5 Key Factors to Consider When Choosing a Medicare Skilled Nursing Facility
Skilled nursing facilities offer 24-hour medically necessary care in a structured setting. Medicare covers a person’s stay there if their physician determines they need skilled nursing services after an inpatient hospital stay of at least three days.
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People who do not have a Medicare Advantage Plan or other supplemental coverage may have to pay the Medicare coinsurance fee out of pocket. Supplemental coverage is available through private companies for an additional premium.
Preparing nutritionally balanced meals often becomes challenging for seniors with medical conditions. This is why dining services are among the most valuable Medicare skilled nursing benefits. Communities offering this care provide restaurant-quality food and licensed dieticians to create personalized meal plans for each resident’s medical needs.
Skilled nursing facilities provide patients access to various treatment options for their physical, occupational, and speech therapy needs. In addition, medication management is a significant part of this type of care, and a team of healthcare experts oversees your loved one’s medications to ensure they are being taken as prescribed. Depending on your loved one’s health needs, they may also benefit from social interaction.
Medicare-certified SNFs must have a licensed doctor to prescribe individualized care plans, including physical and speech therapy. These plans are based on daily assessments that help identify health goals.
The environment in which a loved one spends their time directly impacts their health. This applies to hospitals, homes, shopping malls, restaurants, and other spaces.
Individuals with chronic medical conditions or debilitating illnesses may need more long-term care than a hospital stay can provide. For Medicare beneficiaries, this includes skilled nursing facilities.
To qualify, your doctor must certify that you require daily skilled nursing care to meet your medical needs. This must result from an illness or injury during your qualifying three-day inpatient hospital stay (not counting days spent as an observation patient) and related to the diagnosis that led to your hospital stay. Some Medicare Advantage plans waive the 3-day rule, so it’s best to check with your provider to see what rules apply.
Medicare covers short-term stays in an SNF under specific eligibility requirements. However, beneficiaries should understand that coverage is limited in duration, and coinsurance amounts may apply.
SNFs are regulated by the federal Centers for Medicare and Medicaid Services (CMS). A multidisciplinary team of healthcare professionals plans your treatment based on daily assessments and doctor’s orders