Skilled nursing care is often used interchangeably with other senior care terms, such as nursing homes or senior rehabilitation centers. However, it refers to the service being provided, not the setting where it takes place. In fact, skilled nursing care can apply to a variety of care settings, from a private home to a care facility.

Let’s define what is (and isn’t) skilled nursing care, so you and your loved one have a better sense of what to expect.

What is skilled nursing care?

Skilled nursing is a set of services for complex health conditions that require the expertise of professionally certified nurses, therapists or doctors.

As mentioned above, this type of care refers to the service, not the setting. This care may occur in a private home, nursing home, senior rehabilitation center or another care facility.

The defining quality of skilled nursing is that it’s provided by certified medical professionals instead of a health aide.

What services does skilled nursing care provide?

This type of care highly depends on the patient’s care needs. Some examples of skilled nursing include:

Intravenous (IV) therapy
Catheter care
Physical therapy
Vital signs monitoring
Wound care
Cardiac care
Orthopedic care
Stroke recovery care
Pulmonary care
Diabetes care
Transplant care
Nutrition therapy
Pain management

In general, skilled nursing must be prescribed by a doctor as part of the patient’s care plan. Having a doctor’s certification is also an essential step in getting this type of care covered by your health insurance.

Who’s considered skilled nursing staff?

Skilled nursing can be provided by a variety of certified health professionals. Staff may include nurses, therapists, pathologists, audiologists, doctors, social workers or licensed medical equipment technicians.

These are just a handful of staff members who may be involved in skilled nursing. Depending on the patient’s medical history, the care plan may require several staff members in order to get outcomes.

What’s the difference between skilled nursing care and a nursing home?

Skilled nursing is the service, while a nursing home is the facility in which care is given. Overall, a nursing home provides 24-hour medical attention and patients receive care on a full-time basis.

On the other hand, skilled nursing is a more general term. This care can be part-time or full-time, take place in a private home or at a care facility. Whenever the services are granted by a certified medical professional, it’s considered skilled nursing.

What isn’t skilled nursing care?

Skilled nursing is a specific set of services performed by a certified medical professional. It’s quite different from other services that care facilities may provide. Specifically, it’s distinct from what is called custodial care.

Custodial care refers to daily tasks that a health aide might help a patient with. These day-to-day activities may include bathing, dressing, toileting and/or feeding. Unlike skilled nursing, custodial care involves more general care and is performed by a health aide.

While extremely important for the patient’s quality of life, custodial care isn’t typically covered by health insurance because it’s not medically specific. This is in direct contrast to skilled nursing that must be prescribed by a doctor.

How does skilled nursing care compare to assisted living care?

Skilled nursing is also different than assisted living care, which is a type of care facility for seniors who aren’t able to live independently.

The biggest distinction is that assisted living care typically provides custodial care, not skilled nursing. In other words, seniors who live in assisted living don’t typically have serious underlying medical conditions. Instead they require assistance with daily tasks, as listed above.

To clarify, the service of skilled nursing isn’t usually provided at an assisted living facility.

What are the benefits of skilled nursing care?

This type of care is highly beneficial for patients. In fact, it’s essential for them to receive the care they need to get medical outcomes.

One of the main benefits of this care is that it isn’t setting-specific. You and your loved one can decide on where to get this type of care, whether in the privacy of your home or at a 24-hour care facility.

Should I be worried about COVID and skilled nursing care?

It’s important to take precautions when it comes to COVID and skilled nursing. Seniors who need this type of care are usually most vulnerable to COVID. Ask your care provider to find out what they’re doing to keep your loved one safe.

How much does skilled nursing care cost?

The cost will vary greatly depending on the amount of care needed and the care setting. Experts estimate skilled nursing ranges from $140-$771 per day, with an average of around $250 per day. As you can imagine, full-time skilled nursing will be much more expensive than a few hours a day.

Likewise, the care setting can increase the price. A full-time care facility, such as a nursing home, may cost more than in-home nursing care (which doesn’t include meals and other amenities). Of course, the final price will depend on your loved one’s needs and level of comfort.

How can I pay for skilled nursing care?

The good news is that skilled nursing, as prescribed by a doctor, is covered by government-sponsored health care, including Medicare and Medicaid.

However, there may be limits on Medicare coverage depending on whether this care is short-term or long-term. Short-term care of up to 20 days is paid in full, while days 21-100 are partially paid for. Starting on day 101, costs are the full responsibility of the patient. Thus, long-term skilled nursing may not be covered by Medicare.

However, you may be able to get health coverage in other ways, such as:

Medicaid: Medicaid generally pays for this type of care. A hospital stay is typically required to get full coverage.

Private insurance: Your private insurance may also cover it in the care setting of your choice. Specifically, you’ll usually get coverage paid by private insurance after day 20. Check with your provider for more details.

Veteran’s benefits: Veterans may also be covered for this care. It’s essential to contact a benefits specialist to understand coverage details.

Long-term care insurance: Long-term care insurance may also pay for this care. Of course, coverage will depend on your provider.

Life insurance: Sometimes life insurance can be paid out early to cover this care.

How can I find the right skilled nursing care?

Skilled nursing is vital for your loved one – and it’s vital to get the right provider. Jumpstart your search on My Caring Plan. Here you’ll find different providers of skilled nursing, including in-home, nursing home, senior rehabilitation center, and other care facilities.

These resources will guide you towards making a decision that’s right for your loved one. Whether at home or in a care facility, skilled nursing can make a huge impact on your loved one’s quality of life.

Sources:

Eldercare Locator, Administration on Aging, eldercare.acl.gov