When most people think of nursing homes, they think of a place where their elderly relatives go to live. This is after they can no longer take care of themselves. However, there is a big difference between skilled nursing and nursing homes. Skilled nursing is a type of care that is provided in hospitals, rehabilitation centers, and other medical facilities. Nursing homes are residential facilities that provide long-term care for elderly or disabled individuals who cannot live independently. In this blog post, we will discuss the differences between skilled nursing and nursing homes. Also, how each one is covered by Medicare.
What is Skilled Nursing
Skilled nursing care is a high level of medical care that must be provided by or under the direct supervision of licensed health professionals. For instance, as registered nurses (RNs) and physical, speech, and occupational therapists. These services can be necessary over the short term for rehabilitation from an illness or injury. They may be required over the long term for patients who need a high level of care on a frequent or constant basis. This is usually due to a chronic medical condition.
Examples of skilled nursing services include wound care, intravenous (IV) therapy, injections, catheter care, physical therapy, and monitoring of vital signs and medical equipment. Skilled nursing care provided in any setting for any duration must be ordered by a doctor. This to insure it is to be covered by Medicare, Medicaid, the U.S. Department of Veterans Affairs (VA), or private health insurance.
Skilled Nursing at Home
As more seniors choose to age in place, home health agencies have responded by offering skilled services provided by licensed nurses or therapists in clients’ homes. When prescribed by a doctor, these skilled care services can be covered by Medicare. Also, some private health insurance policies, the VA, and long-term care insurance policies will cover. Utilizing a home health care provider enables a senior to receive highly effective medical treatment. This is while remaining as independent as possible in the comfort of their own home.
Seniors who require more assistance than can be provided in the home may need to consider a move to an assisted living facility (ALF). Assisted living facilities provide a wide range of services to individuals who want to maintain some level of independence but require support with activities of daily living (ADLs).
At a Facility
Assisted living facilities vary widely in the levels of care available. State licensing often determines the tiers of medical care that can be provided in these settings. Residents’ care plans are created, overseen, and regularly reviewed by RNs and licensed practical nurses (LPNs). Some level of security, personal care, and nursing staff is available around the clock, but the purpose of assisted living is to provide non medical supervision and support, not 24/7 skilled care.
If a resident’s care needs exceed what the ALF can provide, they must either hire a home health agency to come in and provide additional services in their apartment. They can also consider moving to the next level of residential care: a nursing home.
Nursing Homes
Nursing homes are licensed healthcare residences for individuals who require a higher level of medical care than can be provided in an assisted living facility. Skilled nursing staff consisting of RNs, LPNs, and certified nursing assistants (CNAs). They are available to provide 24-hour medical attention and assist with ADLs.
Many people also refer to nursing homes as skilled nursing facilities (SNFs). While this isn’t necessarily incorrect, it’s important to understand the difference between a nursing home and a skilled nursing facility. Both provide around-the-clock medical care on-site. However, SNFs are commonly used for short-term rehabilitative stays. They are at least partially covered by Medicare for up to 100 days in many instances. Medicare does not pay for long-term or permanent stays in nursing homes.
Medicaid, on the other hand, covers both short-term stays and extended stays in nursing facilities for seniors with limited assets and low income who have a medical need for this high level of care. Keep in mind that the details of this coverage and eligibility requirements vary by state.
Understanding the state in which your loved ones need care is very important. We hope to take a few moments to read this, clears up any confusion. Give us a call about any Medicare questions you may have.