What Is Skilled Nursing Care, Assisted Living and a Nursing Home?
People typically use the words “skilled nursing, “assisted living” and “nursing home” interchangeably, but they’re actually all different terms.
Nursing home is a term used to describe the physical building where residents receive assisted living or skilled nursing care.
Assisted living is for seniors who don’t need around-the-clock nursing care but who could use help with activities of daily living (ADL). ADLs include assistance with eating, medication reminders, bathing, dressing and getting out of bed.
Skilled nursing care refers to a patient’s need for care or treatment that can only be performed by licensed nurses. This type of care is usually offered in hospitals, assisted living communities, Life Plan Communities, nursing homes and other certified locations. Skilled nursing is mostly regulated by the U.S. Department of Health and Centers for Medicare & Medicaid Services (CMS). To be certified by CMS, skilled nursing communities must meet strict criteria and are subject to periodic inspections to ensure quality standards are being met.
Types of skilled nursing care
If you or a loved one has had a stroke, surgery or extensive treatment for kidney, heart or respiratory conditions, they may still require rehabilitation at a skilled nursing community following their release from the hospital. Medicare will pay for skilled nursing services if a physician prescribes specialized therapies – physical and occupational therapy – medications, medical equipment and supplies, and social services, to help your loved one meet their health goals. However, to qualify, you must go to a Medicare-certified skilled nursing community.
Physical therapy: After an illness, surgery or hospitalization, a rehab care team will create a personalized plan for the most optimal outcome.
Occupational therapy: Help adapting to social and physical environments through specialized therapies for getting dressed, memory training and coordination exercises.
Speech therapy: Addresses communication issues and swallowing dysfunction. Speech and language pathologists design a treatment plan to help with language ability, provide alternate communication strategies and give appropriate diet recommendations.
Skilled nursing communities can offer a wide range of services and medical care: physical therapy, occupational therapy, speech-language pathology, wound care, intravenous (IV) therapy, injections and monitoring of vital signs and medical equipment.
Skilled nursing staff includes:
- Registered nurses
- Licensed practical nurses
- Speech/Language pathologists
- Licensed vocational nurses
- Medical directors
They also must have a transfer agreement with a hospital in case a resident requires emergency care.
Helpful tips and question to ask
As you evaluate all the possible care options, here are some helpful tips to get you started and important questions to ask before you decide.
- Reach out to people you trust to be unbiased – consultants, friends, family or a physicians – for their candid advice and recommendations.
- Once you have a list of care options, the state of New Jersey Report Card for Health Facilities has been replaced by the CMS-Five Star Quality Rating System. To compare your options, visit Nursing Home Compare webpage at Medicare.gov
- You can also check a community’s online reviews, but because personal reviews can be very objective, it’s important to weigh them with other information you’ve already collected.
- Once you’ve narrow down your list, start scheduling visits to your top communities. As you’re doing this, consider other important details, such as how they answer the phone, the time it takes for them to return messages and their helpfulness.
Even if you know the differences among the types of care available, it can be hard to know which skilled nursing community is best for you or your loved one. To help seniors, their families and caregivers compare different skilled nursing communities more easily, CMS created a Five-Star Quality Rating System that gives each community a rating between 1 and 5 Stars. A 5-Star rating signifies “much above average quality” care. A 1-Star rating represents “much below average quality.”
Taking a tour? Note the following:
- What are your impressions of the place?
- Does it look and smell clean?
- Does the staff smile and greet residents by name?
- Do the residents seem well cared for and happy?
- Could you imagine your loved one living here?
Some important questions to ask:
- Is there an entrance fee? If so, how much is it?
- What’s the monthly fee?
- What’s covered by the monthly fee? What’s not covered? (i.e., phone, cable TV, housekeeping, meals, health care)
- How much input do residents, family members and your family doctor have regarding your loved one’s care?
- Is there a calendar of resident activities?
- What’s their schedule for a typical day?
- Try the food. How is it?
- What’s the dining arrangement? Do residents eat in a dining room or in their rooms? Is it cafeteria-style or sit-down?
- What’s the visitation policy? Are there set hours, or are visiting hours open?
- What security safeguards are in place?
- How much notice is given before discharge?
- What happens if a resident runs out of money?
- What’s the staff-to-resident-ratio?
- What forms of insurance does the community accept?
If you’re unsure which type of skilled nursing care is best for you or your loved one, contact your doctor or physician to assess what services you’ll need now or in the future. Harrogate offers on-site independent living, rehabilitation and skilled nursing. If you’d like to learn more about Harrogate or discuss your care options, use our contact form or call 1-866-606-0178.