Skilled Nursing Facility

A skilled nursing facility is a special facility or part of a hospital that provides medically necessary professional services from nurses, physical and occupational therapists, speech pathologists and audiologists. Skilled nursing facilities provide round-the-clock assistance with healthcare and activities of daily living. There are numerous federal regulations regarding what skilled nursing facilities must and must not do.

Skilled nursing facilities, including nursing homes, may not discriminate against residents on the basis of race, color, ethnicity, religion, age, sex and other protected characteristics. Skilled nursing facilities that violate the rules can be reported to authorities, such as the local long-term care ombudsmen and state nursing home regulatory agencies. For example, a woman who suspects her mother was denied entry to a particular nursing home in California because of her race could report the incident to the California Department of Public Health. If her mom doesn’t have any other care options, she might take up the matter with the nursing home and try to get her mom admitted. If there are other equally good options, she could also consider choosing a facility that feels more welcoming.

Any patient entering a skilled nursing facility must receive an initial health assessment as well as ongoing health assessments to evaluate his or her physical and mental health, medications, ability to handle activities of daily living such as bathing and getting dressed, and ability to speak and make decisions. Patients needing post-hospital care in an SNF may use Medicare to pay for up to 100 days in a Medicare-certified skilled nursing facility, if the patient meets Medicare's requirements. The facility and Medicare, which covers skilled nursing care, use specific assessments to determine whether Medicare will pay for the patient’s stay in the facility or the patient will be responsible for the cost. 

Skilled nursing facilities cannot charge a buy-in fee, as some assisted living communities do, and are required to put their services and fees in writing and give these details to the patient – or the patient's caregiver, on the patient's behalf – so he or she can make an informed decision before moving into a facility.

Skilled nursing facilities can be extremely expensive for long-term stays. For example, in 2016, a private room in a skilled nursing facility or nursing home cost over $100,000 a year, according to a recent report on long-term care by Lincoln Financial Group. For more information, see Things Nursing Homes Are Not Allowed to Do and A Quick Guide to Medicaid and Nursing Home Rules.