Your loved ones need care due to medical conditions. You have heard about skilled nursing, nursing home, home health, and other terms but are a bit confused and haven’t found the one suiting your needs. No need to worry about the confusion. It might happen to people who are not familiar with this field.
The article explains the differences between Skilled Nursing Care and a Nursing Home, the tasks, and insurance policy coverage, and whatever you need to know.
Table of Contents
- 1 What is skilled nursing?
- 2 Skilled nursing care at your place of residence
- 3 What services are involved in skilled nursing?
- 4 What is a nursing home?
- 5 What services nursing homes provide?
- 6 Skilled nursing vs. nursing home; differences in insurance coverages
- 7 Skilled nursing facility vs. nursing home
- 8 When Is Skilled Nursing Care Needed?
- 9 What Qualifies a Patient for Skilled Nursing Care?
- 10 Skilled nursing in Las Vegas
- 11 FAQs
What is skilled nursing?
Skilled nursing care is services provided by a trained registered nurse working under a doctor’s management. It’s almost the same level of nursing care you receive in a hospital.
Patients might need to visit a Skilled Nursing Facility (SNF) to receive further recovery after a;
- surgery
- injury
- or illness.
Depending on the patient’s case, they might receive rehabilitation services from speech, occupational, or physical therapists as well. Skilled nursing care, often referred to as post-acute care, is provided following an emergency hospital stay.
The skilled nursing facility provides patients transitional care. They get better until being able to go home. Remember that skilled nursing care is a high level of medical care. Licensed health care professionals must provide skilled nursing. A registered nurse, occupational, physical, or speech therapist needs to monitor the care process.
Patients might need skilled nursing in the short term. However, people who need long-term care and a constant visit to healthcare could also receive services due to chronic medical conditions.
Examples of skilled nursing including but not limited to;
- Intravenous (IV) therapy
- Injections
- Catheter care
- Physical therapy
- Monitoring vital signs and medical equipment
Medicare, Medicaid, VA, or private health insurances cover skilled nursing only when a doctor orders it. The insurance coverage will get explained in the below section.
You could also receive some skilled nursing services in your place of residence.
Skilled nursing care at your place of residence
There has been a tendency among seniors to age in their own homes. Age in place has become popular among the elderly recently. According to the American Association of Retired Persons (AARP), “about 90% of American elderly want to continue living in their place of residence as long as possible”.
Why the seniors prefer aging in place?
The elderly wish to maintain their independence. Unfortunately, aging makes it difficult to live independently and without help. But with family, friends, and skilled nurse help, seniors can still have some independence living in their place of residence.
The elderly can control their life decisions, personal activities, and routines better while being at home. It could be a bit difficult handling such matters in senior living facilities. Residents rely on staff who have to care for several other residents.
There is no place like home. It might sound cliche, but the core sentiment is true. Your home offers a sense of:
- security,
- comfort,
- and familiarity.
It becomes particularly true for the elderly. They feel all the good things at their own home. Some of the seniors might never feel good in a nursing home or living facility.
Not everyone can afford the costs of nursing homes. A shared room could cost between $10,000 to $20,000 per year in a nursing home. On the other hand, the private rooms can cost higher. The US Department of Housing and Urban Development indicates that “the elderly who pick to stay in their home can save thousands of dollars.”
Health and Care Professional Network can provide the help you need while residing in your place of residence.
What services are involved in skilled nursing?
The services are different and up to the provided location; a hospital setting or nursing home. Some of the services by a skilled nursing facility include;
- Physical, occupational, speech therapy
- Injections
- Using aspiration devices
- Planning, managing and evaluating patient care
- Applying dressings for wound care
- Taking care of skin diseases
- Inserting catheters and feeding lines
Specific care management that SNF can provide include;
- Parkinson’s or Alzheimer’s Disease
- Wound Care management
- Stroke
- Acute Illness
The type provided care is up to the patient’s situation.
What is a nursing home?
A nursing home is a facility for the residential care of the disabled or the elderly. There are other names for the nursing homes such as;
- Rest homes,
- Care homes,
- Old people’s homes,
- Long-term care facilities.
Nursing homes have skilled nurses and nurse’s aides on hand 27 hours a day.
People often might need to move to the nursing home when unable to take care of themselves due to the following issues;
- Functional
- Behavioral
- Cognitive
- Medical
Nursing home care might also provide medication or controlling chronic conditions.
