What’s a Skilled Nursing Facility and How Can You Pay for It?
- Many older adults spend some time in a skilled nursing facility. What are these senior living communities, and how can they help? Find out how to pay for care.
Older adults with medical needs sometimes require more care than home health services can provide.
Seniors with chronic conditions, or who are recovering from injury, illness or surgery, often get treatment in a skilled nursing facility (SNF).
SNFs, sometimes also known as nursing homes or post-acute care centers, provide nursing services to seniors and younger adults with disabilities in a safe residential setting, where they can be looked after 24 hours a day during a time of intense medical need.
What Is a Skilled Nursing Facility?
Skilled nursing facilities are inpatient senior care centers that offer 24-hour nursing services, usually over a short-term period, for injuries, medical conditions and seniors recovering from medical procedures.
Residents of a nursing care home may have a private room or share a space. Meals are provided by facility staff, as are medications and other interventions needed for residents’ treatment. Activities at an SNF revolve around each resident’s plan of care, which must be drafted by a doctor prior to admission to the facility.
Individual facilities may be large or small, attached to other senior living facilities or independent, and while many provide memory care services for seniors with Alzheimer’s, some do not.
Common Reasons for SNF Care
Seniors move into skilled nursing facilities for a variety of reasons, almost all of them health-related. It is common for seniors to move into a skilled nursing facility after a fall that results in injury. During the weeks or months of recovery, on-site health workers guide therapy services to help the resident recover as much as possible before going home.
Many seniors spend a short time recovering in an SNF from surgery, such as a hip or knee replacement, while others spend time in a facility adjusting to a new disability, such as partial paralysis after a stroke.
Adults of all ages sometimes check into an SNF for short-term therapy and medical supervision after being diagnosed with a serious illness. People with uncontrolled diabetes sometimes spend a week or more in an SNF being carefully observed until their blood sugar is manageable and the person knows how to self-administer medication.
Some residents choose an SNF for end-of-life or hospice care. Nursing homes are not the only choice for this service, though some find constant nursing assistance helpful for administering comfort care measures.
Nursing Home Care Services
The services seniors get at a nursing home are usually focused on rehabilitation after a medical issue negatively affects their health. Resident doctors can diagnose and prescribe treatments for seniors’ medical needs, while nurses and medication aides distribute prescription drugs.
Physical therapists often use a gym on the premises to help seniors improve their fitness and mobility, while occupational therapists help newly disabled residents re-learn how to do everyday tasks.
Other services provided in a nursing care home are more social than medical. Seniors with cognitive impairment or progressive dementia often benefit from interactions with other people close to their age, and the social environment in a nursing home can potentially slow the advance of their symptoms.
How Are SNFs Different From Other Types of Long Term Care Facilities?
Skilled nursing facilities are not to be confused with other types of senior care. Older adults have several levels of living arrangements to choose from, depending on their needs. S
killed nursing is fundamentally different from these other senior living arrangements:
- Assisted living
Assisted living communities function much like apartment complexes, with each resident enjoying a maximum level of independence and privacy. Residents of an assisted living facility often have in-home assistance from personal caregivers with activities of daily living, such as bathing, dressing and meal preparation, though medical care is usually not included.
- Memory care
Memory care services are intended for seniors with Alzheimer’s disease and other forms of dementia. Though these conditions can sometimes be managed in a skilled nursing setting, a dedicated memory care unit offers long-term care for seniors with chronic cognitive conditions.
- Adult day care
Adult day programs are almost always offered at outpatient care centers as part of a senior’s daily activities. Occupational therapists often conduct group sessions at these facilities, but medical care is not typically part of the program.
- Hospice care
Hospice services are sometimes part of skilled nursing care, though it is more often a part of assisted living or residential senior living. Hospice residents are usually in the end stage of a serious illness, and the focus of care for them is more on comfort than rehabilitation.
Paying for SNF Medical Services
Many of the seniors who check into a skilled nursing facility have many of their inpatient healthcare needs covered by Medicare. Medicare provides insurance benefits for eligible seniors aged 65 and over, as well as younger adults with certain qualifying disabilities.
Medicare Part A covers some inpatient care costs in hospitals and other overnight care facilities. Part A benefits include up to 100 days of care in a skilled nursing facility, plus up to 3 days of evaluation during a qualifying hospital stay.
Medicare benefits are staggered by term of stay, with residents gradually taking on a greater share of the cost of services. Provided a beneficiary has not reached the lifetime coverage maximum and still has Part A benefits available, Medicare’s payment schedule is:
- 1-20 days: Full coverage
- 21-100 days: Medicare pays $176 a day for covered services
- 101 days and beyond: No coverage
Medicaid is a joint federal-state health insurance program that provides basic health services for adults with limited income and qualifying disabilities. Benefits provided by Medicaid vary from one state to another, but in general the program can pay for all necessary residential and therapeutic services for seniors who have exhausted their resources.
Some services, such as personal clothing, cosmetics and entertainment, are not paid for by Medicaid. Other extras, such as a private room, may be covered if a doctor endorses them as medically necessary.