Skilled Nursing Facility (SNF)

How does a skilled nursing facility work?

A skilled nursing facility provides a higher level of care than a nursing home. This is because of the special therapies and treatments provided by therapists and nurses. These healthcare professionals fulfill doctors’ orders to help people get back on their feet. Examples of the care they provide for patients include:

• Physical and occupational therapists help someone regain the strength and skills to walk again. This can mean learning how to use a walker, crutches, and a cane.
• Occupational therapists help people who have had a stroke to feed themselves. They know about special equipment like built-up forks that help people regain some level of independence.
• Speech and language pathologists work with patients to recover the ability to talk and understand what others are saying.
• Support with activities of daily living (ADLs), such as bathing, toileting, and dressing.
• Amenities such as those one would have at home, including meals, laundry services, and a private or semi-private room. While at a SNF people can take part in social activities in which they are interested.

Patients of skilled nursing facilities typically were in the hospital receiving care and treatment for:

• Surgery, including joint replacement or because of a cancer diagnosis.
• A heart attack or stroke that has affected their ability to care for themselves. People take part in therapies to improve function such as the ability to walk independently or talk.
• A serious infection that requires ongoing intravenous (IV) therapy to recover.
• Wound care that is best done in a sub-acute setting.
• An accident that affects the ability to function and care for oneself. One example is traumatic brain injury (TBI).
• Care of people with degenerative illnesses such as Parkinson’s.

The goal is that a person recovering from a hospitalization will be able to achieve their highest level of well-being and function.

What are the requirements for admission to a skilled nursing facility?

A person is admitted to a skilled nursing facility (SNF) when their doctor decides they require daily skilled care. The SNF must be approved and certified by Medicare. The patient is eligible for their SNF stay to be covered by Medicare when:

• They have Medicare Part A hospital insurance and have days left in their benefit period (p. 13).
• It follows a minimum of a prequalifying 3-day hospital stay for a medical condition.
  • This applies even when you were admitted to the hospital for a different health need.
  • The hospital stay needs to be 3 days in a row.
  • You must go into the SNF shortly after leaving the hospital (about 30 days).
• You get a condition while in the SNF for a hospital-related health problem that requires subacute care. An example is if you develop a wound that needs special treatment, including IV therapy.
• You need and receive skilled care services every day.

How to decide between skilled nursing care and a nursing home?

People can have different reasons for needing skilled nursing care than those offered by a nursing home. Both offer some of the same services.

Someone who benefits from skilled nursing care:

• Needs subacute care around the clock. This includes treatments such as IV therapy and wound care.
• Typically needs care by therapists and their assistants every day or several days per week.
• May be able to do some of their ADLs but need help with others. An example is a person who has had knee replacement surgery.
  • They can feed themselves and move around though it is limited.
  • These patients need help with transferring from bed to chair and getting dressed.
  • Physical therapists work with them every day to regain strength and learn how to safely walk.

Residents of a nursing home:

• May need skilled nursing on occasion.
• Need help with ADLs including moving, bathing, dressing, and eating.
• Benefit from living somewhere where they are safe, cared for, and kept as comfortable as possible.

How many days does medicare pay for a skilled nursing facility in 2022?

Original Medicare Part A pays for all costs for days 1-20 for each benefit period.

• A benefit period begins on the day your loved one starts getting inpatient hospital or SNF care. They can get up to 100 days of SNF coverage in a benefit period (p. 14).
• Your loved one must have Medicare Part A hospital insurance and have days left in their benefit period (p. 13). NOTE: The SNF days that are counted begin with your first day in the hospital.
• You are then responsible for paying:
  • Co-insurance of $194.50 per day for days 21-100 of the benefit period. NOTE: Some medigap policies or long-term care insurances may cover a portion of the co-insurance. Check with your loved one’s insurance providers.
  • All costs beyond the 100 days in SNF care.
• If your loved one is enrolled in a Medicare Advantage plan, check with their insurance provider if they include any coverage of SNF co-pays.
• Check with your state’s Medicaid office to learn if your loved one is eligible to have any of SNF fees paid.

How to find a skilled nursing facility near me?

There are several ways to locate a skilled nursing facility (SNF) near you. Keep in mind that some nursing homes have units dedicated to SNF care and others do not.

• Check with your loved one’s doctor’s office or hospital social worker about SNFs in your area.
• Use this Medicare.gov locator to search for services including inpatient rehabilitation

What is a skilled nursing facility vs nursing home?

• See our answer explaining the difference between a SNF and nursing home on our nursing home page.