Does Medicare Pay For Nursing Home Care? Everything You Should Know
Understanding Medicare’s rules for paying for nursing home care can be confusing. You might find yourself wondering, “Does Medicare pay for nursing home care, or
Your loved one just got discharged from the hospital, but they can’t go home because they need high-level medical care that cannot be provided at home. A quick search on which senior care option is right for them reveals two similar terms: skilled nursing homes and nursing homes.
Now, you’re confused. Are they the same? What’s the difference? Which is right for my loved one?
While both skilled nursing facilities and nursing homes appear similar, there are a few differences to remember to choose the right care option for your loved one.
Skilled nursing homes also called skilled nursing facilities (SNFs) offer skilled nursing care, which is the highest level of medical and rehabilitative care you can receive outside of a hospital. Care is provided by medical professionals such as registered nurses, licensed practical nurses (LPNs), and occupational, physical, and speech therapists under the supervision of a doctor.
In some cases, skilled nursing care can be provided in stand-alone skilled nursing facilities (SNFs), in a different wing of a nursing home, or in senior rehabilitation centers.
One thing to keep in mind is that skilled nursing homes provide short-term post-acute care after a discharge from the hospital, which may be following a major injury, illness, or surgery. The average length of stay in a skilled nursing home is 21 days.
Since skilled nursing home care is tailored to help your loved one recover after an illness or injury, common services offered include:
While residents have access to these skilled services, they also get support with personal care and activities of daily living such as bathing, grooming, and eating.
While skilled nursing care can also be provided at home, most seniors opt for skilled nursing facilities because of the availability of medical equipment.
Nursing homes offer long-term care for seniors who have medical conditions that have affected their ability to live independently. Residents require ongoing medical care which is provided by licensed practical nurses. And sometimes provided by nurse aides under the supervision of a registered nurse.
Services offered include:
The average length of time spent in a nursing home is around 2 years.
The major difference between SNF nursing homes and traditional nursing homes is in the length of stay and intensity of medical care provided.
Regardless of the type of nursing home your loved one would need, you’d need a doctor’s order. This confirms that they meet state requirements for admission into a nursing or skilled nursing home.
Once you have this recommendation for the length of stay and level of care, you can now go ahead to choose either option based on your loved one’s care needs.
To determine which of the two options is right for your elderly loved one, the first question you should answer is what are the needs of my loved one?
Answering these questions will help you determine if a nursing home or skilled nursing facility is right for your loved one.
Let’s take a look at two scenarios.
Your loved one who had a fall and sustained some bruises due to worsening dementia symptoms was just discharged from the hospital. The doctor recommends that since dementia symptoms are worsening and impacting her ability to live independently, s
In this case, a nursing home is the right option, as your loved one needshe’ll need around-the-clock supervision to keep her safe.
long-term care including support with daily activities and basic health care such as administering pills.
Say the fall caused your loved one to have a hip-replacement surgery. In this case, after a discharge from the hospital, a skilled nursing home specializing in providing skilled nursing short-term care would be the right option.
After recovery from a skilled nursing home, you can choose to transition your loved one to a nursing home for long-term round-the-clock care or go with other care options such as home care or memory care in an assisted living home.
To find a skilled nursing home or nursing home near you, you can use the Nursing Home Compare tool provided by the Center for Medicare and Medicaid Services (CMS). You can also run a quick search in Google or Bing with keywords such as “skilled nursing homes in my areas”, “nursing homes near to me”, and other related keywords.
When considering which facility to move forward with, be sure to keep the following in mind.
A funded facility can reduce your costs if your loved one has a medicare plan, and is eligible for Medicaid. A licensed facility ensures your loved one is getting care in an environment that meets state and federal requirements.
You may have to pay for some services out of pocket. It’s best to know the overall cost of services for living in the facility, which of them is covered by Medicare, Medicaid, or long-term care insurance (if your loved one has a plan), and which of them would you have to pay for.
Skilled Nursing Homes are an essential component of the government’s Medicare and Medicaid services programs, ensuring coverage and support for those in need.
The Centers for Medicare & Medicaid Services (CMS) oversee the regulations and standards that these centers must adhere to, ensuring the protection of residents’ rights and the provision of high-quality care.
To access information and updates on these programs, you can visit the CMS website, where you’ll find a variety of resources, from general information on healthcare policies to reporting on prevention and mental health programs.
Whether your loved one needs short-term skilled nursing care to recover from a major illness or surgery or requires long-term care to thrive in their golden years, Amy’s Eden compassionate caregivers are up to the task.
We provide specialized skilled nursing care and long-term care in our client’s homes or our assisted living homes.
From post-operative care to wound care, dementia care, and more, you can count on our decade of experience to offer the needed support for your loved one to thrive in comfort and happiness.
Contact us today to learn more about our nursing care services for your beloved senior.
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