As a person ages the number of health problems that they can encounter inevitably increases. Ultimately, there may come a time when you or a relative of yours will require short-term skilled nursing services.

Sections We Will Cover

This guide will touch on the following sections of information.

Please feel free to click on any link below to go directly to that specific section:

1. What is Short-Term Skilled Nursing?
2. Rehabilitative Skilled Nursing Facility vs Skilled Nursing Home
3. How Long Can I Stay in a Skilled Nursing Facility?
4. Cost of a Short-Term Skilled Nursing Facility
5. Does Medicare Pay for Short-Term Skilled Nursing?
6. Does Medicaid Cover Skilled Nursing Costs?
7. What is My Daily Deductible for Short-Term Skilled Nursing?
8. How Can I Find Short-Term Rehabilitative Skilled Nursing Near Me?

 

What is Short-Term Skilled Nursing?

Short Term Skilled Nursing, is the term used to describe medical care which is provided for a patient with the direct supervision of qualified health professionals such as nurses and therapists for recovery. Short Term Skilled Nursing typically follows a hospital discharge with a fixed number of days available for the stay.

Short-term senior rehab is usually given as care for patients to overcome an illness or recover from an injury. On the other hand, long-term skilled nursing is provided for patients suffering from chronic medical conditions who are not expected to recover from their condition sufficiently to leave the long-term skilled nursing facility (also known as a nursing home).

Skilled nursing services include:

• Caring for wounds.
• Facilitating intravenous (IV) therapy.
• Installing and removing a catheter.
• Conducting physical therapy.
• Providing speech and or swallowing therapy
• Monitoring of patient's vital signs.
• Administering medications
• Conducting occupational therapy

Short-term skilled nursing for seniors can only be provided to patients if it is ordered by a doctor and is covered by health insurance such as Medicare, Medicaid, Veterans Affairs, or private health insurance providers.

Rehabilitative Skilled Nursing Facility vs Skilled Nursing Home

Most people use the terms skilled nursing facility and skilled nursing home interchangeably. While both are associated with medical care, the two terms apply to different types of care. A skilled nursing home, also known as long-term skilled nursing, refers to the physical building where individuals who need medical care are housed to be provided 24-hour medical care and attention by qualified medical staff. Most nursing homes house patients for long-term or permanent stays.. The stay in a nursing home may be paid for out of the patient’s resources, or by relatives. Medicare does not cover the cost but in certain instances, Medicaid may kick in.

A skilled nursing facility, or SNF, refers to a facility where patients are housed for short-term stays following a hospital stay. Some of the services at an SNF include but are not limited to, senior care, meal preparation, and assistance with daily routines for rehabilitation patients who need temporary high-level care from qualified medical personnel. Skilled nursing facilities may house patients for up to 100 days, and Medicare covers some of the costs.

SNFs can accommodate extended stays for patients if needed, but they do not accept permanent stays comparable to a nursing home. In terms of medical personnel, skilled nursing facilities have more highly qualified medical staff than nursing homes. However, both facilities must meet strict standards and be inspected regularly to ensure high-quality care for patients.

How Long Can I Stay in a Skilled Nursing Facility?

Skilled nursing facilities work as a transitional care center for patients from a hospital stay until they can return to their homes. Because of this, patients will stay only in an SNF for short periods. Once mostly healed and rehabilitated, patients are discharged to return home or their prior place of residence if that happens to be an assisted or independent living facility.

A patient who is ready to be discharged from the hospital may still need to have post-hospital care, which an SNF can provide. Some SNFs are located within a hospital facility and can provide transitional care to patients until they are well enough to go home. However, a patient has the right to select the rehab facility they prefer and are under no obligation to use the short-term rehab facilities that the hospital offers.

A patient covered by Medicare, Medicaid, or any private medical insurance can stay in an SNF for a maximum of 100 days as part of their policies. However, if the patient needs to stay in the SNF for more than 100 days, the patient must pay for the extra days out of pocket. A skilled nursing facility will usually notify patients if their 100 days of coverage is running out and will usually help them transition back home to complete any needed treatments. However, it is not the short-term facility’s responsibility to keep track of those costs so patients or their caregivers need to be aware of how many days they have already spent in a SNF so that they can avoid paying for the costs out of pocket.

Patients will get a renewed SNF coverage of 100 days only after being out of SNF care for two months and after being admitted for another inpatient stay of no less than three days. Medical insurance, if available, may cover these services for patients who medically need therapy even after they have used up their first 100 days. However, Medicare will not cover any costs of skilled nursing beyond the first 100 days.

Patients with additional medical insurance, such as long-term care insurance, can use these insurance policies to cover the costs after the coverage from Medicare ends. 

Cost of a Short-Term Skilled Nursing Facility

A short-term skilled nursing facility has highly qualified staff, including licensed registered nurses (RNs), therapists, and medical doctors who closely monitor them. Because of the high level of care that patients will receive, staying in an SNF is expensive, and the costs can vary from one patient to another.

Twenty-five percent of patients stay in an SNF for 90 days or less following an inpatient stay in a hospital due to injury, surgery, stroke, heart attack, or a significant decline in health. However, those patients who stay in an SNF for longer durations and still need assistance with their activities of daily living must move to long-term skilled nursing to complete their recovery.

A SNF with 100 beds should have about 40 nursing assistants, 13 LPNs (Licensed Practical Nurses), and 7 RNs (Registered Nurses) on rotational duty, in addition to at least one full-time physician. Because of this, the cost of maintaining the salaries of these staff is factored into the cost of a patient's stay so it can become quite expensive.

