What Is a Skilled Nursing Facility?
A skilled nursing facility is an in-patient rehabilitation and medical treatment center staffed with trained medical professionals. They provide the medically-necessary services of licensed nurses, physical and occupational therapists, speech pathologists, and audiologists.
Skilled nursing facilities give patients round-the-clock assistance with healthcare and activities of daily living (ADLs). There are numerous federal regulations regarding what skilled nursing facilities can and cannot do.
- A skilled nursing facility is an in-patient treatment and rehabilitation center featuring licensed nurses and other medical professionals.
- These services can be very expensive but most skilled nursing facilities are covered, at least in part, by private health insurance or else Medicare or Medicaid.
- Patients in a skilled nursing facility can be expected to remain there temporarily, in contrast to a more permanent nursing home setting.
Skilled Nursing Facility vs. Nursing Home
Typically, a skilled nursing facility is a temporary residence for patients undergoing medically-necessary rehabilitation treatment. A nursing home, on the other hand, is more often a permanent residence for people in need of custodial care 24/7.
How a Skilled Nursing Facility Works
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, and the ability to handle activities of daily living, such as bathing and getting dressed.
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 facility and try to get her mom admitted. If there are other equally good options, she could also consider choosing another facility.
A skilled nursing facility is required by law to provide you with a written description of your legal rights, which can vary by state.
Special Considerations: Paying for a Skilled Nursing Facility
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. After the 100 days patients are responsible for all costs—some or all of which can be covered private insurance or Medicaid for those who are eligible.
For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period is $176 in 2020
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. In 2019, for example, a private room in a skilled nursing facility or nursing home cost an average of $102,200 a year, according to a report on long-term care by Genworth.