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What is Nursing Homes?
A Nursing Home, also known as a Skilled Nursing Facility or SNF, has Registered Nurses who help
provide 24-hour care to people who can no longer care for themselves due to physical, emotional,
or mental conditions. A licensed physician supervises each patient’s care and a nurse or other
medical professional is almost always on the premises. Most nursing homes have two basic types
of services: skilled medical care and custodial care.
provide 24-hour care to people who can no longer care for themselves due to physical, emotional,
or mental conditions. A licensed physician supervises each patient’s care and a nurse or other
medical professional is almost always on the premises. Most nursing homes have two basic types
of services: skilled medical care and custodial care.
Custodial or personal care includes assistance with what are known as the activities of daily
living, such as:
People who are able to recover from a disabling injury or illness, may temporarily need the custodial
care as they are getting back the strength and balance to be independent again. For people who are
losing their ability to function independently due to chronic disease and increasing frailty, custodial
care may be a long-term need. In the most severe cases where a person is bed-bound, ongoing
supervision by an RN is necessary along with the custodial care, to ensure proper hydration and
nutrition and to prevent skin breakdown. If a custodial care resident becomes ill or injured, they
may spend a period of time in skilled care, and then return to custodial care. Whether a resident is
under skilled or custodial care is important in terms of who provides the care and who pays for the
services provided.
living, such as:
- bathing
- dressing
- eating
- grooming
- getting in and out of bed, or walking around
- toileting (incontinence care)
People who are able to recover from a disabling injury or illness, may temporarily need the custodial
care as they are getting back the strength and balance to be independent again. For people who are
losing their ability to function independently due to chronic disease and increasing frailty, custodial
care may be a long-term need. In the most severe cases where a person is bed-bound, ongoing
supervision by an RN is necessary along with the custodial care, to ensure proper hydration and
nutrition and to prevent skin breakdown. If a custodial care resident becomes ill or injured, they
may spend a period of time in skilled care, and then return to custodial care. Whether a resident is
under skilled or custodial care is important in terms of who provides the care and who pays for the
services provided.
Skilled medical care includes services of trained professionals that are needed for a limited
period of time following an injury or illness:
Skilled care may also be needed on a long term basis if a resident requires injections, ventilation or
other treatment of that nature.
period of time following an injury or illness:
- An R.N. doing wound care and changing dressings after a major surgery, or administering
and monitoring I.V. antibiotics for a severe infection. - A physical therapist helping to correct strength and balance problems that have made it
difficult for a patient to walk or get on and off the bed, toilet or furniture. - A speech therapist helping a person regain the ability to communicate after a stroke.
- An occupational therapist helping a person relearn independent self-care in areas such as
dressing, grooming and eating.
Skilled care may also be needed on a long term basis if a resident requires injections, ventilation or
other treatment of that nature.
Most medical insurance coverage follows Medicare guidelines. Private insurance and
Medicare pay for nursing home care only for limited time periods following a hospitalization:
* You must have been hospitalized for at least 3 days.
* You must enter the nursing home within 30 days of the hospitalization.
* Only the first 20 days are 100% covered; then there is a daily deductible.
* There’s a 100-day maximum related to any one hospitalization and diagnosis.
* You must be making regular progress as documented by medical professionals. If progress
toward independence is no longer occurring, insurance coverage ends.
Medicare pay for nursing home care only for limited time periods following a hospitalization:
* You must have been hospitalized for at least 3 days.
* You must enter the nursing home within 30 days of the hospitalization.
* Only the first 20 days are 100% covered; then there is a daily deductible.
* There’s a 100-day maximum related to any one hospitalization and diagnosis.
* You must be making regular progress as documented by medical professionals. If progress
toward independence is no longer occurring, insurance coverage ends.
In addition, most Nursing Homes provide:
Skilled Nursing Facility care is expensive, and the cost continues to rise. The average daily cost of a
private room in a Nursing Home was $192/day or $70,080 a year, according to the 2004 MetLife
Market Survey of Nursing Home and Home Care Costs. This is a more than $4,000 annual increase
over the prior year. The cost of a shared Nursing Home room averaged $169 a day, or $61,685 a
year.
In addition to a private or semi-private room and the care options you choose, where you live also
affects how much you'll spend for Nursing Home care. Alaska reported the highest rates for a
private room in a Skilled Nursing Facility, at $204,765 a year or $561 a day on average. The lowest
rates were found in Shreveport, Louisiana, at $36,135 a year or $99 a day.
