What’s skilled nursing facility (SNF) care?

What’s skilled nursing facility (SNF) care?

SNFs provide high quality medical care from skilled nursing or therapy staff to treat, manage, and observe your condition, and evaluate your care. Skilled care is nursing and therapy care that can only be safely and effectively performed by, or under the supervision of, skilled nursing or therapy professionals. These professionals may be:

• Doctors
• Registered nurses
• Licensed practical and vocational nurses
• Physical and occupational therapists
• Speech‑language pathologists
• Audiologists

Examples of SNF care include physical therapy and intravenous injections given by a registered nurse or doctor. Keep in mind SNF care is different from custodial care. Custodial care helps you with daily activities, like bathing and dressing. It may also include care that most people do themselves, like using eye drops, oxygen, and taking care of colostomy or bladder catheters. Custodial care is often given in a nursing facility.

When and how long does Medicare cover care in a SNF?

SNF care is generally provided daily, on a short‑term basis. Medicare covers up to 100 days of care in a SNF, in a single benefit period, as long as you stay eligible.

What’s covered by Original Medicare?

• For days 1–20, Medicare pays the full cost for covered services. You pay nothing.
• For days 21–100, Medicare pays all but a daily coinsurance for covered services. You pay a daily coinsurance.
• For days beyond 100, Medicare pays nothing. You pay the full cost for covered services.

The coinsurance is up to $200 per day in 2023. It can change each year. If you have a Medicare Supplement Insurance (Medigap) policy with Original Medicare or have a Medicare Advantage Plan, your costs may be different, or you may have more coverage.

Why would I need skilled nursing or skilled therapy care?

You may get skilled nursing care when it’s necessary to:

• Help improve your condition.
• Maintain your current condition, or prevent or delay it from getting worse.

You may get skilled therapy care when it’s necessary to:

• Help improve your condition.
• Set up a maintenance program designed to maintain your current condition or prevent or delay it from getting worse.
• Perform a safe and effective maintenance program. Complications in your condition, or the complexity of services you get may sometimes require continued skilled therapy care, even after the maintenance program is set up.

Skilled care helps you get better, function more independently, and may help you manage your health.