What is Skilled Nursing Care? Learn about Nursing Home Services, Rehabilitation, Community, & Skilled Nursing Facility Options
Skilled nursing care is a form of long-term, comprehensive healthcare for individuals experiencing significant functional loss and/or physical limitations.
Nursing care can be provided in facilities or at the home location of an individual.
Homecare is often delivered on either a daily basis or as needed to address health concerns that emerge over time with varying severity levels.
This blog post provides detailed information about skilled nursing services, community options, and facility options within the United States (and abroad) that you might be considering.
What is Skilled Nursing Care?
Skilled nursing care refers to a type of health care that is provided by licensed registered nurses (RNs) and licensed practical nurses (LPNs) who are specially trained to provide this type of care.
Services:
Skilled nursing care services can include wound care, IV therapy, medication management, mental health therapist, and more. These services are typically provided in a hospital or skilled nursing community setting depending on the level of care needs.
Community and Facility Options:
There are many skilled nursing facilities located throughout the United States that provide quality care for patients. These facilities offer a variety of services and amenities that can meet the needs of any patient.
They can be called the following:
- Living Communities
- Assisted Living Communities
- Skilled Nursing Facility
- Nursing Home
Each of these locations provided care that can range from low to a high-level of medical care.
What Services are Included in Skilled Nursing Facilities?
Skilled nursing care generally includes a wide range of health services and support, including but not limited to:
- Assistance with activities of daily living (bathing, dressing, grooming, etc.)
- Medication management
- Coordination of care with other health professionals
- Rehabilitation therapies (physical, occupational, speech)
- Nutritional counseling and support
- Wound care
- Disease management and education
It is vital when considering the need for skilled nursing services to ensure the nursing home care is providing the help a patient needs. Families need to be actively involved with the care their loved ones are receiving to ensure the nursing care provided is not subpar.
What are the Community and Facility Options for Nursing Facilities and Nursing Homes?
Community-based skilled nursing care is care that is provided in the home or in a community setting, such as an adult day care center. This type of care is typically less expensive than facility-based care and can be more convenient for patients and their families.
Community-based care is designed for adults who do not need a high level of care but still need specialized care in a skilled care facility.
Facility-based skilled nursing care is care that is provided in a hospital, nursing home, or another type of long-term care facility. This type of care can be more expensive than community-based care but may be necessary for patients who require more intensive medical attention.
It is critical to work with your treating physician when determining viable care options.
How do I know if I Need Skilled Nursing Care?
Skilled nursing care can provide the necessary medical attention and support to help patients recover from an illness or injury, manage a chronic condition, or maintain their overall health.
Skilled nurses can administer medications, perform treatments and therapies, monitor of vital signs, and provide education and support to patients and their families.
You or your loved one may need to consider skilled care if the following are true:
- A sudden decline in health or a change in condition that requires more medical attention than can be provided at home
- A new diagnosis that requires close monitoring and/or complex care
- A need for specialized therapies or treatments, such as IV therapy or wound care
- Difficulty managing medications or other self-care tasks
If your family member is showing signs of not being able to take care of themselves, they may need to be placed in a nursing home or other type of long-term care facility. We understand that some nursing homes have given the industry a bad name, but it is worth noting that nursing homes must meet strict criteria, and ensure a high level of quality standards are being met.
If they fail to meet these standards the Centers for Medicare and Medicaid could remove their approval to be a Medicare-approved facility.
How do I Pay for Skilled Nursing Care: Senior Care Options, Medicare, Medicaid, and more
Original Medicare:
If you are covered by Medicare Part A, you can get medically necessary skilled nursing care in an SNF. Part B of Medicare coverage may cover some home health services and some outpatient therapy services. Without a Medigap plan, if coverage falls under Part A the first 20 days will be covered at 100 percent. Days 21 to 100 will include a daily copay. After 100 days you are responsible for all costs.
Medicare Supplement Plan:
If you have a Medicare supplement plan, it may cover some of the costs not covered by Original Medicare Parts A or B. If you enrolled in the Medigap Plan F, you are covered 100 percent for all 100 days in a skilled nursing facility.
Medicare Advantage Plan:
If you have a Medicare Advantage Plan, it will cover all of your Part A and Part B benefits. The costs differ for each plan as they may include a copay, coinsurance, and deductible from day one.
Medicaid:
Each state has its own Medicaid program. You may be able to get coverage for skilled nursing care if you qualify for Medicaid.
Private insurance:
Some private insurance plans may cover skilled nursing care. Check with your insurer to see if your policy provides coverage.