- Respite Care (care so that caregivers can take a break)
- Interim medical care (after a hospital stay)
Skilled Nursing Facility care is expensive, and the cost continues to rise. The average daily cost of a
private room in a Nursing Home was $192/day or $70,080 a year, according to the 2004 MetLife
Market Survey of Nursing Home and Home Care Costs. This is a more than $4,000 annual increase
over the prior year. The cost of a shared Nursing Home room averaged $169 a day, or $61,685 a
year.
In addition to a private or semi-private room and the care options you choose, where you live also
affects how much you'll spend for Nursing Home care. Alaska reported the highest rates for a
private room in a Skilled Nursing Facility, at $204,765 a year or $561 a day on average. The lowest
rates were found in Shreveport, Louisiana, at $36,135 a year or $99 a day.
While you are receiving skilled care, or rehabilitation, the nursing home will provide any needed
custodial care along with the professional services, and Medicare pays. If you have Medigap
insurance, it may cover deductibles and some other charges. However if you reach a point where
you no longer have “rehab potential,” but still need daily services of an RN in addition to the
custodial care, you must bear the cost of the care. For many people this means drawing down
savings, sometimes to the point where your assets are mostly depleted, and then you may qualify
for Medicaid (called Medi-Cal in California). Medicaid will then start paying for the long-term care
in a Nursing Home.
Some residents spend only a short time in a Nursing Home; others spend the rest of their lives
there. However, the Nursing Home population has been declining in recent years as more choices
become available for seniors who need help. With the rise of Assisted Living Facilities, for example,
people who might formerly have gone into a Nursing Home yet are able to manage with more
limited care, now have an additional option.
Each senior's need for care or assistance is unique. Some individuals may have a short-term need,
perhaps caused by a fall and a broken hip, that necessitates a brief hospitalization followed by
rehabilitation. After a one- or two-month Nursing Home stay, the senior may be able to return home
and continue receiving some services such as physical therapy from a home health care agency, if
necessary.
Other people have more long-term needs, possibly due to Alzheimer's, extreme frailty, or a stroke.
In this case, care is necessary on an ongoing basis.
custodial care along with the professional services, and Medicare pays. If you have Medigap
insurance, it may cover deductibles and some other charges. However if you reach a point where
you no longer have “rehab potential,” but still need daily services of an RN in addition to the
custodial care, you must bear the cost of the care. For many people this means drawing down
savings, sometimes to the point where your assets are mostly depleted, and then you may qualify
for Medicaid (called Medi-Cal in California). Medicaid will then start paying for the long-term care
in a Nursing Home.
Some residents spend only a short time in a Nursing Home; others spend the rest of their lives
there. However, the Nursing Home population has been declining in recent years as more choices
become available for seniors who need help. With the rise of Assisted Living Facilities, for example,
people who might formerly have gone into a Nursing Home yet are able to manage with more
limited care, now have an additional option.
Each senior's need for care or assistance is unique. Some individuals may have a short-term need,
perhaps caused by a fall and a broken hip, that necessitates a brief hospitalization followed by
rehabilitation. After a one- or two-month Nursing Home stay, the senior may be able to return home
and continue receiving some services such as physical therapy from a home health care agency, if
necessary.
Other people have more long-term needs, possibly due to Alzheimer's, extreme frailty, or a stroke.
In this case, care is necessary on an ongoing basis.
A Skilled Nursing Facility is for an individual who meets one or more of the following
criteria:
- Cannot take care of themselves because of physical, emotional, or mental problems;
- Can no longer care for their own personal needs, such as eating, bathing, using the toilet,
moving around, or taking medications (custodial care); - Requires more care than can be provided by their caregiver, and cannot live alone;
- Might wander away if unsupervised;
- Has extensive medical needs requiring daily attention or monitoring by an RN supervised by
an MD; - Is going to be discharged from the hospital and requires temporary Skilled Nursing care or
rehabilitation before returning home or to a residential facility; - Has been recommended for a Nursing Home by a physician.
- Some Skilled Nursing Facilities can handle the following special needs:
- Kidney dialysis treatment
- Alzheimer's and dementia care
- Respiratory care
- Parkinson's care
- Terminal illnesses (Hospice Care) in cooperation with a separate Hospice agency that visits
the facility to provide specialized care - Chronic psychiatric care
- Private pay
- Long-term care insurance
- Medicaid (called “MediCal” in California)
- Medicare
Residential Care Facility Listing
