What Is a Skilled Nursing Facility?

A skilled nursing facility is an in-patient rehabilitation center staffed with trained medical professionals. Such facilities provide the medically necessary services of nurses, physical and occupational therapists, speech pathologists, and audiologists.

Typically, a skilled nursing facility is a temporary residence for patients undergoing medically necessary rehabilitation treatment. A nursing home is more often a permanent residence for people in need of custodial care.

Skilled nursing facilities provide round-the-clock assistance with healthcare and activities of daily living. There are numerous federal regulations regarding what skilled nursing facilities must and must not do.

Understanding the Skilled Nursing Facility

Skilled nursing facilities and nursing homes are barred from discriminating against residents based on race, color, ethnicity, religion, age, sex, and other protected characteristics. Skilled nursing facilities that violate the rules can be reported to authorities, such as the local long-term care ombudsmen and state nursing home regulatory agencies.

For example, a woman who suspects her mother was denied entry to a particular nursing home in California because of her race could report the incident to the California Department of Public Health. If her mom doesn’t have any other care options, she might take up the matter with the nursing home and try to get her mom admitted. If there are other equally good options, she could also consider choosing another facility.

Paying for a Skilled Nursing Facility

Any patient entering a skilled nursing facility receives an initial health assessment as well as ongoing health assessments to evaluate physical and mental health, medications, ability to handle activities of daily living such as bathing and getting dressed, and ability to speak and make decisions.

Patients needing post-hospital care in a skilled nursing facility who are enrolled in Medicare are covered for stays of up to 100 days in a Medicare-certified skilled nursing facility if the patient meets Medicare's requirements. 

The facility and Medicare use specific assessments to determine whether Medicare will pay for the patient's stay or the patient will be responsible for some or all of the cost. 

Skilled nursing facilities cannot charge a buy-in fee, as some assisted living communities do, and are required to put their services and fees in writing and give these details in advance to the patient or the patient's caregiver.

Skilled nursing facilities can be extremely expensive for long-term stays. For example, in 2016, a private room in a skilled nursing facility or nursing home cost over $100,000 a year, according to a recent report on long-term care by Lincoln Financial Group.