What Qualifies a Patient for Skilled Nursing Care?

What Qualifies a Patient for Skilled Nursing Care?

Skilled Nurse helping patient lift weights

As the population ages, the demand for specialized healthcare services for seniors continues to grow. Among the various options available, skilled nursing care and rehabilitation play a crucial role in addressing the unique needs of older adults, especially those recovering from medical procedures or managing chronic conditions. 

If you have an older adult loved one in your life, or if you or a loved one may need rehabilitation in the future, you might be thinking about options for care needs. This blog is meant to help you understand how skilled nursing can benefit you or your loved one, as well as what qualifies a patient for skilled nursing care, the services offered, and the importance of this level of care for seniors.

What Is Skilled Nursing Care?

Skilled nursing care is a form of healthcare provided by licensed nurses and other medical professionals in a specialized community. They offer around-the-clock, 24/7 medical care for patients with various needs, including:

  • Post-operative recovery
  • Rehabilitative services
  • Physical therapy, speech therapy, and occupational therapy
  • Long-term medical conditions
  • Wound care
  • Intensive medical care
  • Injections
  • Vital sign monitoring

The services provided in skilled nursing are essential for addressing the complex healthcare requirements of seniors.

What Qualifies a Patient for Skilled Nursing Care?

To be eligible for skilled nursing care, patients typically need to meet specific criteria. One crucial factor is the requirement for a qualifying hospital stay. The Centers for Medicare & Medicaid Services (CMS) outline the criteria for a hospital stay to qualify for subsequent skilled nursing care.

Short- or long-term care by trained professionals is often called for after an illness or injury, or a planned elective procedure. Some medical conditions that could require skilled nursing for seniors are:

  • Cardiac failure
  • Chronic obstructive pulmonary disease (COPD)
  • Diabetes
  • Fall-related injuries
  • Hip or bone fractures
  • Orthopedic surgery
  • Parkinson’s disease
  • Stroke

Skilled Nursing Services

Skilled nursing care offers a range of services designed to meet the diverse needs of their residents. Below are just some of the many services they include.

Around-the-Clock Medical Care

Skilled nursing provides continuous medical care delivered by licensed nurses, ensuring that residents have access to professional assistance around the clock, 24/7 care.

Rehabilitative Therapies

The communities offer various rehabilitative therapies, including physical therapy, speech therapy, and occupational therapy, tailored to address the specific needs of each resident. These therapies play a crucial role in enhancing independence and improving overall well-being.

Private or Semi-Private Rooms

Skilled nursing prioritizes resident comfort and privacy by offering private or semi-private rooms. Here at Eastcastle Place, all our rooms are fully private. This accommodation option allows residents to maintain a sense of personal space while fostering a community atmosphere within the community.

Hospice Care

Skilled nursing is equipped to provide hospice care when needed. This specialized care ensures that residents with terminal illnesses receive the necessary support and comfort during their final stages of life.

home caregiver helping a senior woman using a walker at home - assisted living concepts

Personalized Care Plans

Patients in skilled nursing benefit from personalized care plans. These plans are meticulously crafted to address the specific medical conditions and requirements of each resident, ensuring a tailored and effective approach to healthcare.

Short-Term and Long-Term Care

Skilled nursing caters to both short-term and long-term care needs. Whether a resident is recovering from a specific medical procedure or requires ongoing assistance for a chronic condition, the focus on providing the appropriate level of care throughout the stay is a hallmark of skilled nursing services. This versatility ensures that seniors receive the necessary support, whether their stay is temporary or extended.

Paying for Skilled Nursing

Understanding how to pay for skilled nursing care is a common concern for seniors and their families. Fortunately, Medicare coverage often applies to skilled nursing services, provided certain criteria are met based on CMS guidelines for admission. 

It is essential to be aware of the duration of coverage and the need for a qualifying hospital stay to access these benefits. Alternative payment options such as long-term care insurance or private pay may be explored for longer-term care needs. At Eastcastle Place, we have specialists to assist you with this process.

Skilled Nursing at Eastcastle Place

If you or a loved one require skilled nursing care, Eastcastle Place can help. Our caring team will provide supportive, around-the-clock skilled nursing care in a positive and uplifting environment that encourages healing.

In addition, those within our skilled nursing program will enjoy a range of services and amenities, including:

  • Private suites with private restrooms
  • Restaurant-style dining
  • Engaging programming
  • Transportation for medical-related appointments
  • Housekeeping and laundry services
  • Access to a dentist, podiatrist, behavioral health services, optometry and audiology services

If you are interested in skilled nursing at Eastcastle Place, contact us to learn more about our services or to schedule a visit.