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Skilled Nursing Care vs. Nursing Home: Differences & Similarities

Skilled nursing care is offered by professional nurses catering to patients who generally require short-term but sometimes also long-term nursing solutions. It provides high levels of nursing and medical care, intensive rehabilitation and 24-hour monitoring, often following acute hospital care because of surgery or severe illness or injury.  It can last for a few days or weeks, or in more serious cases, months.

Local nursing homes, on the other hand, can offer 24/7 skilled nursing and custodial care to people who do not need to be in hospitals, but demand more assistance than what they can get from contracting home health care agencies near them, or in other senior care options such as assisted living homes.

Skilled nursing facilities offer more of a permanent solution where seniors can access rehabilitative care, skilled nursing care, personal care, medical services as well as recreation in a safe and supervised environment.

To understand the two options better, here is a detailed comparison of nursing homes and skilled nursing care taking into account their similarities as well as differences.

Nursing Home vs Skilled Nursing: Ideal Candidates

Both nursing homes and skilled nursing care are put in place to help people who have various nursing needs. These can include:

•    Rehabilitation

•    Complex wound dressing

•    Tube Feedings

•    Cardiac and stroke recovery

•    Joint replacements

•    IV care

•    Injections

•    Rapidly changing health status

It is safe to say that skilled nursing care tends to look after the short term care of individuals, while nursing homes deal with long-term care. Typically people receive specialized nursing care before moving to traditional nursing homes when they recover. This said, ideal candidates for the skilled care from nurses would be people who are recovering from having surgery or have a condition that warrants intensive care until they feel better enough to go back to their ordinary lives.

For older adults who need 24/7 nursing care, they can benefit from at home skilled nursing services temporarily until they go to the nursing residences where they will continue getting the care they require.

Keep in mind that nursing homes are not only for aging individuals because they open their doors to all patients who can benefit from their services. Most often, however, senior citizens make up a high percentage of occupants in skilled nursing communities.

Nursing Home vs Skilled Nursing: Personnel

Only trained professionals, i.e. nurses administer skilled nursing care. It is the same for nursing homes, although in nursing homes, residents can get help with some other responsibilities such as help with day to day activities that caregivers without professional medical training can take care of. Professionals who offer skilled nursing care may include:

•    Medical directors

•    Licensed nurse practitioners

•    Registered nurses

•    Audiologists

•    Licensed vocational nurses

•    Language/speech therapists

While not all the above professionals may work in a nursing home, they may contact them to come in and offer their services when the residents require them. Staff one can expect in skilled nursing homes include recreational personnel, housekeeping, administration, nurses, and nursing aides.

Skilled Nursing vs Nursing Home: Services

Nursing homes do not only look after people who have injuries or severe medical conditions. A high percentage accommodate seniors who have dementia, Parkinson’s disease, Alzheimer’s or respiratory ailments. Personnel in these nursing communities also assist occupants with daily living activities. These include walking, maneuvering in and out of bed, dressing, bathing, eating, and personal hygiene. Others may also provide other services like:

•    Laundry services

•    Limited transpiration

•    Educational and social services

•    Laboratory, pharmaceutical, and radiology services

The above may not be possible when one is a benefactor of at-home skilled nursing care because the expert nurses may not be in a position to handle all the responsibilities. Additionally, residents in nursing homes may also work with other medical professionals. These can include physical therapists who collaborate with the patients to rectify balance and strength issues, speech therapists who help residents to reclaim the ability to communicate after suffering from a stroke and occupational therapists who work with the occupants to aid them in becoming independent again, especially with duties like personal hygiene, eating and dressing.

Note that at home skilled nursing care mostly does not include hospice or palliative care. Some nursing homes, however, include such services. This mainly applies to senior communities that provide continuing care, allowing an individual to remain in the community for the rest of their life if he/she wishes, even when medical needs change.

Skilled Nursing vs Nursing Home: Housing Options

When a person’s health condition is not too complicated, they can receive skilled nursing care in their homes. It is where nurses will visit their clients at home if need be to deliver the services that senior citizens require. It works out well in many situations, such as when all the older adult needs is medication reminders, administration, or wound care since the RN will not have to use any equipment from the hospitals.

In such scenarios, the nurses usually work with other caregivers to make sure that the person they are working with receive all the medical care services they need without complications.

Some professionals also take advantage of electro-modality technologies that assisted people with pain management or incontinence problems in their homes. Industry experts agree that being in a familiar and comfortable environment while undergoing nursing care can enhance the healing process.

In contrast, skilled nursing care facilities exist to help people get the nursing care they need when it is not possible, or they do not desire to receive specialized nursing care at home. They mainly focus on medical services; thus, it is not possible for a person to move in for an extended amount of time unless they need to receive extended medical care. Skilled nursing facilities treat patients and then release them when they are better and can take advantage of other housing options, such as living in their own homes or in local retirement communities near them.

