Skilled Nursing Facilities: Everything You Need to Know

What is a skilled nursing facility?

A skilled nursing facility (SNF) is a specialized healthcare residence designed to provide 24-hour medical care and support to individuals who need continuous nursing care and supervision. These facilities are staffed by licensed health professionals, including registered nurses, licensed practical nurses, and certified nurse aides, who offer a range of medical and rehabilitative services. Skilled nursing facilities cater to patients recovering from surgery, illness, or injury who require complex wound care, intravenous therapy, physical therapy, and other intensive treatments that cannot be adequately provided at home or in an assisted living setting.

This type of care is typically prescribed by a physician when an individual's medical needs are too complex to be managed without professional assistance. The goal at a skilled nursing facility is not only to provide necessary medical care but also to enhance the quality of life for residents through comprehensive care planning, therapeutic activities, and social engagement. These facilities focus on both short-term rehabilitation with the aim of helping residents return to their homes, as well as long-term care for individuals with chronic health issues or disabilities who need ongoing support.

Skilled nursing vs. nursing home

Originating after World War II, the term "nursing home" was traditionally used to describe any long-term residential care facility for the elderly. Over time, as the need for specialized care grew, "skilled nursing facility" emerged as a term for sites offering higher levels of medical care under the supervision of licensed health professionals.

Nursing homes are typically permanent residences providing 24-hour care and support for individuals who need assistance with daily activities but do not require continuous medical supervision. Federal regulations require that a registered nurse be present for at least eight consecutive hours every day, ensuring that medical care is available, although not necessarily round-the-clock. On the other hand, skilled nursing facilities focus on patients who need intensive medical care following surgery, illness, or injury, offering a range of rehabilitative services and requiring a higher standard of medical oversight.

What services does skilled nursing provide?

Skilled nursing facilities offer a comprehensive range of medical and rehabilitative services to support recovery and maintain health after a hospital stay. These facilities are equipped to handle a variety of complex health needs, particularly for patients recovering from conditions like strokes, heart attacks, or major surgeries.

Specialized therapies and medical care

Skilled nursing communities provide targeted therapies prescribed by physicians to help patients reach their health goals. These include:

  • Physical Therapy: Tailored to aid recovery from illness, injury, or surgery, physical therapy helps improve mobility and strength.
  • Occupational Therapy: Focuses on enabling patients to adapt to their social and physical environments, improving skills needed for daily activities such as dressing and memory tasks.
  • Speech Therapy: Offers treatment for communication challenges and swallowing dysfunctions, crafted by speech and language pathologists.

Comprehensive Healthcare Services

Beyond therapies, SNFs offer extensive medical care including:

  • Wound Care: Managing and treating complex wounds.
  • Intravenous (IV) Therapy: Administration of medications and nutrition directly into veins.
  • Vital Signs and Medical Equipment Monitoring: Ensuring that patients’ health metrics are within safe ranges and that medical equipment functions properly.

Supportive care and staff expertise

The skilled nursing staff is made up of a diverse team of health care professionals, including registered nurses, licensed practical nurses, speech/language pathologists, and more. These facilities also ensure a connection to local hospitals through transfer agreements for emergency care situations.

Does Medicare pay for skilled nursing?

Medicare Part A provides coverage for short-term skilled nursing facility care under specific conditions:

  • You have Medicare Part A coverage and unused days left in your benefit period.
  • You stayed in a hospital for at least three days before entering the SNF.
  • Your doctor prescribed you daily skilled care that must be provided by therapists or skilled nursing staff.

Coverage includes essential services such as a semi-private room, meals, and necessary therapies, and can extend up to 100 days per benefit period. This care must address a hospital-related medical condition or a condition that arose during your stay in the SNF for a related condition. The costs are fully covered by Medicare for the first 20 days, after which you pay a copayment from days 21 to 100. Beyond 100 days, you cover all costs.

Financial assistance for SNF care

Paying for skilled nursing care often requires beyond Medicare, especially considering that Medicare's coverage is typically limited to short-term stays. Here are several alternatives for funding skilled nursing care:


Medicaid provides coverage for long-term skilled nursing care for seniors who meet income and asset criteria. To qualify, the SNF must be state-certified and Medicaid-approved. This program is particularly important for those who need extended care beyond the duration Medicare covers.

Long-Term Care Insurance

Long-term care insurance (LTC) is specifically designed to cover expenses associated with prolonged health care needs, including stays in SNFs. This type of insurance can significantly alleviate financial burdens, allowing for a wider range of care options and longer coverage periods than Medicare.

Veteran Benefits

Senior veterans may have access to long-term care through Veteran Benefits, which cover skilled nursing care if the VA determines the care is necessary for the veteran’s ongoing treatment and personal care. To use these benefits, veterans must be enrolled in VA healthcare and receive services in VA-approved facilities.

Out-of-Pocket Payments

For those without comprehensive insurance or eligibility for government programs, paying out-of-pocket is another option. Families often use savings, income, or assets such as home equity to fund SNF care. Selling a property, obtaining a reverse mortgage, or renting out a home can provide necessary funds for skilled nursing expenses.

Program of All-Inclusive Care for the Elderly (PACE)

PACE is a federal program aimed at keeping seniors in their communities rather than SNFs whenever possible. Eligibility requires individuals to be 55 or older, living in a PACE service area, and certified as needing a nursing home-level of care. PACE covers all medical and social services, including some SNF care when necessary, through Medicare and Medicaid funds.

Exploring these options early, ideally before the need for skilled nursing arises, can provide families with a plan that ensures quality care without undue financial strain.

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