Complete Guide to Skilled Nursing Facilities
Skilled nursing facilities (SNFs) provide intensive medical care and rehabilitation services for seniors with complex health needs. This guide covers everything families need to know.
What Skilled Nursing Provides
Medical Services:
- 24-hour licensed nursing care (RNs and LPNs)
- Physician oversight with regular visits
- Medication management and IV therapy
- Wound care and post-surgical care
- Ventilator and tracheostomy care
- Dialysis coordination
Rehabilitation:
- Physical therapy
- Occupational therapy
- Speech-language pathology
- Recovery from stroke, surgery, or injury
Daily Living:
- All meals and nutritional management
- Complete personal care assistance
- Housekeeping and laundry
Short-Term vs. Long-Term Stays
Short-term (Rehab):
- Typically 2–6 weeks
- Recovery after hospitalization
- Goal is to return home or to lower level of care
- Often covered by Medicare
Long-term (Custodial):
- Ongoing residence
- For those needing permanent skilled care
- Usually paid by Medicaid or private funds
Costs
National averages:
- Semi-private room: $260/day ($7,800/month)
- Private room: $300/day ($9,000/month)
Washington State:
- Semi-private: $300–$350/day
- Private: $350–$450/day
Paying for Care
Medicare (short-term):
- Covers up to 100 days after qualifying hospital stay
- Days 1–20: Fully covered
- Days 21–100: Daily copay ($204 in 2024)
- Must show skilled care is medically necessary
Medicaid (long-term):
- Covers ongoing nursing home care
- Must meet income and asset limits
- Rules vary by state
Other options:
- Long-term care insurance
- Veterans benefits
- Private pay
Evaluating Quality
Check:
- Medicare's Care Compare (5-star ratings)
- State inspection reports
- Staffing levels and turnover
- Complaint history
Visit and observe:
- Cleanliness and odor
- Staff interactions with residents
- Resident appearance and engagement
- Response time to call lights
Ask about:
- Staff-to-resident ratios by shift
- How they handle medical emergencies
- Family communication practices
- How they manage pain and comfort