With nursing homes, a majority have a residential setting where seniors or other people who need care can share rooms as they take advantage of the services they require. Some are even part of hospitals so that residents can easily access other professionals like doctors when they are in need. Occupants decide whether they want to have a roommate or reside in a private room. Private rooms, of course, are more expensive.

Living spaces in the nursing homes come with all the necessary modifications that help to make the lives of the patients a lot easier. These include grab rails in the hallways, handrails on steps, landings and ramps that promote safe entries and exits, and shower grab bars and held showers. Older adults who are also suffering from dementia may want to look into specialized dementia nursing homes near them that know how to handle all dementia stages properly.

Nursing Homes vs Skilled Nursing: Length of Stay

There are usually no time limits in regards to how long a person can stay in a nursing home. Seniors who cannot live at home or in any other long-term care option can make the establishments their permanent home. In addition to medical care, they also receive custodial care that non-medical professionals deliver.

With skilled nursing care, one does not usually need it for a very long time. Many patients do not receive this type of attention for more than three months because the situations that warrant this type of care are typically temporary.

Nursing Homes and Skilled Nursing: Medicare Coverage

Medicare or Medicaid can pay for staying in nursing homes in certain situations. Patients receiving skilled nursing care can benefit from Medicare cover even when it is only for a short period.

There are two requirements one must meet before Medicare pays for skilled nursing care. The first is that an older adult must have recently stayed in a hospital. The second stipulates that a professional doctor must verify that a person requires skilled nursing care on a daily basis.

With prior hospital stay, one must be in the hospital for three consecutive days without counting the day of discharge. Candidates must not have been held under observation as they must have been admitted to the medical facility. Additionally, the stay in a skilled nursing facility has to be within 30 days of discharge.

In regards to every day skilled nursing care, the requirement stipulates that an expert doctor must certify that an individual requires skilled rehabilitative or nursing care services.  The services rendered have to be related to the condition that made a person be in the hospital in the first place. 

Nursing Homes and Skilled Nursing: Costs

Because both skilled nursing care and nursing homes deal with medical services, they do not come cheaply. What residents pay for staying in nursing communities depends on a variety of factors. These factors include the type of facility one picks, the services they receive, amenities present, and location. The more luxury senior living communities that include nursing care as part of their care package will generally cost more.

Standard charges typically take account of services beyond board to include supervision, meals, housekeeping, and laundry. Extras may consist of additional nursing services and medication administration. Many facilities charge on a daily basis where a person could end up paying more than $100,000 annually.

A general rule with skilled nursing care is that the professionals delivering the services get paid by the hour. Most people under this arrangement may need up to 40 hours of care in a week. A patient may have to pay $20+ for every hour of service they receive, depending on the state they are in.

Nursing Homes and Skilled Nursing: Regulations

The Department of Health regulates institutions or professionals who are in charge of providing skilled nursing care. It is not the same case for nursing homes. These have extra regulatory requirements they have to meet. It includes transfer agreements with local hospitals in case patients need rehab or emergency care.

Nursing homes also go through inspections or surveys that evaluate any immediate threats or violations to the satisfaction and safety of patients. If there are any, administrators must assess the results of the study to implement a plan of correction. When they do not do it correctly, there are repercussions such as reappointment of supervisors, fines, or suspension of admission for new residents or the license of the facility.

Paying for Skilled Nursing Care and Nursing Homes

As aforementioned, Medicare pays for skilled nursing care for qualified individuals. It is essential to look up all the requirements to know if a person is an eligible candidate. The information is available online or from the relevant offices in the town or state you are in.

Medicare pays for care by registered nurses, semi-private room (two to four beds per room, all meals, and therapy including occupational, speech, and physical. It can also cover medical social services, prescription medication, some medical supplies and equipment, and transportation in an ambulance when other modes of traveling are dangerous to the policyholder’s health. Medicare will not cover a private room that is not necessary medically, a private duty nurse, and personal convenience items like telephone, radio, or television.

Seniors can also look up some Medicare Supplement plans which assist in paying for some of the expenses that the original plan excludes. The government does not offer this, but it standardizes the cover and allows private insurance companies to take over the responsibility of providing this to interested clients.

Because nursing home patients do not use Medicaid especially in the initial stages of their stay, residents majorly utilize personal resources to cover their residency. These can include savings and other investments that one may have. Some insurance firms also allow retirees to use life insurance cover the expenses of long-term care.

One does not have to suffer when they cannot afford nursing homes. Many programs help individuals with low income. Just visit a nearby aging office to get all details on the available options and the ones to apply for.

While seniors can benefit from the specific type of medical care with skilled nursing, it does not mean that it is for everyone. One has to carefully evaluate their needs and health condition to determine whether it is the best option for their situation.

Older adults who stay in nursing homes can be sure of receiving top-notch care that will allow them to thrive in their post-retirement years as they benefit from a combination of both custodial / personal care and medical services.

When unsure of the option to pick, it is advisable to consult with a professional physician or doctor who will assess the services that a person will require now and in the future. Planning and visiting a couple of facilities can help to put retired adult’s mind at ease while searching for the ideal long-term care solution.



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