What is skilled care?

Skilled care is health care provided 24 hours a day by nursing and/or rehabilitation staff to manage, observe, and evaluate your care. It is for residents who need help with more than just daily living activities.

Why would I need skilled nursing or rehabilitation care?

You receive skilled care to improve your condition, maintain your current condition, or prevent your condition from worsening. Skilled care helps you function as independently as possible and/or learn to take care of your health needs.

Does Medicare pay for a nursing home stay?

Absolutely! If you require skilled care and meet the criterion below, Medicare pays for your stay.

How do I qualify for skilled care under Medicare?

ALL of the following must be true:

  1. You have Medicare Part A (Hospital Insurance)
  2. You have a “qualifying” hospital stay- an inpatient hospital stay of three overnights, three midnights, or more.
  3. Your doctor has decided that you need daily skilled care and writes an order for such care.
  4. You need skilled services for a medical condition that was treated during the qualifying hospital stay OR you are admitted to a Medicare-certified skilled nursing facility within a set time period, usually within 30 days of your hospital discharge.

How long does Medicare cover my skilled nursing care?

Medicare uses a period of time called a “benefit period” to keep track of how many days of skilled benefits you use. A benefit period includes 100 days of skilled nursing care plus 60 days of wellness. There is no limit to the number of benefit periods you may have. Once a benefit period ends, however, you must have another three-day qualifying hospital stay and meet the Medicare needs as qualified above.

Is a DNR the same as a Living Will?

No. A Do Not Resuscitate (DNR) is a request from family and/or loved ones to the physician requesting that they do not start basic life support if the patient stops breathing and/or the heart stops beating. A Living Will is developed by the resident and specifies which measures to take or not to take to extend life.

What are advance directives?

Advance Directives are documents that state a patient’s choices about treatment; including decisions about refusing treatment, being placed on life support, and stopping treatment at a point the patient chooses. It also includes requesting life-sustaining treatment if that is what is wanted.

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