Skilled Nursing Care

Table of Contents

• What Is a Skilled Nursing Facility?
• What Does a Skilled Nursing Facility Look Like?
• What Is It Like to Live in a Skilled Nursing Facility?
• Is a Skilled Nursing Facility Right for Me?
• Cost of Skilled Nursing Facilities
• Questions to Ask When Researching a Skilled Nursing Facility
• Licensing and Inspection Requirements

What Is a Skilled Nursing Facility?

A skilled nursing facility (SNF) provides skilled nursing care, a level of care provided by a registered nurse who monitors a patient’s health and administers treatment around-the-clock. This may be provided through long-term care or short-term rehab. Once known as nursing homes, many of these communities have upgraded to provide more comfortable and modern care for residents. They may feature, for example, flat screen TVs in all personal rooms, or more high-tech rehabilitation equipment than offered in the past.

Skilled nursing care provides a higher degree of assistance with daily tasks than assisted living communities. However, skilled nursing care is not as intensive as sub-acute care, or comprehensive in-patient care for someone with an acute illness or injury (both of which can be provided in select SNFs).

Some patients attend SNFs on a short-term basis if nursing care or occupational, physical, or speech therapy is needed following a hospital stay. Or in some cases, patients use it for long-term care due to a chronic health condition.

In addition to nursing care, SNF staff provide assistance with daily tasks – much like assisted living – including bathing, grooming, getting dressed, and managing medications.

What Does Skilled Nursing Care Look Like?

Modern skilled nursing care facilities (SNFs) are often housed in large buildings, but provide home-like communal areas. They include:

• Living rooms
• Dining areas
• Porches
• Outdoor gardens

These community spaces give residents a place to socialize, enjoy entertainment, or participate in group activities.

SNFs are designed to keep residents safe and secure, while also fostering as much mobility as possible. They are often equipped with features like non-skid floors, handrails in hallways and bathrooms, and handicap accessibility throughout.
Residents generally live in private or semi-private rooms with a bathroom. SNFs may be separate communities, or they may be part of a Continuing Care Retirement Community that offers multiple tiers of care such as independent living and assisted living.

What Is It Like to Live in a Skilled Nursing Facility?

SNFs typically provide residents with either a private or semi-private bedroom with a bathroom. Since staff will assist with daily tasks like getting dressed or eating meals, residents operate on a routine schedule. They are able to move freely around within the building throughout the day, but communities often have a curfew in place.

Additionally, there are usually amenities onsite. These may include:

• Beauty salons or barber shops
• Gift shops
• Fitness centers
• Cafés, possibly even a Starbucks

Each resident’s health is monitored by the registered nurses on staff, and emergency care is available at all times if needed.

Is a Skilled Nursing Facility Right for Me?

Consider these statements below to determine if a couple of them describe you, or your loved one:

• There are medical issues that require long-term attention
• Alzheimer’s or dementia has been diagnosed, and memory care treatment is not enough
• Medical treatments or procedures are needed on a regular basis
• Health needs to be monitored daily
• Care from a nurse is required daily

If one or more of these statements apply, then a Skilled Nursing Facility may be a good option. You could also consider the following solutions:

• Home Health Care (if you prefer to stay in your home)

If you or your loved one are in better health than these statements indicate, the following solutions may be a better fit:

• Assisted Living
• Residential Care Home
• Memory Care
• Home Care

Still not sure? Take our Care Assessment to see what care level may be best.

Cost of Skilled Nursing Facilities

Costs of SNFs often vary based on the following factors:

• Geographic location of the facility
• Type of room
• Amenities

Some facilities charge a monthly room rate, in addition to daily care rates, and may charge extra for nursing care and supervision beyond the basic level that’s already included.

According to Genworth’s Cost of Care Survey, the National Daily Median cost of nursing home facilities in the United States is $285 for semi-private rooms and $320 for private rooms. On a monthly basis, these averages are $8,669 for semi-private and $9,733 for private rooms.

Skilled Nursing Care can be covered by the following funding sources:

• Private Funds
• Long-Term Care Insurance
• Veterans Benefits
• Private Health Insurance Policies
• Medicare
• Medicaid

If the SNF is Medicare certified, some or all of the care may be covered by government programs as shown below:

• Day 1-Day 20: Covered by Medicare at 100 percent. (To qualify for Medicare coverage, a three-night inpatient hospital stay is required and patients must enter the facility within 30 days of hospitalization.)*
• Day 21-Day 100: Copay of $141.50 per day. Copays may be covered by private insurance or Medicaid (if the recipient qualifies).
• After Day 100: Private pay or covered by Medicaid (if recipient qualifies)

*For all of Medicare’s requirements, see “Medicare Coverage of Skilled Nursing Facility Care,” published by the Centers for Medicare & Medicaid Services. If you have a Medicare Advantage Plan, coverage may vary.

Questions to Ask When Researching a Skilled Nursing Facility

• Does it appear to be a clean and hospitable setting?
• Do the residents seem cared for and content?
• Can residents make choices about their daily routine?
• Are the meals prepared onsite or offsite?
• Is there a controlled entry system (especially important if there’s a concern about your loved one wandering)?
• Visit during off hours (like in the evenings or on weekends). Does the community still look as well maintained and organized as it did during daytime hours?
• Is the staff friendly and helpful?
• Do they offer personalized treatment plans?
• How often and how many nurses are staffed at a time? 
• What is the staff-to-patient ratio?

Licensing and Inspection Requirements

Skilled Nursing Facilities are heavily monitored and must be licensed and inspected by the agency in each state that oversees long-term care facilities. Their deficiency scores are public records that can be found through your state government.