5 ways to choose the right skilled nursing facility

As your loved one ages, there may come a time when you need to find a skilled nursing facility (SNF). Skilled nursing facilities provide 24-hour medical care and help with activities of daily living (ADLs), making them an option for people who can no longer live safely on their own or in assisted living. With so many options available, you may be wondering how to choose the right skilled nursing facility for your loved one. 

When possible, give yourself time to research skilled nursing facilities and determine which ones best match your loved one’s medical, personal, and daily care needs. Taking time to compare your options can help you make a more informed decision about where they’ll live. Unfortunately, you won’t always have time to plan. If a sudden change in your loved one’s mental or physical health requires skilled nursing care, or they need placement after surgery, you may have to make this decision quickly. 

Whether you need to find a skilled nursing facility right away or have time to prepare, this guide can help. Start by comparing the services, location, cost, reputation, and accreditation of each community so you can make the most informed choice possible for your loved one. 

What is a skilled nursing facility? 

A skilled nursing facility may be appropriate for someone who needs medical support that goes beyond therapy alone. These communities may provide short-term rehabilitation, long-term care, and hospice care to help make sure your loved one receives the support they need. They also offer round-the-clock staffing and care for residents who require it. Services may include: 

• Help with daily activities such as bathing, dressing, and eating 

• Medication management 

• Wound care and recovery after surgery 

• Personalized health care options and living arrangements 

• Occupational, speech, and physical therapy 

5 things to consider when choosing a skilled nursing facility 

Services offered 

Skilled nursing facilities offer different services based on the level of care a resident needs. Most provide help with ADLs, such as bathing, dressing, grooming, and eating. Some may also provide more comprehensive medical care, including treatment for injuries or chronic conditions. Look for a skilled nursing facility that provides the specific services your loved one needs. The following services may also support their health, comfort, and quality of life.

• Medical care: Each community should have physicians available for emergencies. Whether physicians are on staff or on call, residents should be able to receive treatment as often as necessary. Ask how medical concerns are handled and when a physician is available. 

• Hospitalization: In an emergency, a skilled nursing facility should have arrangements in place to help residents receive prompt medical attention. Ask the administration what plans and procedures it follows when a resident needs emergency care or hospitalization. 

• Nursing care: Nursing care is highly individualized, and the care that staff members provide may directly affect a resident’s well-being. The community should have licensed practical nurses (LPNs) on duty during the day and night, a registered nurse (RN) on most shifts, and certified nursing assistants (CNAs) who interact with residents frequently. CNAs may help residents with bathing, dressing, eating, and other personal care needs. 

• Rehabilitation: It’s important to have a team of specialists available who can help residents regain abilities they’ve lost, such as walking and talking. Ask which types of rehabilitation services the community provides. 

• Activities: Regular activity programming can help prevent isolation and give residents opportunities to spend time with others and build relationships. 

• Religious services: Some older adults may want to continue attending religious services. If this matters to your loved one, ask whether the community offers services on-site or can accommodate participation in virtual services. 

• Food: Meal planning is an important part of providing quality care at mealtimes. A dietitian should create meals that are balanced, varied, and appealing while considering each resident’s nutritional needs. Ask how the community handles individual dietary needs and meal planning. 

• Grooming: A good community will have an on-site barber or beautician to help residents meet their grooming needs. 

Location 

Choose a skilled nursing facility that is conveniently located for your loved one and the people who plan to visit. If you’re the person who needs care, staying close to family and other important people may be a priority. If you’re choosing care for a loved one, look for a community that is reasonably easy to reach. Also consider access to public transportation, nearby amenities, and the distance to a local hospital.

Cost 

Skilled nursing facilities can be costly, so it’s important to compare prices among your options. Consider insurance coverage and government benefits when budgeting for nursing home care. The way your loved one enters a community may affect payment. If they enter an SNF directly from a hospital, Medicare will often pay for care for a limited time.

When someone enters an SNF directly from home, the cost typically comes out of their own pocket. Medicaid is used when a person’s resources have been spent. Medicaid provides funding that will pay most SNF costs for people with limited incomes. Eligibility varies from one state to another, and coverage is available only to people who receive care in Medicaid-certified communities.

When will Medicare cover SNF care? Medicare will cover SNF care when the following conditions are met:

• You have Medicare Part A and have days remaining in your benefit period to use 

• You have a qualifying hospital stay of three consecutive days or more, starting on the day the hospital admits you 

• You need SNF services ordered by your doctor that require the skills of professionals such as registered nurses 

• You need and require skilled specialty care every day 

• You need a skilled service for an ongoing condition or for a new condition that appears while you’re receiving care for a previous condition 

• The skilled services are necessary for the treatment of your condition 

• You receive your care in a Medicare-certified SNF 

How long does Medicare cover SNF care? Medicare uses benefit periods to determine your use of hospital and SNF services. A benefit period begins on the day you’re admitted as an inpatient to a hospital or SNF. You can receive up to 100 days of SNF coverage during a benefit period. After you use those 100 days, your current benefit period must end before your SNF benefits can renew. You must pay the inpatient hospital amount for each benefit period. There is no limit to the number of benefit periods you may have. Once a period ends, you must complete another qualifying three-day hospital stay before you can receive up to another 100 days of benefits. 

When does a benefit period end? Your benefit period ends when you haven’t been in a hospital or SNF for 60 consecutive days. It also ends if you’re in an SNF but haven’t received skilled care there for at least 60 consecutive days. 

Reputation 

A skilled nursing facility’s reputation can help you evaluate your options. Talk with friends and family members who have experience with different local nursing homes, and read online reviews. You can also ask your loved one’s doctor whether they provide care at any local nursing homes. To learn more about the quality of care at SNFs in your area, visit www.medicare.gov/care-compare. This site includes a list of Medicare- and Medicaid-certified communities to help guide your decision. Your Area Agency on Aging can also provide information about skilled nursing facilities in your area. To find the local phone number for your Area Agency on Aging, visit Eldercare.gov or call the Eldercare Locator at 1-800-677-1116.

Accreditation 

Look for a skilled nursing facility accredited by a reputable organization. Accreditation indicates that the community meets certain standards for quality, safety, and health inspections. As you compare communities, confirm that all required licenses and certificates are current and displayed. 

Choosing a skilled nursing facility for yourself or your loved one can feel difficult, especially when time is short. Comparing services, location, cost, reputation, and accreditation can help you identify a community that meets your needs. Take the time you have to ask questions, review your options, and make an informed choice.