NURSING HOMES

AND SKILLED NURSING FACILITIES

Nursing Homes

And Skilled Nursing Facilities


Nursing Homes and Skilled Nursing Facilities are long-term care facilities that provide twenty-four hour skilled nursing, assistance with activities of daily living, health services, short-term rehabilitation and recovery services and a number of other health-related services and activities.

  1. A Skilled Nursing Facility (SNF) is a nursing home certified to participate and be reimbursed by Medicare.


  1. A Nursing Facility (NF) is a nursing home certified to participate and be reimbursed by Medicaid.






  1. Skilled Nursing Facilities (SNFs) and Nursing Homes (NFs) that participate in Medicare and/or Medicaid are required to have




  1. The primary care giver in a certified nursing home is a "Certified Nurses Aide" (CNA), a non-professional nursing assistant.  In other words, most of the resident care care in nursing facilities (both NFs and SNFs) is provided by certified nursing assistants, not by skilled   or licensed staff members. 

  2. The goal of Skilled Nursing Facilities is to integrate custodial care with nursing, psycho-social and rehabilitative services on a continual basis.

  3. The function and services of Nursing Homes (NFs) and Skilled Nursing Facilities (SNFs) are designed to accommodate adults who need continuous nursing care and require 24/7 assistance for serious health-related conditions without being in a hospital.

  4. A plan of care is usually developed for each individual resident based on his or her needs at the time of admission.

  5.   Some residents will return home after a short rehabilitative stay  or recuperation following hospitalization for an illness or accident. Others may require care for an extended period due to the chronic nature of their illness, needs or disabilities.

  6. Some facilities offer specialized programs for residents suffering from advanced stages of Alzheimer's Disease or dementia.
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Good Candidates For Skilled Nursing Facilities

Good candidates for Skilled Nursing Facilities and Nursing Homes include people who need continuous nursing or custodial care services and require 24/7 assistance for serious health-related conditions without being in a hospital.

A nursing facility is for an individual who meets one or more of the following qualifications:

  1. Cannot take care of themselves because of physical, emotional or mental problems

  2. Can no longer care for their own personal needs (custodial care such as eating, bathing, using the toilet, moving around or taking medications)

  3. Requires more care than can be provided by their caregiver, and cannot live alone

  4.   Might wander away if unsupervised

  5. Has extensive medical needs requiring daily attention or monitoring by an RN and supervised by a medical doctor

  6. Is going to be discharged from the hospital and requires temporary skilled nursing care or rehabilitation before returning home or to a residential facility

  7.   Has been recommended for a nursing home by a physician 


  1. Resident nursing and care needs can be long-term, due to chronic physical or mental conditions. Long-term residents of SNFs and nursing home residents include vulnerable older adults, frail or disabled older veterans, or younger veterans and adults with physical or mental disabilities.

  2. Personal nursing and care needs can also be temporary in nature, such as recuperation, rehabilitation or therapy after a serious illness, surgery, medical event or accident. Temporary residents of nursing homes and skilled nursing facilities may include adults of any age needing short-term nursing care and therapeutic or rehabilitative services while recovering from an accident, serious illness or other qualifying medical crisis. 

  3. Nursing facilities can also be used as temporary care sites when caregivers need respite

  4. Residents in skilled nursing facilities may also receive physical, occupational, speech therapy and other rehabilitative health and medical services as required.
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Licensing and Regulation of Nursing Facilities

  1. Nursing Homes and Skilled Nursing Facilities are licensed, regulated and inspected by individual states.  The nursing home industry is considered one of the two most heavily regulated industries in the United States (the other being the nuclear power industry).  

  2. Nursing homes that participate in Medicare and Medicaid programs are also subject to federal regulations and requirements regarding staffing and quality of care provided for residents.  

  3. In 2002 Medicare launched a Nursing Home Comparison website to help improve the quality of nursing homes by promoting more competition among nursing facilities.
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Features of Nursing Facilities / Skilled Nursing Facilities

  1.   Nursing Homes and Skilled Nursing Facilities provide housing and services to adults in constant need of nursing care and/or aid performing basic activities of daily living (ADLs): getting in and out of bed, bathing and using the toilet, personal hygiene, dressing, eating, and managing or taking their medications as directed.

  2.   Skilled nursing facilities provide the highest level of supervision and medical services for residents compared to other Senior living options.

  3.   Nursing Homes (NFs) and Skilled Nursing Facilities (SNFs) offer either short or long-term residences for people who need continuous nursing or custodial care services, and require 24/7 assistance for serious health-related conditions without being in a hospital.

  4. Residents in skilled nursing facilities may also receive physical, occupational, speech therapy and other rehabilitative health and medical services as required. 

  5. These facilities may be independent or part of a senior continuing care community.  They generally offer recreation and organized social activities in addition to care services.

  6. Resident living space may include private or semiprivate rooms shared with a roommate.  The emphasis is on patient care so the general environment and ‘feel’ is more hospital-like and less like a home environment.

  7. Individual state regulations define the services that Skilled Nursing Facilities and Nursing Homes can provide.
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  8. Strict safety regulations are adhered to within these facilities to accommodate the physical and mental disabilities of their residents.

