SKILLED NURSING FACILITY CARE (SNF)
- Nursing homes that are Medicare certified SNF's
- Hospital Inpatient 3 nights
- Moderately complex medical problem
What constitutes moderately complex care?
- IV's, IM injections
- Feeding tubes
- Dressing changes (usually more than simple)
- Restorative care (care and teaching by licensed nurse) (e.g. care & training on: ostomy care, feeding tube care, wound care, etc.
Who decides eligibility?
The receiving SNF determines eligibility for Medicare benefits and assumes the financial responsibility if they determine the benefits incorrectly.
Medicare pays for:
100 days (the first 20 days Medicare pays 100%, the next 80 days pays 80%)
Note: 100 days of benefit is renewed when the resident has not been in a hospital or SNF for 60 days in a row and has now re-entered a hospital for 3 nights in a row.
Also: The patient can elect to use the benefit anytime within 30 days of being in an acute care hospital for 3 nights (e.g. if they went home from hospital and they are finding they need more care, they can directly enter a SNF if within 30 days of hospital discharge.
What must a SNF provide?
Services SNF must provide: (required)
- Rehabilitation services (OT/PT/Speech)
- 24 hour skilled nursing services
How often is the patient seen by a physician or midlevel provider at a SNF?
- Physician first visit within 30 days of admission
- Physician/Mid-level alternate every 30 days x 3 then every 60 days
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