 2024 | D | Care Planning | F0641 | Corrected |
| Jun 20, 2024 | D | Care Planning | F0645 | Corrected |
| Jun 20, 2024 | D | Care Planning | F0656 | Corrected |
| Jun 20, 2024 | D | Resident Rights | F0623 | Corrected |
| Jun 20, 2024 | D | Resident Rights | F0625 | Corrected |
| May 06, 2024 | D | Quality of Care | F0689 | Corrected |
| Feb 15, 2024 | D | Abuse/Neglect | F0610 | Corrected |
| Feb 15, 2024 | D | Care Planning | F0658 | Corrected |
| Jan 11, 2024 | G | Abuse/Neglect | F0600 | Corrected |
| Jan 11, 2024 | D | Abuse/Neglect | F0610 | Corrected |
| Jan 11, 2024 | F | Nutrition | F0812 | Corrected |
| Jan 11, 2024 | E | Pharmacy | F0761 | Corrected |
| Jan 11, 2024 | E | Quality of Care | F0677 | Corrected |
| Jan 11, 2024 | D | Care Planning | F0658 | Corrected |
| Dec 28, 2023 | D | Quality of Care | F0689 | Corrected |
| May 25, 2023 | E | Administration | F0835 | Corrected |
| May 25, 2023 | E | Resident Rights | F0569 | Corrected |
| Dec 22, 2022 | F | Administration | F0835 | Corrected |
| Dec 22, 2022 | F | Resident Rights | F0567 | Corrected |
| Dec 06, 2022 | D | Care Planning | F0658 | Corrected |
| Feb 28, 2022 | E | Nutrition | F0812 | Corrected |
| Feb 28, 2022 | E | Resident Rights | F0569 | Corrected |
Facility Characteristics
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Ownership: For-Profit LLC
Part of: Vertical Services
Resident Census by Payment Source
144
Total Residents
Medicare
4
(2.8%)
ⓘ
Medicaid
109
(75.7%)
ⓘ
Private Pay/Other
31
(21.5%)
ⓘ
Programs & Services
Residents' Group
ⓘ
Family Engagement
Active councils help families stay involved in care decisions and facility operations.
Active
Resident Council
ⓘ
Quality Measures
CMS quality measures assess care quality for long-stay and short-stay residents. Lower percentages generally indicate better outcomes for most measures.
Source: CMS Nursing Home Compare (Data as of Jan 2026)
High-Risk Clinical Events
3.0
Score
73% better than avg
Missouri avg: 10.9
Composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and ADL decline
Functional Decline
9.6
Score
51% better than avg
Missouri avg: 19.5
Composite score based on ADL decline, walking ability decline, and incontinence
Long-Stay Resident Measures
Measures for residents who stay 101 days or more. For most measures, lower percentages indicate better care.
Need for Help with Daily Activities Increased
4.4%
Lost Too Much Weight
1.7%
Urinary Tract Infection
0.0%
Depressive Symptoms
69.0%
Falls with Major Injury
1.7%
Pneumococcal Vaccine
79.3%
Antipsychotic Use
23.8%
Walking Ability Worsened
5.0%
Influenza Vaccine
73.2%
High Risk Residents with Pressure Ulcers
2.0%
Low Risk Long-Stay Residents with Bowel/Bladder Incontinence
19.5%
Short-Stay Resident Measures
Measures for residents who stay 100 days or less (typically rehabilitation patients).
Pneumococcal Vaccine
63.4%
Near average
Missouri: 66.6%
Short-Stay Residents Who Received a New Antipsychotic Medication
5.0%
125% worse than avg
Missouri: 2.2%
Influenza Vaccine
15.6%
75% worse than avg
Missouri: 63.5%
Penalties & Fines
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database (Data as of Jan 2026)
Total Fines
$30K
Missouri avg: $73K
59% better than avg
Number of Fines
1
Missouri avg: 2.4
Compared to Missouri Average
Facility: $30K |
Missouri Avg: $73K
Penalty History
Showing all 1 penalties (Jul 2025 - Jul 2025)
Jul 3, 2025
Civil Money Penalty
$30K
Financial Trends
Historical financial and operational data for ADVANCED CARE OF ST JOSEPH based on CMS SNF Cost Reports.
