What Is A Skilled Nursing Facility?
Nursing homes, by definition, are skilled nursing facilities. They are referred to as (SNFs). A SNF provides a broad range of health and personal care services. An SNF is considered the highest level of care for elders outside of a hospital.
Elder Care Facilities In General
Nursing homes provide personal care for the elder, providing needed assistance with feeding, bathing, dressing, and bathroom visits. Nursing homes differ from other assisted living arrangements such as Board-and Care facilities because nursing homes also provide actual medical care.
Nursing Homes Provide Medical Care
Under the law, a verified and licensed doctor must supervise each patient’s care whether or not they are on the premises. In contrast, in most cases, a nurse or other medical professional, such as a physician’s assistant, must always be present on the premises.
Given the medically vulnerable nature of many of these patients, skilled nursing care must be present seven days a week, every day of the week. A constant and continued presence is not required of other healthcare professionals, such as speech therapists and occupational therapists.
However, most state laws require that these healthcare practitioners be readily accessible and on call to provide regular and scheduled care.
Locating A Nursing Home
Chances are when you are looking for a nursing home, you are under pressure to move fast due to a recent hospitalization or a loved one’s severe decline in health. The more information you have, the greater your chances of finding the right fit for your loved one.
Receiving An Advanced Copy of Fees, Services, Charges and Costs
You have the legal right to be provided in writing with all of the nursing home’s services, charges, fees, and costs before the elder take’s occupancy at the facility.
The Statement of Charges
Irrespective of whether these fees, charges, or costs are billed to you directly or to a third-party provider for payment. There are other laws you should know before you select a nursing home:
- The nursing home prohibits charging you a minimum entrance fee if Medicare or Medicaid pays for your care.
- The federal government requires nursing homes to provide written and verbal information regarding your option to apply and receive Medicare and Medicaid benefits for payment of services. Including an itemized list of Medicare and Medicaid medical services, testing, medical equipment, and drug and health products they offer.
- Under the law, the nursing home must also provide information on receiving a refund if you paid for an item or service already covered by the nursing home.
Limits On What Medicare Will Pay
Skilled Nursing Facilities Is Defined As Long Term Care
Medicare usually does not cover long-term care services or personal care—such as help with bathing or supervision, often called custodial care. This has been somewhat modified on what is known as the Medicare Advantage Program, which can work in conjunction with certain states’ Medicaid programs and third-party single-payer insurance providers working with Medicare.
Generally, a skilled nursing facility, hospice care, or home health care may be available under certain circumstances. They include:
- You have had a recent prior hospital stay of at least three days.
- You are admitted to a Medicare-certified nursing facility within 30 days of your previous hospital stay.
- If you meet all these conditions and depending on your other medical insurance, such as gap coverage, Medicare will pay for most of your costs for up to 100 days.
Selecting A Nursing Home
If you are new to managing a parent’s elder care needs, including selecting a facility that will meet their long-term needs either through private insurance, Medicare or Medicaid programs, or a mixture of both, the conditions and terms of access to medical services and custodial care can be a bewildering process.
One way to obtain help in figuring these issues out is to select a senior living consulting and referral service to assist you.
One such service that is highly respected is called A Place for Mom. They have programs that will help you determine the types of medical insurance coverage you have and have referral resources to assist you in the application process. They can also help you locate retirement communities.
