Does insurance or the family pay for a personal/private caregiver in a skilled nursing facility?

Thank you for your feedback. My mother just passed away so as siblings we are trying to sort this all out. His 30-year caregiver is not paid by us. I think maybe through Medicare?But your feedback helps me know where to begin looking for answers specific to his needs. So I'll contact SSI, IHS and Medicare.

The typical long term insurance is either for care in a facility or in-home. Find out who was paying for this caregiver all these years.
I honestly doubt an insurance company was...the life time caps on those policies would have been used up long before 30 years.

My parents had a great policy for in-home care. But, it was just that ... in-home only. The lifetime cap would have meant the benefits would have expired after 7 years.

Who has been paying for the caregiver for the last thirty years? You could see if this cover could be transferred with him as part of a care package, perhaps.

I think additional caregivers would be private pay by the family,  especially as you note the CG will assist him with non medical needs. I do not think any insurance company pays for CG in a facility as that would mean they are paying twice for his care.

I had a friend with excellent long term care insurance. It covered the facility cost, and also for a private caregiver.

I think that is a really exceptional situation. Generally the personal attendant would be private pay. Is your brother on SSI? Does he have a case worker? I think I'd start by discussing the financial aspects of moving to a SNF with them.