Long-term care insurance:
If you have long-term care insurance, it may cover skilled nursing care. Long-term care insurance can provide insurance coverage for 2 years, 3 years, and 5 years. Some older policies do not cap the total number of years they will provide coverage. Check your policy to see if it covers this type of care.
Veterans benefits:
If you are a veteran, you may be eligible for skilled nursing care through the Veterans Affairs (VA) health care system. Costs are based on income and current VA disability ratings.
Self-pay:
Why this is the most expensive option, you may be able to negotiate a payment plan with the skilled nursing facility if you are self-paying.
Medicare includes coverage for Home health care which is another care option for an aging adult that could be considered.
What are the Benefits of Skilled Nursing Care Services?
The benefits of skilled nursing services include some of the following:
- Skilled nursing care can help improve a patient’s overall health and quality of life.
- Provide the needed rehabilitation services and occupational therapy
- Trained medical professionals providing skilled services to check vital signs and medical equipment are in good working condition
- Skilled nursing care can provide vital support and assistance with activities of daily living, and catheter care, such as bathing, dressing, and eating.
- Skilled nursing care can help to prevent or manage chronic health conditions, such as diabetes or heart disease.
- Skilled nursing care can provide peace of mind for patients and their families, knowing that there is someone there to provide expert medical care and support.
Are there any Risks Associated with Skilled Nursing Facilities and Nursing Homes?
There are certain risks associated with skilled nursing care, particularly when it comes to the administration of medication and other treatments. There is also a risk of falls and injuries, as well as the potential for contracting infections.
Precautions:
To minimize the risks associated with skilled nursing care, it is important to follow all precautions and instructions from the care team. This includes washing hands regularly, using proper body mechanics when moving patients, and following infection control protocols.
What is the Difference Between Skilled Nursing Care and Long-term Care?
Skilled nursing care is a type of medical care that is provided by licensed nurses. This type of care is typically given to patients who are recovering from an illness or injury and need help with their daily activities.
Skilled nursing care can be given in a hospital, nursing home, or another type of health facility.
Long-term care is a type of medical care that is provided to people who have chronic illnesses or disabilities. This type of care can be given in a variety of settings, including nursing homes, assisted living facilities, and home health agencies.
Long-term care services can include help with activities of daily living, such as bathing and dressing, as well as more specialized services, such as physical therapy or hospice care.
24-hour care is typically provided with both skilled care services and unskilled care services.
What is the Difference Between Skilled Nursing Care and In-home Care?
In-home care is a type of care that helps people who need assistance with activities of daily living (ADLs) and other personal care services. ADLs include things like bathing, dressing, eating, using the restroom, and transferring from a bed to a chair.
Skilled nursing care is a type of medical care that is provided by licensed nurses. This type of care can be given in a hospital, nursing home, or other health facilities. Skilled nursing care includes things like giving medication, wound care, and monitoring vital signs.
In addition, skilled nursing is mostly regulated by the Centers for Medicare and Medicaid where a family member can provide in-home care without a license.
What Level of Care is Provided in an Assisted Living Facility?
The level of care provided in an assisted living facility can vary depending on the needs of the residents.
Most assisted living facilities to provide basic care, such as help with bathing, dressing, and eating. Some facilities also provide more comprehensive care, such as help with medication management, transportation, and other activities of daily living.
The level of care provided is typically based on the assessed needs of the residents and can be adjusted as those needs change over time.
How do I Find a Skilled Nursing Care Facility near me?
Start your search for a skilled nursing care facility by asking your doctor or other health care providers for recommendations. You can also contact your state’s long-term care ombudsman.
When you visit a skilled nursing care facility, pay attention to how clean and well-maintained it is. Also, ask about the staff-to-patient ratio and the types of services that are available.
Don't Panic Seek the helpful Advise of a Certified Medicare Insurance Agent
If you’re feeling overwhelmed by all of the Medicare options available, don’t panic! You can always seek the helpful advice of a certified Medicare insurance agent.
At Integrity Now Insurance Brokers our Medicare agents are specially trained to help individuals select the best Medicare plan for their needs and budget. Plus, they can answer any questions you may have about how Medicare works.
If you need residential care including a senior’s private home, we are here to help find a health insurance plan that provides the best coverage.
Private health insurance such as Medigap plan G or F can supplement your out-of-pocket costs related to Original Medicare. Or you can choose to leave Original Medicare and enroll in a Medicare Advantage plan.
Either way, we are here to help! Call us today or complete our online Medicare quote form.