Licensed practical nurses often provide nursing home care, and the nurse aides work under the supervision of a registered nurse. The provided care focuses on daily living, such as;
- eating,
- bathing,
- and dressing.
The nursing home also gets known as “custodial care.”
A nursing home provides patients long-term residential care. They are to create a comfortable and safe environment for people who cannot live independently. The people who provide the services don’t need to have a medical background.
What services nursing homes provide?
The provided services include but not limited to;
- Personal care (eating, visiting the bathroom, stretching, or getting dressed)
- Personal hygiene
- Recreational activities
- Medication monitoring
- General care (using oxygen, catheter care, eye drops, vitamins,
- Transportation services
- 24-hour emergency care
- Room and board
- Social and recreational activities
- Housekeeping services
Skilled nursing vs. nursing home; differences in insurance coverages
The skilled nursing and nursing homes are different in terms of medical coverage. The major difference is that Medicare covers skilled nursing care in most cases but not the long-term care services in nursing homes.
What does Medicare cover?
According to Medicare, the services covered by the program include but not limited to;
- Physical & occupational therapy (if necessary for patients health)
- Medications
- Semi-private room
- Medical social services
- Dietary counseling
- Swing bed services
- Medical supplies and equipment used in the facility
- Skilled nursing care
- Meals
- Speech-language pathology services (if necessary for the patient)
- Ambulance transportation to the nearest supplier of required services
The coverage is different for staying in a skilled nursing facility. This is how Medicare covers the expenses for the skilled nursing facilities;
- Days 1–20: $0 per day.
- Days 21–100: $167.50 per day to be covered by patient or insurance.
- Days 101 and beyond: all costs covered by patient or insurance.
Remember that Medicare will only pay for the first 20 days of the 100 days in full. For days 21-100, the patient will have to pay coinsurance. If the patient needs coverage beyond 100 days, Medicare won’t support it.
The services by a nursing home for the long term are defined as non-medical custodial. Medicare doesn’t cover them, and you have to pay it on your own. If the nursing home is also a skilled nursing facility, it entitles you to take advantage of the 100 days option.
What does Medicaid cover?
Medicare covers many of the skilled nursing facility stays. However, it’s only for a limited period. Medicaid might pay for skilled nursing facility care if your situation doesn’t meet Medicare’s requirements or has reached the limit.
A few nursing homes are also Medicare-certified skilled nursing facilities. If the patient is discharged from the hospital to a skilled nursing facility that is also a nursing home. In that case, the person might not need to change the center when their skilled nursing requirements are complete. If the discharged patient is eligible for Medicaid, and the nursing home is a Medicaid, they may stay in the center and take advantage of the Medicaid.
To visit a nursing home, you need to determine whether it receives Medicaid coverage or not. It must be proven that the long-term care the patient needs is medically necessary before Medicaid pays for the nursing home.
Other factors disqualify a patient from Medicaid coverage. Having too many assets is one of them, such as;
- Motor vehicles
- Real property
- A retirement account
- Money in the bank
The rules, regulations, and requirements are different in each State. For instance. Florida has a screening process gets called Comprehensive Assessment and Review for Long-Term Care Services (CARES).
You would better contact the local Medicaid office in your State and explain your specific details.
Skilled nursing facility vs. nursing home
A skilled nursing facility provides services to patients after a hospital stay. They address a specific medical, rehabilitative purpose. The final goal is the patient going home.
A nursing home is to provides custodial care. It involves many of the non-medical and daily activities such as;
- Bathing
- Grooming
- Medication monitoring
- Social and recreation activities
According to the Centers for Medicare and Medicaid Services (CMC), “the average duration of stay in a Skilled Nursing Facility is 28 days”.
Skilled nursing is high-quality and comprehensive. It’s advanced care services for patients after a major medical issue. After the rehabilitation, the patient can return home but might need further help. However, the required help will get reduced so friends, family, caregivers, or home assists.
The Nursing home is for people who need less serious or specialized medical care needs. They provide average and general care. Skilled nursing facilities need licensed staff, but nursing homes don’t need such employees on-site at all times. It’s not that nursing homes don’t have any skilled medical staff. They have such skilled nurses specialized in a field, but the focus is on general care. They have skilled staff for Alzheimer’s and dementia patients as well.
The summary of differences
The differences between skilled nursing and home nurse can be summarized as follows;
- The type and level of care; nursing homes focus on general care plus specialized care. Skilled nursing focuses on specialized care.
