Frequently Asked Questions
What is a skilled nursing facility?
Generally speaking, a skilled nursing facility is a clinical care provider of 24-hour licensed nursing. A “SNF”, as they are often referred to, is primarily engaged in providing services for residents who require medical or nursing care and/or therapy services for the rehabilitation of injured, disabled, or sick persons. Care typically includes: rehabilitation, intravenous therapy, post-surgical stabilization, pulmonary management, and wound care. Additionally, facilities provide assistance with administration of medications, and aid in a variety of daily living needs, including dressing, bathing, walking and eating.
Does a skilled nursing facility provide other services?
Most facilities do provide additional services, and some are included in your regular inpatient care. It is always best to check with admissions or social services to determine which services are available to you.
- Psychiatric /psychological services
- Podiatry and optometry
- Social services
- Housekeeping and laundry
- Beauty/barber shop*
*Usually available as additional fees to daily rates
Will my own doctor check on me in the facility?
- This depends on whether your doctor has privileges in the facility where you are admitted. If he or she is not credentialed for your facility, then your case will be referred to another doctor who is on staff there.
- While everyone’s medical condition varies, typically the facility physician will make rounds once per week.
- A nurse practitioner who works under the physician’s supervision is typically in the facility 2-3 times per week, seeing various patients during each visit.
- Upon discharge, a facility will usually release information pertaining to your medical status to your personal physician at your request.
How do I know if I qualify for Medicare or Medicaid? What’s the difference between the programs?
Medicare is a federal health insurance program. It typically covers some expenses related to a stay in a skilled nursing facility, but only after an inpatient hospital stay covering a period of “three midnights” and only for a related illness or injury. Generally, you may be eligible for Medicare if you or your spouse has paid into Social Security for at least 10 years.
Additionally, you must be:
- Age 65 or older and receiving social security retirement benefits,
- Under age 65 with certain disabilities and have received social security disability benefits for 24 months,
- Or be any age but diagnosed with End-Stage Renal Disease
Talk to a social worker at your hospital or visit www.medicare.gov for more information on eligibility requirements and to find out what services Medicare covers for skilled nursing facility stays. Medicaid is a federally-supported, state-operated health care assistance program that pays for health care services.
Who is eligible?
- Certain individuals or families with substantially low incomes, who may have no medical insurance or inadequate medical insurance.
- Generally, eligibility is based on extreme financial need and medical necessity.
Speak to a social worker at the hospital or visit www.cms.hhs.gov/medicaid/eligibility to learn more about eligibility and the criteria specific to each. Because each state operates its own Medicaid program, eligibility requirements and coverage may vary from state to state.
Also, to find Medicare and Medicaid-certified skilled nursing facilities, go to www.medicare.gov/nhcompare.
What if I have insurance coverage other than traditional Medicare or Medicaid?
Talk with a social worker at the hospital or contact your insurance provider member services department for more information on eligibility requirements and to find out what services your insurance covers for skilled nursing facility stays.
What should I bring with me to the facility?
- First and foremost, bring all insurance and/or Medicare/Medicaid cards.
- Provide any and all insurance coverage cards to the admissions representative at the facility.
- Also, make sure to have drivers license and social security cards with you as they may be needed to complete the admission process.
Also, bring items that will make your stay more restful and easier on you, such as:
- Comfortable clothing, with your name clearly written on the label. Bring enough clothing for at least 7-10 days.
- A pair of non-skid, supportive shoes and socks
- Toothbrush/toothpaste, denture cups
- Comb, brush, personal lotions, deodorant and other essential toiletries
- Hearing aide, eyeglasses and eyeglass case
- Reading materials, family photos
- Small television and telephone – In most facilities, you may arrange to have these services provided at your expense. You may also bring your cell phone should you wish to use it instead of a wall jack telephone. Some facilities provide TV’s in their rooms, so just ask your assigned social worker at the hospital if you should bring one with you.
What should I leave at home?
- Large amounts of money
- Electrical items, including extension cords, space heaters and electric blankets
How do I know if I or a loved one can still live at home or should move into some kind of a facility?
- Requiring daily assistance with eating, dressing, bathing or using the toilet.
- Forgetting to take medications or perhaps taking too many
- Behaving in ways that could be harmful (to yourself or to others)
- Wandering away from home or frequent signs of memory loss
If you find you or a family member need help, here are some options, one of which may suit your specific situation:
- Find the right skilled nursing facility if you or a loved one has suffered an illness or injury and requires rehabilitation and continuous medical care, whether for the short or long-term. And, keep in mind that unfortunately there may be certain medical conditions that cause continued decline, regardless of the clinical solutions available.
- Move into an assisted living community which offers assistance in the areas of housekeeping services, provision of meals and personal care.
- Continue to live at home after recovering from an injury or illness, but bring in additional assistance such as home care professionals and/or utilize community services (Meals on Wheels, for instance).