Nursing Home versus Skilled Nursing Facility: Is there a Difference?

Friday, May 11, 2018

Nursing Home versus Skilled Nursing Facility: Is there a Difference?

Written by Malman Law, reviewed by Steve J. Malman.

When you look for a nursing home for a loved one, you may be perplexed at the number of options. Today, you have a few senior nursing facilities and deciding on the right one can be a challenge. You know of nursing homes, because those are the more familiar option.

While you may assume there is one type of nursing home, you will soon realize there are two different types. These two are rather distinct; therefore, it is important you understand how skilled nursing varies from nursing homes before selecting one for your loved one.

The terms are often used interchangeably, but these nursing home types are extremely different from one another.

The Regulations Governing Nursing Home Facilities in Chicago

One important difference is how these facilities are regulated. The national government does not have a regulation for nursing homes. Instead, every state’s Department of Health oversees nursing home facilities and combines them with regulators from the U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services (CMS). They then work to regulate and oversee nursing homes.

How are Regular Nursing Homes Regulated?

Nursing homes have inspections known as CMS surveys. These are used to look for violations and safety threats to residents. The administrator assesses their received survey and will create a plan of correction for the DHS authorities to review. If they fail to fix what they propose, they may face fines or have their license revoked.

How are Skilled Nursing Homes Regulated?

Skilled nursing facilities are federally regulated. The U.S. Department of Health and CMS take a more comprehensive approach to reviewing and regulating these facilities compared to regular nursing homes. That is because a skilled home has an experienced medical staff including registered nurses and physicians. Nursing homes often have custodial care, which does not require the same regulations.

What is Skilled Nursing Home Care?

Skilled nursing homes are exactly as they sound. They have professionals on-site and there regularly taking care of loved ones. The staff in these facilities are permanent, and they are not brought in as-needed. Instead, you can expect one of the following on-site always:

• Panel of medical directors
• Audiologist
• Licensed nursing
• Registered nursing
• Speech and language therapists
• Vocational nurses
• Licensed physicians

These professionals are not found in a nursing home regularly. They are available daily to skilled nursing home residents, and they will provide them with a safe, comfortable environment that caters to their disability, illness, or just complications associated with aging.

Skilled Nursing Care in a Home

Sometimes, skilled nursing home care is done at the patient’s home; instead of a facility. These services are provided by registered nurses or therapists. The service must be prescribed by a physician to have the services covered by Medicare – or at least a portion of it.

Skilled Nursing Care in Assisted Living

Some assisted living facilities will offer skilled nursing care. When registered, residents will have a care plan created by a licensed, registered nurse and the team at the facility will follow that plan. They have personal care and nursing staff there around the clock, but the supervision is not as in-depth as a regular skilled nursing home facility.

What is a Regular Nursing Home?

Traditional nursing homes do not provide specific types of services to specific patients. Instead, they provide generalized custodial care. Residents in a nursing home still receive excellent care, but that care is not medically focused. Therefore, nursing homes are best for residents who need assistance, but do not have specific medical needs.

A nursing home does not have a limit on how long a resident can stay either. Skilled nursing home does. Medicaid and Medicare do not pay for nursing homes; therefore, there is no financial assistance or limitations in that respect.

Nursing homes are often a permanent residence, while skilled nursing care is used temporarily. In some cases, skilled nursing homes can be used for end-of-life care, but it depends on the patient’s situation.

Because the service is less medical-based, the services your loved one would receive at a typical nursing home include:

• Help with daily hygiene needs
• Providing meal services
• Offering housekeeping
• Providing general care
• Assisting residents with mobility issues
• Offering transportation
• Assisting with toileting
• Helping patients dress

Nursing homes provide adults with daily care and assistance so that they are safe, healthy, and happy. The care is often customized to the resident’s level of mobility and special medical needs.

Medical Coverage for Both

The biggest difference between skilled nursing care and nursing homes is the coverage. Medicare and Medicaid do rely on 24-hour care for residents as a medically necessary cost and part of coverage. However, they do not cover every aspect.

Paying for nursing home options often relies on a person setting up long-term care insurance policies beforehand. Sometimes, these facilities are paid for from a savings account where money was set aside to pay for long-term care.

Most residents use Medicare or Medicaid. These programs look at the resident’s income and assets, then determine if they fall within the state-assigned limits.

Skilled Nursing Receives Medicare and Medicaid

Skilling nursing facilities are regulated by Department of Health, while nursing homes are not. Therefore, they have regulatory requirements and Medicare personally ensures these facilities meet qualifications. The care at a skilled nursing home, such as medical attention, physical therapy, and administering medications requires more skill. Medicare will cover treatment in a skilled nursing facility for up to 100 days. Some seniors stay longer, but if you must stay past the 100-day mark it will be from your own pocket or other long-term care insurance policies.

Medicare does not cover traditional nursing homes, because they lack the regulations that skilled nursing facilities provide.

Skilled Nursing Care is Short-Term

Another key difference is the longevity. Skilled nursing homes are not meant for long-term care. Instead, a resident will stay there until they are medically able to move back to a traditional nursing home. For example, a patient is released from the hospital and may be prescribed skilled nursing until they recover from an illness and then can move toward long-term nursing home care once again.

Residents may also move from a nursing home into a skilled nursing facility for a short period recovering from an injury, illness, or surgery. Then, after they have been rehabilitated they move back to their original nursing home.

What if a Resident Needs Long-Term Skilled Care?

Some skilled nursing homes offer long-term care. After all, there are some residents who may not be expected to recover enough to move back to a traditional nursing home. In these instances, you would want to see if the nursing home you pick offers skilled care long-term or if they are a short-term care facility.

Most long-term care facilities will have respiratory therapists and other services on-site. Long-term facilities are typically combined with a nursing home so that they can care for patients longer than the short period of a typical skilled nursing home.

Safety and Hazards in Skilled Nursing Homes versus Typical Nursing Homes

One key difference to note is the risk factor. A skilled nursing home is subject to heavy scrutiny by the state and federal government. They must meet specific regulations, inspected regularly, and hazards are caught and corrected faster than a typical nursing home.

State nursing home inspections, unfortunately, understate the issues found in nursing homes, including present dangers. While government oversight has seen improvements over the past few years, the health and safety violations of state nursing homes are still astounding and unacceptable.

Therefore, if you are looking at a typical nursing home, make sure you research the inspection history, complaints, and choose one that puts themselves above the minimum state-required standards for health and safety.

The New Inspection Process

A new inspection process was initiated November 28, 2017. However, it may take a few years for all nursing homes registered to undergo the new inspection due to the sheer volume of nursing homes in the country.

The findings from inspections for one year will not be used to calculate the star rating of nursing homes. And ratings may not always reflect the most recent inspection until the government can catch up on all inspections. However, these new health and safety inspection requirements are designed to reduce the number of neglect and abuse cases in typical nursing home facilities as well as skilled nursing homes registered in Illinois and the rest of the country.

When Abuse or Neglect Happens, Contact an Attorney

Despite your efforts to research and find the right facility, your loved one suffered a serious injury or illness due to neglect or abuse. You can hold that nursing home accountable and prevent the same from happening to others by reporting it and contacting an attorney at Malman Law.

Our team will advocate for your loved one, help you receive the compensation you deserve, and protect others from receiving similar treatment.

To get started, meet with one of our advocates today by calling 888-625-6265 or request a free consultation online today.