What Is a Common Reason for Admission to a Skilled Nursing Facility?

A common reason for admission to a skilled nursing facility is recovery from surgery, injury, or acute illness that requires round-the-clock nursing and rehabilitative services.

Skilled nursing facilities provide services such as wound care, medication administration, and physical and occupational therapy. Patients may also be admitted if they have chronic conditions that necessitate constant medical supervision.

What Qualifies a Patient for Skilled Nursing Care?

The eligibility requirements for admission into a skilled nursing facility, particularly for coverage under Medicare, include several specific conditions.

Firstly, the individual must have Medicare Part A (hospital insurance) with remaining days in their benefit period. A benefit period begins the day a person is admitted to a hospital or a skilled nursing facility and ends 60 days after the end of their stay.

Secondly, the patient must have had a qualifying hospital stay, which typically means they must have been an inpatient in a hospital for at least three days.

Thirdly, their doctor must believe they require skilled nursing care on a daily basis, which must be administered under the supervision of skilled nurses and therapists, and must be directly related to the condition treated during the qualifying hospital stay.

Finally, the individual must be admitted to a skilled nursing facility that is certified by Medicare, meaning the facility meets strict standards to maintain their Medicare certification.

Once admitted, Medicare covers services including a semi-private room, meals, skilled nursing care, rehabilitative services, medication, medical social services, medical supplies, and limited ambulance transportation. Medicare will generally cover up to 100 days of treatment in a skilled nursing facility. Refusal of daily skilled care or therapy can result in denial of coverage for the remainder of the stay.

What is a Skilled Nursing Facility?

A Skilled Nursing Facility (SNF) is a residential center that offers 24-hour nursing and rehabilitative services to patients either on a short-term or long-term basis. These facilities are designed to assist individuals recovering from surgery, injury, or acute illness and may also accommodate those with chronic conditions requiring continuous medical supervision.

Services provided in an SNF include wound care, medication administration, physical and occupational therapy, and pulmonary rehabilitation. To be eligible for Medicare coverage in an SNF, patients must meet specific criteria, which include having Medicare Part A with remaining benefit period days, a qualifying hospital stay, and a doctor’s assessment that daily skilled nursing care is necessary. Furthermore, the chosen SNF must be certified by Medicare.

What Are The Reasons To Choose a Skilled Nursing Facility?

A Skilled Nursing Facility (SNF) is a healthcare institution that offers specialized, transitional, or rehabilitative care. These facilities are equipped with trained medical professionals and therapists who provide round-the-clock care. There are several key reasons why a patient might be referred to a skilled nursing facility:

1. Specialized Nursing Care: Patients recovering from major health events like heart attacks, strokes, or Alzheimer’s disease may require specialized nursing care. Skilled nursing facilities employ in-house therapists who provide the necessary therapies such as speech, movement, and other rehabilitative therapies.
2. Transitional Nursing Care: Following a critical hospital stay, patients may be referred to a skilled nursing facility for transitional care. The aim is to transition the patient from intensive, round-the-clock care to a more independent state of living, either at home or in a long-term care facility.
3. Rehabilitation: Patients may also be referred to skilled nursing facilities for rehabilitation. This could be due to old injuries not healing well, or as part of a recovery plan following hospitalization or a major health event.
4. 24/7 Support: Skilled nursing facilities provide round-the-clock care from licensed nurses and therapists. This includes wound care, intravenous (IV) therapies, lymphedema therapy and ostomy care, amongst others.
5. Specialized Therapy: Skilled nursing facilities also offer physical, occupational, and speech therapy. These therapies aim to help patients regain mobility, communication skills, and muscle strength, and to regain as much independence as possible.
6. Help with Activities of Daily Living: In addition to medical care, skilled nursing facilities also provide help with activities of daily living (ADLs), such as bathing, dressing, grooming, eating, and going to the bathroom.
7. Homelike Setting: Skilled nursing facilities are designed to provide a comfortable and homey atmosphere. They offer private and semi-private rooms, inviting common areas, and provide daily meals and snacks.
8. Engaging Activities: To support the mental and emotional well-being of patients, skilled nursing facilities often offer a variety of cultural, recreational, social, and spiritual activities.

Frequently Asked Questions