6 questions and answers about skilled nursing care

by Christian Schreiber, staff blogger

In addition to Retirement Living, Assisted Living, and at-home care, Providence Life Services offers Christian care and expert rehabilitation at our four healthcare and rehabilitation centers. This blog answers some common questions we hear from people who suddenly need skilled nursing care and/or rehab services. Feel free to print it out and put it in a file, so it's handy when you need it!

1. What should I look for in a Skilled Nursing community?

First determine the needs of the patient. Most skilled nursing communities offer both long-term medical care and short-term rehab/therapy services. If the patient needs long-term care, you’ll want to be sure the surroundings are comfortable. It will probably never feel like “home,” but the staff, the food, and the recreation opportunities should all be high quality.

If the patient needs rehab, ask about the success rates in dealing with his or her particular diagnosis. Tour the building and the rehab area, using all your senses to make an assessment: Does it smell clean? Is there clutter in the rooms and work areas? Are the staff and other residents noisy? What sort of licensing or expertise do the caregivers have?

Whether you are considering long-term care or a short-term stay, you'll want to consider such questions as, How appetizing is the food? In what ways do the staff interact with the residents? Do the other residents seem content and well-groomed? What kind of activities are posted on the monthly calendar? Is there a sample menu you can review? All these details will help you make a decision after you’ve done some research.

2. What is “Skilled Care”?

“Skilled care” requires the daily involvement of licensed nursing and/or rehabilitation staff. By contrast, help with basic “activities of daily living” (dressing, bathing, walking, etc.), is considered “custodial care” and is not covered under Medicare.

3. What is Medicare?

Medicare is a health insurance program for people age 65 and older or for younger individuals with certain conditions or disabilities. Medicare assists with costs for hospital stays, skilled nursing care (up to 100 days), and Hospice care. Covered services include a semi-private room, therapy, meals, medications, medical supplies, skilled nursing care, medical social services, and dietary counseling. For the first 20 days, Medicare pays 100% of the covered charges. A daily co-insurance rate is applied on days 21–100.

4. What are the eligibility requirements if I want Medicare to cover the cost of my skilled nursing care?

• You must have Medicare Part A benefits.

• You must have spent three consecutive nights in an acute care hospital.

• Your physician must certify that you need daily skilled care.

• When you leave the hospital, you must be admitted to a Medicare-certified skilled nursing center within 30 days.

5. How long will Medicare coverage last?

The maximum benefit period is 100 days if the qualifying conditions are met. You will be notified when you no longer meet the requirements for skilled care benefits.

6. What is Medicaid?

Medicaid is a state-administered program designed to help people in need of financial assistance for medical care. This program is administered by the Illinois Department of Healthcare and Family Services (HFS).

If you have other questions about Skilled Nursing, rehabilitation services, or Medicare, Providence can help! You can visit our website to find out more, or email your question to info@provlife.com.

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