When you find yourself in need of the services provided by a Skilled Nursing Facility for yourself or a loved one, there are some actions you can take to find the facility that offers the best care in your area. A Skilled Nursing Facility offers medically necessary care 24 hours a day. The facility has a staff of physicians, both registered and practitioner nurses, and medical therapists. The personnel at a Skilled Nursing Facility are trained in the care and rehabilitation needs of patients ready to leave a hospital but who have not recovered enough for independent living. You can find your ideal facility by researching and comparing the quality of care offered at local skilled nursing facilities.
Seven Questions to Ask When Comparing Skilled Nursing Facilities
1. Does the Skilled Nursing Facility have the specific medical or rehabilitation services that your recovery needs? A personal physician or hospital discharge worker performs a needs assessment for the type of care needed when in a skilled nursing facility. It is advisable to rule out any facility that does not have those services you need.
2. Does the Skilled Nursing Facility accept your Medicare insurance? Not all skilled nursing facilities are certified Medicare participating providers. The Centers for Medicare & Medicaid Services can provide you with a list of Skilled Nursing Facilities that they have certified for Medicare coverage. It is advisable to rule out any facility that is not Medicare-certified as you can end up being responsible for the entire bill.
3. Can you review the quality of care ratings given to the facility? When you are looking for the best level of care at any facility, ask to review their report ratings from inspections regarding the quality of staffing needs, health measures, and safety standards. Those inspection reports will include the information and formulas used to support the given ratings. A top-level Skilled Nursing Facility will have a 5-star rating. It is advisable to rule out any facility that declines your request to review their inspection reports.
4. What are the costs for the services that you need? When making a Skilled Nursing Facility selection, you want to know what the costs are for both the basic daily care and services that you need and for any extra fee-based services that you may want such as custodial care. Both the basic daily rates and the extra fee-based services can vary from one facility to another with the highest star-rated facilities often charging more. Knowing your financial responsibility with each facility under consideration can help you make an affordable comparison.
5. What is the Medicare coverage for Skilled Nursing Facilities? Medicare Part A helps with care and certain services while in a skilled nursing facility for up to 100 days. There is a sliding scale for out-of-pocket costs to the patient after the first 20 days. From days 21 through 100, the patient will be responsible for applicable co-insurance payments or personal payments. After day 100 the patient will be responsible for the full cost of treatments. The total amount that a patient is responsible for depends on the basic rates and fee-based services charged at the selected facility. Be sure to ask for a breakdown of all rates and fees so that your final facility selection takes into consideration your ability to pay those expenses not covered or allowed within your Medicare benefits. It is advisable to talk with the facility’s billing office to arrange for a payment plan if the final patient bill cannot be paid-in-full immediately.
6. What is the difference between skilled nursing vs. custodial care services? While both services are available in a Skilled Nursing Facility, the major difference in skilled nursing vs. custodial care is what type of care is being provided. Skilled nursing requires the provider to be a licensed medical professional or a skilled medical specialist. Custodial care is services safely performed by non-licensed caregivers. Another major difference in skilled nursing vs. custodial care is the Medicare helps with skilled nursing care and does not help with custodial care. Payment for custodial care is the responsibility of the patient.
7. Can you make an on-site visit to the facility before making a final decision? After you have made a list of those skilled nursing facilities that meet all of your requirements, ask each one for an on-site visit to make a personal evaluation. When you tour a facility, you can meet with staff personnel, view the patients’ rooms, see how well equipped the therapy treatment rooms are, ask questions about meal service and special dietary needs, view the overall cleanliness of the facility, and see what extra services are available. It is recommended that only those facilities that have given you a positive impression be on your list for a final decision.
When you need the services of a Skilled Nursing Facility it is best to know all that you can about the treatments being offered, what the estimated total costs are, if the skilled nursing facility is Medicare-certified, and if the facility allows for a payment plan for expenses that are not covered by insurance. Don’t hesitate to ask all the questions that are on your mind. Just remember that recovering your health and your ability to care for yourself when you leave the facility is the ultimate goal for both the Skilled Nursing Facility staff, so do take advantage of all their skills and treatments.