 

     Number of Residents in Skilled Nursing Facilities

  1. The national average of residents per nursing facility is 110 beds.

Basic Services Provided By NFs and SNFs

  1. A clean, furnished room (private or shared)

  2. Dietary services: nutritious meals and snacks, in accordance with  the individual resident’s medical plan of care

  3.   Housekeeping and linen service

  4.   Personal (custodial) care (including incontinence care)

  5.   Therapeutic recreation and activities

  6. 24-hour onsite medical staff including registered nurses (RNs), licensed practical nurses/licensed vocational nurses (LPNs/LVNs) and certified nurses’ aides (CNAs)

  7.   Supervision by physicians, some of whom are on call to consult with staff and  visit patients as needed

  8.   Respite care (relief for caregivers)
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Additional Services May Be Provided For An Extra Fee

  1. Rehabilitation: occupational, physical, respiratory, speech therapy

  2. Special Care Units  (Alzheimer’s and dementia care)

  3. Pharmacy, laboratory and radiology services

  4. Dental services

  5. Personal care or hygiene items (sundries)

  6. Personal laundry service
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  1. Skilled Nursing Facility care is expensive, and costs continue to rise.

  2. In 2009 the average daily cost of a private room (with no additional services) in a Nursing Home in 2009 was $219 a day, or $79,935 a year. 

  3. In 2009 the average cost of a shared Nursing Home room (with no additional services) was $198 a day, or $72,270 a year.

  4. In addition to a private or semi-private room and the care options you choose, where you live also affects how much you'll spend for Nursing Home care.
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Payment Options for Skilled Nursing Facilities & Nursing Homes




  1. Many residents (or residents’ families) pay for the care out of their own private funds.

  2. Some nursing home residents have assistance from long-term care insurance policies.

  3. Still other residents may receive help with costs from state Medicaid programs when their finances are depleted.  (Medicaid is accepted by many nursing homes for ongoing care, but a person’s eligibility must be established.)

  4. The federal Medicare program covers limited rehabilitative services for a specified period of time when deemed beneficial to an individual's care. 

  5. Medicare pays for up to 100 days of care; individuals must be referred by a physician upon hospital discharge and have the need for skilled nursing care.  Often Medicare will pay only for a few weeks of rehabilitation services after hospitalization.
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Resources For Skilled Nursing Facilities and Nursing Homes

  1.   Medicare’s Nursing Home Compare                          www.medicare.gov/NHCompare

  2.   National Long Term Care Ombudsman Resource Center www.ltcombudsman.org

  3.   National Citizens Coalition for Nursing Home Reform  www.nccnhr.org

Find Medicare’s nursing home ratings and comparisons now.

http://www.medicare.gov/NHCompare/Include/DataSection/Questions/ProximitySearch.asp?bhcp=1

Skilled Nursing Facilities And Nursing Homes Are Also Called

  1.   Nursing Facilities (NFs)

  2.   Skilled Nursing Facilities (SNFs)

  3.   Skilled Care Facilities

  4.   Continuing Care Facilities (CCFs)

  5.   Rest Homes

  6.   Nursing Facilities

  7.   Rehabilitation Facilities

  8.   Elder Care Homes

  9.   Adult Homes

  10.   Homes For The Aged

  11.   Convalescent Homes

Individuals who require more care than can be provided at home by their caregivers are good candidates for Nursing Homes and SNFs.

Individuals being discharged from a hospital but who still need rehabilitation therapy or additional recuperation before returning home are also candidates for nursing homes and skilled nursing facilities.

    Private Pay

LTC Insurance

    Medicaid

  Medicare

Medicaid is the federal program administered by each State to provide health care and related services to those who are determined to be living in poverty. Medicaid also pays for nursing home care for low income elderly and disabled Medicare recipients who require that type of care.

  1. Licensed practical nurses (LPNs) on duty 24 hours a day

  2. An RN on duty at least 8 hours a day, 7 days a week

  1. Private pay

  2. Long-term care insurance

  3. Medicaid (called “MediCal” in California)

  4. Medicare

Paying For Skilled Nursing Facilities and Nursing Homes

Costs For Skilled Nursing Facilities And Services

Nursing Home costs will continue to rise for the foreseeable future.

Example of a resident’s room in a Nursing Home or Skilled Nursing Facility.

Nursing facilities may offer extra services like physical therapy for additional fees.

The services offered by Nursing Homes (NFs) and Skilled Nursing Facilities (SNFs) are regulated by the state and federal government, especially if the facility participates in Medicare or Medicaid programs.

A chart of how the costs of Nursing Home Care are covered:

  1.    5% is LongTerm Care Insurance

  2.    8% is Medicare

  3. 41% is Medicaid

  4. 46% is paid by the individual 

Nursing homes and skilled nursing facilities tend to be more hospital-like living and care environments.

A comparison of average annual costs for Adult Day Care, Assisted Living, In-Home Personal Care and Nursing Home Care (based on 2008 costs).

Contact your local Area Agency On Aging

For More Information About Senior Assisted Living

http://n4a.org/programs/eldercare-locator/resources/

Skilled Nursing Facilities and Nursing Homes are designed to serve long term care residents and short-term patients who need additional post-hospital recovery and rehabilitation with 24/7 nursing care.

Nursing Homes and Skilled Nursing Facilities provide the highest level of care outside of a hospital setting.

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Nursing Homes And Skilled Nursing Facilities

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