Skilled Nursing: Sorting Through the Details

I know that figuring out the best care for a loved one can feel overwhelming, especially when you're considering skilled nursing communities. But don’t worry—I’m here to help you sort through the details so you can make the best decision for your family. Let’s dive in!

What Exactly is a Skilled Nursing Community?

Let's start with the basics. A skilled nursing community (or skilled nursing facility, sometimes called SNF) is a type of healthcare setting that provides 24/7 care for people who need more medical attention than what's offered in typical assisted living or at home. Think of it as a bridge between a hospital stay and going back home, but it can also be a long-term solution for those who need ongoing medical care.

Skilled nursing communities are staffed with registered nurses (RNs), licensed practical nurses (LPNs), and certified nursing assistants (CNAs), along with physical therapists, occupational therapists, and other specialists. These facilities are equipped to handle complex medical issues like wound care, IV therapy, and rehabilitation after surgery or a major illness.

Who Benefits Most from Skilled Nursing?

Skilled nursing is ideal for individuals who require daily medical care or rehab but don't need to stay in a hospital. Here’s when it might be a good fit:

Recovery After Surgery or Illness: If your loved one is bouncing back from a surgery, stroke, or severe illness and needs rehabilitation services, a skilled nursing facility can be a great stepping stone before they’re ready to head home.

Chronic Conditions: People with chronic conditions like severe diabetes, heart disease, or respiratory issues that require consistent monitoring and treatment might also benefit from this level of care.

Long-term Care Needs: For those who need ongoing medical care that’s beyond what can be managed at home or in assisted living, skilled nursing might be the best option.

How Do You Qualify for Skilled Nursing?

Now, qualifying for a skilled nursing facility usually involves a referral from a doctor, especially if Medicare or Medicaid will be footing the bill and usually (but not always) happens after a hospital stay. Typically, your loved one will need to have been in the hospital for at least three nights, have a doctor’s order for skilled care, and need treatment that requires skilled nursing or therapy services.

VERY IMPORTANT SIDE NOTE: if you are advocating for yourself or a loved one and this happens A LOT!! If your loved one enters the hospital and acute rehab may be required as a discharge plan. Make sure that they are put on “admission” and not “observation” status. Observation status does not count towards your three nights. Also, three nights mean they must be in the hospital for three “midnights”. This is a strict Medicare policy but if not done correctly can cause you close to 100 Medicare paid rehab days and instead you will get ZERO!

Types of Skilled Nursing Communities

Not all skilled nursing facilities are the same, so let’s break down the options:

1. Short-term Care Facilities: These focus on rehabilitation and getting residents back on their feet after an illness or surgery. The goal is for them to return home once they’re strong enough.

2. Long-term Care Facilities: These are more about ongoing care for chronic conditions or when a loved one needs help with daily activities over an extended period.

3. Specialized Care Facilities: Some skilled nursing communities focus on specific conditions, like Alzheimer’s or dementia care, offering tailored programs and environments to support these residents.

The Benefits and the Drawbacks of Skilled Nursing Communities

The Good Stuff

Comprehensive Care: Your loved one will have access to around-the-clock nursing care, which can give you peace of mind, knowing they’re in good hands.

Rehabilitation Services: Physical, occupational, and speech therapy are often available on-site, helping residents recover more quickly.

Social Engagement: Many facilities offer activities and social events, which can help combat loneliness and keep residents engaged.

The Not-So-Good:

Cost: Skilled nursing isn’t cheap. The average cost can range from $8,000 to $10,000 per month, depending on location and level of care. While Medicare might cover some of the costs, it usually only does so for a limited time. (Remember 3 Midnight Rule here)

Environment: Some people find skilled nursing facilities to be more clinical and less homelike than other senior living options, which can be an adjustment.

Limited Independence: Because of the high level of care, residents might have less independence compared to other living arrangements like assisted living or at home.

Surprises You Might Not Expect

Flexibility in Care Plans: Skilled nursing facilities often tailor care plans to the individual, adjusting services as needs change. This can be a relief if your loved one's condition improves or worsens.

Transitioning to Long-term Care: If your loved one initially enters for short-term rehab but later requires long-term care, the transition within the same facility can be smoother than moving them to a new place.

Family Involvement: Many facilities encourage families to stay involved in care decisions and even participate in some therapy sessions or activities.

Wrapping It Up

Choosing a skilled nursing community for your loved one is a significant decision, but it doesn't have to be daunting. Remember, the goal is to find a place where they can receive the care they need while maintaining as much comfort and dignity as possible.

If you ever need more guidance or just want to talk things through, I’m always here to help you navigate the options. After all, making sure our loved ones get the best care is what it’s all about.

We're here for you.