Question 1

How long does Medicare pay for a skilled nursing facility?

Accepted Answer

Medicare Part A pays for up to 100 days in a skilled nursing facility per benefit period, usually after a qualifying three-day inpatient hospital stay. Days 1 to 20 are fully covered, and days 21 to 100 require a daily coinsurance. Coverage stops once daily skilled nursing or therapy is no longer needed.

Question 2

When is a skilled nursing facility needed?

Accepted Answer

A skilled nursing facility is needed when medical needs go beyond what can be managed at home or in assisted living, such as complex wound care, IV medications, feeding tubes, complicated medication routines or daily physical, occupational or speech therapy to recover after surgery, a stroke or a hospital stay.

Question 3

How much does a skilled nursing facility cost?

Accepted Answer

Skilled nursing facility costs vary widely by state, region and room type, with private rooms costing more than shared rooms. Medicare may cover short-term rehab, while long-term skilled nursing care is usually paid privately, through long-term care insurance or by Medicaid once a resident qualifies. Ask for the facility's private-pay daily rate.

Question 4

What are Medicare star ratings for skilled nursing facilities?

Accepted Answer

Medicare rates every certified skilled nursing facility from one to five stars, with an overall rating plus separate ratings for health inspections, staffing and quality measures. You can compare skilled nursing facility star ratings for free on Medicare Care Compare, which is more reliable than a facility's own marketing.

Question 5

What questions should you ask when touring a skilled nursing facility?

Accepted Answer

When touring a skilled nursing facility, ask about nurse staffing hours, staff turnover, overnight RN coverage, call-bell response times, recent inspection citations, hospital readmission rates and discharge policies. Visit at different times, including evenings or weekends, and watch how staff interact with residents to judge the quality of care.

Copper Ridge Health Care

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