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 three 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 the 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 three-day hospital stay, or
– started while you were getting SNF care for a medical condition that was treated during a qualifying three-day hospital stay.
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) (e.g., dressing, bathing, ambulation, personal hygiene, 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 (RN or LPN) 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
PLEASE NOTE: THE DAILY ROOM RATE DOES NOT INCLUDE THE FOLLOWING: PHYSICIAN VISIT CHARGES; DENTIST VISIT CHARGES; MEDICATION AND SUNDRY ITEMS; RESIDENT CARE MEDICAL SUPPLIES AND MATERIALS; INCONTINENT CARE SUPPLIES/LINENS; SPECIAL PHYSICIAN-ORDERED THERAPIES SUCH AS PHYSICAL THERAPY, OCCUPATIONAL THERAPY, RESPIRATORY THERAPY, DIAGNOSTIC TESTS, AND OTHER SPECIALIZED CARE PROCEDURES; ETC.