doctor explaining diagnosis to his female patient

Skilled Nursing Requirements for Admission

Are you or a loved one in need of ongoing medical care beyond what your family or an assisted living community can provide? If so, you might be a candidate for a skilled nursing facility (SNF) where a team of professional, certified nurse aides can oversee your treatment and help get you back on your feet as soon as possible. But, how do you know if you’re a good candidate for skilled nursing? What assessments are required for patients being admitted to a skilled nursing facility? And if you meet the skilled nursing facility admission criteria, can a skilled nursing facility refuse admission to a patient? In this article, we’ll answer all of these questions and more!

What Qualifies as a Skilled Nursing Need?

Skilled nursing refers to care that is only able to be safely and effectively performed by (or under the supervision of) medical professionals or other certified staff. Skilled nursing needs are those that require 24-hour monitoring or other specialized therapeutic programs, including(but not limited to):

  • Physical, occupational or speech therapy
  • Medication management/administration
  • IV or intramuscular injections or IV feeding
  • Enteral feeding (or tube feeding)
  • Tracheostomy care
  • Advanced or complex wound care
  • Rehabilitative treatments (e.g., bowel and bladder training programs)

If your needs require a skilled nursing stay, your doctor will make a recommendation to have you placed in a qualified skilled nursing facility, like Lakeland Rehabilitation & Health Care Center, where a team of professionals will evaluate your needs to ensure they develop the best treatment program to help you meet your health goals.

Skilled Nursing Admission Assessments

If you are admitted to a skilled nursing facility and you are covered by Medicare, there are specific assessment requirements to guarantee your coverage for the benefit period. The first assessment must typically be recorded for Medicare within the first 8 days of your stay; following the initial assessment, you’ll likely have daily informal assessments, with formal recorded assessments for Medicare on days 14, 30, 60 and 90 of your covered stay. The skilled nursing facility is required to complete these recorded assessments for Medicare until either you have been discharged or you have used all 100 days of your skilled nursing coverage in the benefit period.

These assessments include recording information about your current physical and mental condition, your medical history, any medications you are taking, how well you can perform the activities of daily living (ADLs, including bathing, dressing, eating, toileting, etc.), your speech and decision-making abilities, and your physical limitations.

Is it possible for a SNF to evaluate your needs and deny you care? Can a skilled nursing facility refuse admission to a patient? Unfortunately, the answer is yes. Because there is not a formal federal definition of level of care for a nursing home or SNF, it is up to each state to decide what that definition encompasses. Typically, however, SNFs evaluate patients in the following four major categories when it comes to level of care needs:

  • Physical functional ability (meaning, your ability to perform the activities of daily living)
  • Your specific health issues and medical needs
  • Specific issues relating to cognitive impairment (memory loss, or whether you can make safe or appropriate decisions without care or supervision)
  • Behavioral issues (such as issues with wandering, impulsivity and aggressiveness)

A SNF is not obligated to admit a patient if they do not feel they can meet the patient’s need; however, they cannot refuse to admit a patient based on discriminatory reasons, such as those based on race, national origin, disability, age or religion. A few reasons a facility may refuse to admit a patient include:

  1. The patient’s welfare cannot be met in the facility (e.g., the patient has advanced Alzheimer’s, and the facility does not provide memory care).
  2. The safety of other individuals or patients in the community is endangered by the patient’s admission.
  3. The health of other individuals or patients in the community is endangered by the patient’s admission.

Skilled Nursing at its Finest at Lakeland Rehabilitation

If you’re looking for a quality skilled nursing facility for yourself or a loved one, look no further than Lakeland Rehabilitation & Health Care Center. At our community, we offer numerous skilled nursing services as well as memory care, and everything we do is focused on YOU – your preferences, your lifestyle and all the things that make you happy. We’ll work together with your physician, family and specialty doctors to create a personalized health plan based on your individual health goals and needs, keeping you involved and informed throughout the care process.

Learn more about how our community can help get you back on your feet quickly. Give us a call at 217-342-2171 or set up a time to tour our community at a time convenient to you.