Wednesday, February 24, 2021

How To Assess A Skilled Nursing Facility

Skilled Home Care is for what they call in the industry, “skilled” needs. According to try to find Medicare-certified facility with at least 4-stars overall, and good ratings for staff quality, resident care, and has a staff-to-resident ratio of 10-to-1 or better.

To qualify for a “skilled” nursing facility, a senior must be home bound and have needs such as wound care, physical, occupational or speech therapy. By Medicare definition, “homebound” means the person is not able to leave their residence for any purpose other than to see a health care provider or attend a religious services.

In most U.S. states, insurance covers ‘skilled” home care services, if you qualify for the benefits under your policy. It's important to check with your insurance carrier about any co-pays or visits.

Senior home care services may supply an aide to come in and assist with activities of daily living (i.e. bathing, dressing, etc). The cost is generally covered by Medicare or Medicaid, but only if it's required and available from the home care facility.

When considering a skilled nursing facility here's some things to research and ask:

  • Is the in-home care facility or service accredited by a governing agency such as Many insurance companies require this accreditation for payment. Accreditation means the facility has met certain requirements in regard to staffing, training, and supervision.      

  • Ask to see the home care agency’s survey report for health & safety.

  • Most states require agencies and skilled nursing facilities to be licensed and reviewed regularly. These reviews may be available upon request and can be valuable for assessing quality of resident care.

  • Ask to see the outcome studies regarding your loved one’s condition.

  • Ask them to provide references from: doctors, social workers, hospital discharge planners, and especially current residents 

  • What are the credentials of the providers? Are they licensed and bonded?

  • Do they provide special resources for memory care or physical therapy?

  • What is the monthly cost of senior living care? What types of payment does the facility accept? (not all accept Medicare).

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