- Type of setting; skilled nursing is a medical setting, while assisted living is considered a residential setting. Patients can receive skilled nursing services in their place of residence as well.
- Availability of staff; home nurses work 8 hours every day, seven days a week, skilled nursing must be accessible and on-call. However, they are not necessary by law to be on-site.
- Length of stay; skilled nursing is short term while home nursing is long term.
- Residency; skilled nursing stays in the center for rehabilitation. The assistance is as long as the patient needs or desires. Both serve a unique purpose based on the client’s current situation.
- The goal of residency; The goal of a skilled nursing facility is rehabilitation and returning to the place of residence or another living environment. At the same time, the home nurse provides services with daily living.
- Level of independence; skilled nursing involves constant monitoring and round-the-clock medical care due to the patient’s health condition. The individual might be more limited. But home nursing involves more freedom.
- Cost; skilled nursing costs more than assisted living due to the round-the-clock medical care.
- Medicare and Medicaid pay most of the skilled nursing with a few exceptions. Medicare or insurance often don’t pay for the assisted living, with a few exceptions.
When Is Skilled Nursing Care Needed?
You may wonder if your loved one or family needs specialized nursing care. It all comes down to the amount of care your senior loved one needs, which might vary from person to person. A skilled nursing care center is the greatest option for a loved one who needs medical care for an injury and support with everyday routines. Skilled nursing care facilities are used for the following purposes:
A patient who has recently had medical problems
A heart attack, stroke, or fractured bones following a fall are serious illnesses or injuries patients endure. While many of these difficulties may be addressed via home care, Bridge Care Suites has qualified therapists and nurses to assist your senior loved one’s recovery. During their short-term stay at the institution, the patient will have round-the-clock access to various licensed specialists who will help them heal completely.
A patient who needs daily care regularly
Skilled nursing care guarantees patients access to qualified personnel around the clock. Qualified nurses who can offer the following specialized services;
- Complex wound coverings and post-operative wound care
- Hospice care
- Intravenous drug administration and monitoring
- Tube feedings
- Vital signs and medical equipment monitoring
- Specialized treatment
- Care for catheters, incontinence, and colostomies
- Specialized injections
- Diabetes management
What Qualifies a Patient for Skilled Nursing Care?
A patient who needs constant daily care for any medical condition is eligible for skilled nursing care. Individuals who need continued medical care following an accident, rehabilitation, or other highly successful medical therapy are eligible for skilled nursing care. Patients at skilled nursing facilities often suffer from a stroke, surgery, an accident, or a serious disease. Patients who require intense wound care or physical and occupational therapy are also eligible for skilled nursing facilities. When services are delivered in a Medicare-certified skilled nursing facility, Medicare pays for specialized therapy, medicine, or equipment ordered by a qualified physician.
It is common for nursing homes and assisted living facilities to have skilled nursing facilities for older people who may not require this level of medical care initially but may need it due to an accident or illness. This is one of the reasons it is critical to ensure that the assisted living facilities or licensed health care houses chosen for an elderly loved one include a skilled nursing facility. In addition, a nursing facility or community where skilled nursing care is provided eliminates the need to relocate if an accident, injury, or medical emergency occurs.
Skilled nursing in Las Vegas
Skilled nursing and nursing home are the two terms in medical care coverage for the patients or the elderly. You might have heard about the differences and get confused.
The article explained that skilled nursing is specialized medical care for rehabilitation after injury or illness. The aim is for the individual to get better to go home. However, the nursing home is more of daily care activity that doesn’t need much medical expertise. The aim is to provide a safe and healthy environment for the person.
As the article explained, “about 90% of American elderly want to continue living in their place of residence as long as possible’’ according to AARP.
You can receive the best care at your place of residence with the Health & Care Professional Network. We have provided a wide range of services from skilled nursing, physical therapy, and imaging services in Las Vegas since 2006.
Receive the service you need by contacting us at +702 871-9917. Our staff is always ready to provide whatever information you need.
FAQs
What Are the Top Three Nursing Home Problems?
Slow response times, Low-quality food, Poor Food
What happens to your money if you end up in a nursing home?
The general premise is that the nursing home receives all your monthly income. Medicaid subsequently pays the nursing home the difference between your monthly income and the amount permitted by the nursing home’s Medicaid contract.
What is the most serious issue in nursing homes?
Personnel issues