Occupancy Rate
57.2%
↑ 6.4pp vs 2022
Net Income
$721,896
↑ ~$1.0M vs 2022
Total Payroll
$2,725,209
↓ ~$629K vs 2022
Profit Margin
13.1%
↑ 16.9pp vs 2022
Loading trend charts...
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Claim What’s Yours: Financial Aid for Missouri Seniors
Program
State Program Name
Eligibility
Benefits
Aged and Disabled Waiver
Missouri Medicaid A&D Waiver
Official government program page
- General: Age 65+ or disabled, Missouri resident, Medicaid- eligible, nursing home-level care need.
- Income Limits (2025): ~$2,829/month (300% FBR, individual).
- Asset Limits: $2,000 (individual), $3,000 (couple).
- MO Specifics: Rural access prioritized.
- Services: Personal care (5-7 hours/day), respite (240 hours/year), adult day care (~$65/day), home health services.
Missouri Supplemental Nursing Care (SNC)
- General: Age 65+, Missouri resident, in approved facility.
- Income Limits: ~$1,215/month (individual).
- Asset Limits: $2,000 (individual).
- MO Specifics: Supplements SSI; facility-based only.
- Services: Monthly cash payment (~$156-$292/month) for care costs.
Structured Family Caregiving Waiver (SFCW)
Missouri Structured Family Caregiving Waiver
Official government program page
- General: Age 65+, Missouri resident, MO HealthNet-eligible, NFLOC, dementia diagnosis, live with caregiver.
- Income Limits (2025): ~$2,901/month (300% FBR, individual); QIT required.
- Asset Limits: $5,909.25 (individual), $11,818.45 (couple).
- MO Specifics: Caregiver must be family; small program size.
- Services: Cash stipend ($1,000-$1,500/month) to family caregiver, respite, training, supplies ($500/year).
MO HealthNet Aged, Blind, and Disabled (ABD)
Missouri MO HealthNet ABD
Official government program page
- General: Age 65+ or disabled, Missouri resident, MO HealthNet-eligible, needs help with 1+ ADL.
- Income Limits (2025): ~$1,690/month (individual, projected); spenddown allowed.
- Asset Limits: $5,909.25 (individual), $11,818.45 (couple).
- MO Specifics: Less intensive than waivers; statewide access.
- Services: Personal care (2-4 hours/day), homemaker services, limited respite, medical equipment.
Medicare Savings Program (MSP)
Missouri Medicare Savings Program
Official government program page
- General: Age 65+ or disabled, Missouri resident, Medicare Part A/B.
- Income Limits (2025): ~$2,510/month (QMB), ~$3,380/month (SLMB), ~$3,598/month (QI)—individual.
- Asset Limits: $9,430 (individual), $14,130 (couple).
- MO Specifics: Three tiers; no waitlist; includes Extra Help for Part D.
- Services: Covers Part B premiums ($174.70/month), deductibles ($240/year), copays (~20%).
Missouri Caregiver Program (Customized Caregiver Training & Relief)
Missouri Caregiver Program
Official government program page
- General: Caregivers of 60+ with dementia, Missouri resident, functional needs (2+ ADLs).
- Income Limits (2025): No strict cap; prioritizes low-income (~$24,980/year individual).
- Asset Limits: Not assessed; need-based.
- MO Specifics: Administered via AAAs and Alzheimer’s Association; rural focus.
- Services: Respite (4-6 hours/week), training, assistive tech ($500/year), supplies.
Senior Community Service Employment Program (SCSEP)
Missouri SCSEP
Official government program page
- General: Age 55+, unemployed, low-income, Missouri resident.
- Income Limits (2025): ~$1,983/month (125% FPL).
- Asset Limits: Not specified; income-focused.
- MO Specifics: Priority for veterans, rural residents; AARP partnership.
- Services: Paid training (~20 hours/week at ~$7.25/hour), job placement.
VA Aid and Attendance (A&A) and Housebound Benefits
Missouri VA Aid and Attendance/Housebound
- General: Age 65+ or disabled veteran/spouse, Missouri resident, wartime service, need for ADL help (A&A) or homebound.
- Income Limits (2025): Net income < ~$1,984/month (veteran with dependent, A&A); pension offsets income.
- Asset Limits: ~$155,356 (net worth limit).
- MO Specifics: High veteran demand in rural/urban areas.
- Services: Cash (~$1,433-$2,642/month veteran, ~$951-$1,318 spouse) for care costs (e.g., in-home, assisted living).
