Medicare will cover skilled care only if all of the following are true:
- You have Medicare Part A* (Hospital Insurance) and have days left in your benefit period.
- You have a qualifying hospital stay. This means an inpatient hospital stay of 3 consecutive days or more. You must enter the SNF within a short period of time of leaving the hospital.
- Your doctor has ordered the services you need for SNF care, which require the skills of professional personnel such as registered nurses, licensed practical nurses, physical therapists, occupational therapists, speech-language pathologists, etc.
- You require skilled care on a daily basis and the services must be ones that can only be provided in an SNF on an inpatient basis.
- You need these skilled services for a medical condition that:
– was treated during a qualifying 3-day hospital stay, or
– started while you were getting SNF care for a medical condition that was treated during a qualifying 3-day hospital stay.
The daily rate for skilled nursing care include room and board:
- Three meals per day served in main dining or rehabilitative dining areas
- Tray service, plus snacks
- Special diets upon physician order
- Daily assistance with activities of daily living (ADLs), i.e., dressing, bathing, ambulation, personal hygiene, and needs
- Daily housekeeping service
- Bed and bathroom linens (less incontinent care linens)
- Administration of medications as prescribed by either attending/alternate physician
- 24-hour supervision by licensed nursing personnel (R.N. or L.P.N.) and Certified Nursing Assistants
- Assistance with feeding
- Planned activities
- Recreational and occupational programs
- Drug regimen review
- Social services consultation
- Discharge planning and referral service
- Rooms furnished in accordance with state and federal regulatory agencies