How Much Per Day?

The cost of staying in an SNF will vary with each state and the quality of the facilities. According to data from a report taken in 2017, the average daily cost of staying in an SNF is around $235 for a semi-private room and $267 for a private room.

How Much Per Month?

Using the average 2017 cost of $235 for semi-private and $267 for private rooms, you can multiply it by 30 days to get an estimate of how much a patient will have to pay for a month's stay in an SNF. This value will be $7,050 per month for a semi-private and $8,010 per month for a private room.

Different Costs per State and Within the State

It is important to consider that the costs of staying in an SNF will vary greatly depending on which state you are in. For example, Texas has the lowest cost, with $140 per day for a semi-private room and $165 for a private room. Alaska has unusually high short-term skilled nursing prices which can be as high as $771 per day for a stay in an SNF.

Likewise, the costs of staying in an SNF will also vary even within the same state. The quality of the facility will determine the difference in prices. SNFs that have top-of-the-line medical equipment and high-end amenities will command a higher price point.

It is important to note that the numbers provided here are to help you estimate the costs of staying in an SNF and do not reflect the real-time costs.

Does Medicare Pay for Short-Term Skilled Nursing?

Fortunately, Medicare will cover a policyholder's stay in a short-term skilled nursing facility for a maximum of 100 days. However, patients must meet the following requirements:

• A patient must have been admitted as an inpatient at a hospital and stayed at least three days receiving medical care.
• A doctor must prescribe that the patient needs skilled nursing care or therapy even after the hospital stay.
• The skilled nursing facility must be Medicare-certified.

Medicare covers up to 100 days of an SNF stay. However, Medicare will not pay for all of the expenses. Medicare will pay for all the costs, 100%, of SNF stay for only the first 20 days. However, if the stay will last longer than 20 days, the patient will have to pay a daily copayment until the patient's 100 days run out. After 100 days, the patient will have to shoulder all the costs out of pocket since Medicare will not pay for the costs beyond 100 days.

Does Medicaid Cover Skilled Nursing Costs? 

A survey done by the American Association for Long-Term Care Insurance noted that 40 percent of the elderly who need long-term care have income levels below the federal poverty line. These individuals may be eligible for Medicaid. Other patients become eligible for Medicaid after they have exhausted their assets and after a spending down.

A spend down is when a person has too much income to become eligible for Medicaid. People may qualify for Medicaid benefits if they spend their excess income on medical bills. For example, an elderly who has a monthly income over $100 above the limit for Medicaid eligibility may qualify if they spend their excess income on medical expenses. However, there are strict regulations on qualifying for Medicaid. It is best to consult with an elder law attorney or a financial advisor when planning to spend down to become Medicaid eligible.

Medicaid eligibility requirements are placed to ensure that people will not commit fraud to become eligible for medical assistance. Certain spend-down actions can disqualify a person from being Medicaid eligible. For example, a person who gives a large financial gift to relatives within five years before applying for Medicaid may be denied eligibility. Note, however, that Medicaid eligibility requirements differ from state to state and will depend on the marital status of the Medicaid applicant.  

Once the person becomes eligible, Medicaid will pay for the complete cost of the stay in an SNF. Furthermore, Medicaid will pay for the SNF care for the long term as long as the patient requires that level of care, even if they will require it for the rest of their life.

What is My Daily Deductible for Short-Term Skilled Nursing?

Medicare and Medicaid are two medical insurance benefits that must not be confused with one another. Medicaid is given to citizens that fall below the poverty line. Because Medicaid is given to people with very low incomes, Medicaid pays for 100% of the cost of staying in a skilled nursing facility.

On the other hand, Medicare also pays for part of the coverage for SNF but does not cover 100% of the costs. The coverage of Medicare can be broken down into benefit periods. A benefit period will run for 100 days, after which patients will need to pay for the costs out of their pockets if they need to stay beyond the 100 days.

Here is the breakdown of the Medicare coverage and how much patients will need to co-pay.

Day 1 to Day 20

Within this period, Medicare will cover the entire cost of the stay in a skilled nursing facility. The patient will pay nothing.

Day 21 to Day 100

Medicare will cover most of the cost of a patient's stay in an SNF, but the patient will have to co-pay a fixed amount. For 2020, the amount that patients will need to copay is $176 per day.

After Day 100

Medicare will no longer pay for any costs associated with your stay in an SNF. Patients with other long-term care insurance can use these policies instead.

It is important to keep in mind how expensive the copay can be for those who must stay in longer than those first 20 days. If a patient needed to stay the full 100 days their total copay would be around $14,000. This needs to be considered when speaking with the facility director or physician to ensure that you have funds available for the copay. If funds are not available you will need to have a candid conversation with the short-term care facility so that other arrangements, like Home Health, can be made.

How Can I Find Short-Term Rehabilitative Skilled Nursing Near Me?

While there are quite a few good search sites available, the absolute best tool to find short-term skilled rehab near you is to look right here on Senioridy’s search platform. You can use our map-based search to locate a Skilled Nursing Rehab Facility near you or you can visit our listing page and filter out the facilities that best fit your needs. Remember, on Senioridy you can compare, save, and share your selections with those other decision-makers in your family so that everyone agrees on the selection that has been made. Then, just reach out directly to that SNF by tapping the phone number or by sending them an inquiry. All calls and inquiries go straight to that assisted living facility with no cost to you for reaching out.

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