Claim What’s Yours Financial Aid for Missouri Seniors
Missouri Medicaid A&D Waiver
Aged and Disabled Waiver
Requirements:
General:Age 65+ or disabled, Missouri resident, Medicaid- eligible, nursing home-level care need.
Income Limits (2025):~$2,829/month (300% FBR, individual).- Asset Limits:$2,000 (individual), $3,000 (couple).
MO Specifics:Rural access prioritized.
Benefits without Contact:
- Services: Personal care (5-7 hours/day), respite (240 hours/year), adult day care (~$65/day), home health services.
MO SNC
Missouri Supplemental Nursing Care (SNC)
Requirements:
- General:Age 65+, Missouri resident, in approved facility.
- Income Limits:~$1,215/month (individual).
- Asset Limits:$2,000 (individual).
- MO Specifics:Supplements SSI; facility-based only.
Benefits without Contact:
- Services: Monthly cash payment (~$156-$292/month) for care costs.
Missouri Structured Family Caregiving Waiver
Structured Family Caregiving Waiver (SFCW)
Requirements:
- General:Age 65+, Missouri resident, MO HealthNet-eligible, NFLOC, dementia diagnosis, live with caregiver.
- Income Limits (2025):~$2,901/month (300% FBR, individual); QIT required.
- Asset Limits:$5,909.25 (individual), $11,818.45 (couple).
- MO Specifics:Caregiver must be family; small program size.
Benefits without Contact:
- Services: Cash stipend ($1,000-$1,500/month) to family caregiver, respite, training, supplies ($500/year).
Missouri MO HealthNet ABD
MO HealthNet Aged, Blind, and Disabled (ABD)
Requirements:
- General:Age 65+ or disabled, Missouri resident, MO HealthNet-eligible, needs help with 1+ ADL.
- Income Limits (2025):~$1,690/month (individual, projected); spenddown allowed.
- Asset Limits:$5,909.25 (individual), $11,818.45 (couple).
- MO Specifics:Less intensive than waivers; statewide access.
Benefits without Contact:
- Services: Personal care (2-4 hours/day), homemaker services, limited respite, medical equipment.
Missouri Medicare Savings Program
Medicare Savings Program (MSP)
Requirements:
- General:Age 65+ or disabled, Missouri resident, Medicare Part A/B.
- Income Limits (2025):~$2,510/month (QMB), ~$3,380/month (SLMB), ~$3,598/month (QI)—individual.
- Asset Limits:$9,430 (individual), $14,130 (couple).
- MO Specifics:Three tiers; no waitlist; includes Extra Help for Part D.
Benefits without Contact:
- Services: Covers Part B premiums ($174.70/month), deductibles ($240/year), copays (~20%).
Missouri Caregiver Program
Missouri Caregiver Program (Customized Caregiver Training & Relief)
Requirements:
- General:Caregivers of 60+ with dementia, Missouri resident, functional needs (2+ ADLs).
- Income Limits (2025):No strict cap; prioritizes low-income (~$24,980/year individual).
- Asset Limits:Not assessed; need-based.
- MO Specifics:Administered via AAAs and Alzheimer’s Association; rural focus.
Benefits without Contact:
- Services: Respite (4-6 hours/week), training, assistive tech ($500/year), supplies.
Missouri SCSEP
Senior Community Service Employment Program (SCSEP)
Requirements:
- General:Age 55+, unemployed, low-income, Missouri resident.
- Income Limits (2025):~$1,983/month (125% FPL).
- Asset Limits:Not specified; income-focused.
- MO Specifics:Priority for veterans, rural residents; AARP partnership.
Benefits without Contact:
- Services: Paid training (~20 hours/week at ~$7.25/hour), job placement.
Missouri VA Aid and Attendance/Housebound
VA Aid and Attendance (A&A) and Housebound Benefits
Requirements:
- General:Age 65+ or disabled veteran/spouse, Missouri resident, wartime service, need for ADL help (A&A) or homebound.
- Income Limits (2025):Net income < ~$1,984/month (veteran with dependent, A&A); pension offsets income.
- Asset Limits:~$155,356 (net worth limit).
- MO Specifics:High veteran demand in rural/urban areas.
Benefits without Contact:
- Services: Cash (~$1,433-$2,642/month veteran, ~$951-$1,318 spouse) for care costs (e.g., in-home, assisted living).
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