Skilled Nursing Facility: What It Is and How It Compares to Nursing Homes

Updated July 10, 2024

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What Is a Skilled Nursing Facility?

A skilled nursing facility is an inpatient rehabilitation and medical treatment🦂 center staffed with trained medical professionals. Patients typically arrive at a skilled nursing facility after a stay in the hospital, and they remain under the care of a doctor.

The facility provides medically necess𒅌ary services with registered nurses (RNs), physical and occupational therapists, speech pathologists, and audiologists, among others.

Skilled nursing facilities also give patients round-the-clock assistance with activities of daily living, to use Medicare's term. These are personal care tasks, such as showering, dressing, getting in and out of a chair, and eating.

Key Takeaways

A skilled nursing facility is an inpatient treatment and rehabilitation center with doctors, registered nurses (RNs), physical therapists, and other medical professionals.
Most skilled nursing facilities are covered, at least in part, by private health insurance, Medicare, or Medicaid.
Medicare covers stays up to 20 days. Coinsurance is required for days 21 to 100, and there is no coverage beyond 100 days.
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. It's common to stay in a skilled nursing facility after a stay in the hospital. 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 these rules and others can be reported to authorities, such as the local 澳洲幸运5官方开奖结果体彩网: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 mother doesn’t have any other care options, she might take up the𒁏 matter with the fac﷽ility and try to get her mom admitted. If there are other equally good options, she could also consider choosing another facility.

Important

A skilled nursing facility is required by law to provide you with a written 澳洲幸运5官方开奖结果体彩网:description of your legal rights, which can vary by state.

Paying for a Skilled Nursing Facility

Patients needing post-hospital care in a skilled nursing facility who are enrolled in Medicare are fully covered for stays of up to 20 days in a Medicare-certified skilled nursing facility if the patient meets Medicare's requirements. Days 21 to 100 require 澳洲幸运5官方开奖结果体彩网:coinsurance, and there is no coverage after day 100.

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. Again, after the 100 days, patients are responsible for all costs—some or all of which can be covered by private insurance or Medicaid for 澳洲幸运5官方开奖结果体彩网:those who are eligible.

Warning

For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period is $204 in 2024.

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.

Nursing homes can be expensive for long-term stays. In 2021, for example, the price of a private room in a nursing home was a median of $106,920 a year ($8,910 per month), according to a report on long-term care by Genworth.

What Is the Difference Between a Skilled Nursing Facility and Long Term Care?

People who live in long-term care facilities don't necessarily need the medical assistance that skilled nursing facilities offer. And long-term care facilities, by definition, attract residents who are looking for an essentially permanent living situation. Skilled nursing facilities are designed to be short-term living arrangements, there only for when a patient's care demands it.

Is a Skilled Nursing Facility Inpatient or Outpatient?

A skilled nursing facility is an inpatient facility, like a hospital. The patient has their own bed, and sometimes their own room, if it's available and you're able to afford it.

Does Medicare Cover a Skilled Nursing Facility?

Medicare Part A covers inpatient stays, including at hospitals and at skilled nursing facilities (SNF). Here's what you need to have to qualify:

A qualifying inpatient hospital stay
A health care provider who says you need "daily skilled care" (e.g. IVs, physical therapy)
A Medicare-certified skilled nursing facility
An "ongoing condition that was also treated during your qualifying inpatient hospital stay (even if it wasn't the reason you were admitted to the hospital)" or a "new condition that started while you were getting SNF care for the ongoing condition"

How Many Days Will Medicare Pay 100% of the Covered Costs of Care in a Skilled Nursing Care Facility?

As long as the stay is qualified—see above—Medicare will cover the first 20 days at a skilled nursing facility. That means you pay nothing for the first 20 days. However, for days 21 to 100, you will need to pay coinsurance. Day 100 is the tipping point: for every day beyond it, you will need to pay for the entire cost of skilled nursing care. Medicare won't cover anything beyond 100 days.

You have a few options to cover this cost, beyond cash. If you have a 澳洲幸运5官方开奖结果体彩网:long-term care insurance policy or Medigap policy, check to see if they will cover it.

How Many Days Is a Patient Typically in a Nursing Home?

A ൲study of over 1,800 nursing home residents in the U.S. found that the median (middle-of-the-road) length of stay prior to death was five months, and the average was nearly 14 months. About half (53%) died within six months of arriving ꦡat the nursing home.

However, there were some disparities due to gender and net worth. Women tended to live longer in nursing homes than men did. (The median length of stay for women was 8 months, whereas the median length of stay for men was three months.) And residents with lower net worths tended to live longer in nursing homes than those with higher net worths. (For residents with net worths in the lowest quartile, the median length of stay was nine months. For residents with net worths in the highest quartile, the median length of stay was three months.)

The Bottom Line

A skilled nursing facility is an inpatient medical center that has a full-time, round-the-clock staff of medical professionals. Patients typically stay in a skilled nursing facility after being discharged from the hospital. Medicare covers the first 20 days. It's different from a nursing home in that patient stays tend to be shorter. A skilled nursing facility is designed to be a temporary solution, whereas a nursing home is designed for long-term living.

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