A Skilled Nursing Facility (SNF) is an inpatient rehabilitation center staffed with trained clinicians, such as licensed nurses, physicians, physical, occupational, and speech therapists. The specialized care services offered in a SNF include medication management and administration, wound care, and physical and occupational therapy. Skilled nursing facilities tend to focus on rehabilitating seniors by helping them with their Activities of Daily Living (ADLs) and providing around-the-clock care during a patient’s stay.
Seniors who find themselves in need of SNF services or their families must first research the skilled nursing facility requirements for admission and their Medicare eligibility requirements. To qualify for Medicare assistance in a skilled nursing facility, seniors will need:
- Valid Medicare Part A hospital insurance with days left in the benefit period. The benefit period starts from the patient’s admission date into the facility and lasts for up to 60 days. While there is no limit to the number of benefit periods, when an inpatient’s benefit period ends, the inpatient must first pay the inpatient hospital a deductible fee of $1,556 for each benefit period before they can start a new benefit period.
- Approval for a three-day inpatient hospital stay before being admitted into a SNF. This does not include the time spent as an outpatient or any observation services. Furthermore, if an inpatient enters and leaves a SNF before sixty days and then suddenly needs to be re-admitted to a SNF within thirty days, they do not need to qualify for another three-day inpatient hospital stay to get the SNF benefits.
- A recommendation from their physician that makes them eligible for a SNF stay. This indicates that they must be cared for or be under the supervision of skilled nursing or therapy staff.
- The facility must be Medicare certified. This means the facility must be assessed by a surveyor who conducts a Life Safety Code (LSC) survey and a Standard Survey. Afterward, the CMS will then approve (or deny) the skilled nursing facility with a “Certification of Compliance.”
Once patients are admitted into a skilled nursing facility, the following essential services are covered under Medicare:
- A shared (semi-private) room
- Facility meals
- Nutritional counseling
- Medication costs (administration and management)
- Medical supplies and services
- Ambulance transportation
- Rehabilitative services (physical, respiratory, and speech therapy)
Nursing Home Admission Checklist Tools
Choosing between long term care options can be a daunting prospect. Below are some helpful nursing home admission checklist tools that allow seniors and their families to evaluate the quality of care provided in facilities across the nation:
- Medicare Nursing Home Checklist: This useful tool serves as a guide for seniors and their families to know what important questions to ask when they visit a facility. It also helps them learn to assess specific areas of a facility, covering a range of topics like safety and care, potential abuse issues, nursing home appearance, living space, menu and food, and the staff.
- Medicare Nursing Home Compare Website: Another helpful tool seniors can use for skilled nursing facility requirements for admission is the Medicare Nursing Home Compare website, which allows anyone to find and compare nursing homes, hospitals, and other healthcare providers nationwide. The Centers for Medicare and Medicaid Services (CMS) uses a Five-Star Quality Rating system to rate facilities from one to five stars—five stars being significantly above average quality and one star being dramatically below average. This tool is quite handy, as it provides recent, relevant information to those choosing a long term care provider. It highlights several key pieces of information, such as inspection results, quality measures, staffing ratios, emergency preparedness, COVID vaccination rates, and any incurred Medicare penalties. Seniors and their families should research prospective facilities before visiting to gain a better idea of what to expect upon their visit.
- AARP Nursing Home Checklist: A printable checklist with questions based on the facility’s basic information, quality of life, safety, and care issues.
- National Caregivers Library Nursing Home Checklist: This checklist includes a series of questions that help seniors or their families grade a nursing home when they visit. It also includes useful tips on what to consider, such as whether the administrator is licensed, if the staff has had background checks, and whether the staff is aware of what constitutes elder abuse.
- U.S. News and World Report Nursing Home Checklist: This checklist offers a wide range of questions, from toileting to nutrition to health inspections. While visitors to a nursing home need not ask every question, this checklist provides useful reminders so visitors can ask the most important questions during a visit.
Even though these checklists contain similar questions, it is still useful to bookmark and print them all, so that when seniors or their families visit facilities, they can combine and tailor the checklists and ensure that the facility can meet the senior’s individual needs and expectations.
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5 Benefits of a Nursing Home Checklist
A nursing home checklist can be used by seniors or their families to systematically compare facilities and evaluate the best long term care options. Therefore, it is essential for visitors to ask specific questions and whether the facility being considered can provide the following:
- Lower Risk of Rehospitalization
A key factor when seniors are looking into skilled nursing facility requirements for admission is how to preempt and avoid rehospitalization. Therefore, it is essential to enquire what ongoing medical monitoring a facility offers, such as wound care, catheter care, physical therapy, and vital signs monitoring. These are all essential services that help seniors regain some level of independence and avoid rehospitalization.
- Access to Specialized Therapy Services
When seniors or their families look into the eligibility requirements for admission to a skilled nursing facility, they should also check what specialized therapy services a facility offers and what rehabilitative care services are Medicare-approved, such as physical, occupational, and speech therapy. If a facility offers all three therapies, the therapists can work together with nurses to provide the best possible care outcome for each resident.
- Opportunities to Socialize
Whether it’s for a long or short-term stay, moving into a skilled nursing facility can be extremely disruptive to seniors. This is especially true if a senior citizen is recovering from an illness or injury. Therefore, families will turn to a nursing home admission checklist that includes questions on social activities and whether the facility offers any social programs that encourage mobility, and physical and mental health while providing social interactions.
- Appropriate Onsite Staffing
Residents in a skilled nursing facility are offered around-the-clock care, which means should a medical emergency occur, the necessary help is available onsite. Therefore, it is helpful for seniors or their families to use a nursing home checklist that includes questions on staffing ratios and onsite clinicians.
- Personalized Care
An essential aspect of skilled nursing is to provide personalized care that is catered to each resident. When a senior or their family is assessing the nursing home admission requirements, they should verify how the facility provides tailored care.
Innovative facilities will have a care plan software in place, enabling the customization of care plans and integrated point of care technology. This way, clinicians can update their records while providing personalized care to the resident with accurate clinical documentation. Therefore, seniors or their families need to ask specific care-related questions to ensure the facility is able to provide personalized care during their stay.
Skilled Nursing Facility Requirements for Admission: What To Look For
Before making a decision, seniors or their families must consider specialized services, the care offered, and Medicare funding when looking at a skilled nursing facility requirements for admission. A skilled nursing facility’s primary purpose is to rehabilitate in the context of a homelike environment with a high quality of care and a variety of social and recreational activities that will promote meaningful friendships and recovery. A nursing home checklist is one to know what to look for when visiting a facility.