Medicare will cover skilled care only if all of the following are true:
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You have Medicare Part A* (Hospital Insurance) and have days left in your benefit period.
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You have a qualifying hospital stay. This means an inpatient hospital stay of 3 consecutive days or more. You must enter the SNF within a short period of time of leaving the hospital.
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Your doctor has ordered the services you need for SNF care, which require the skills of professional personnel such as registered nurses, licensed practical nurses, physical therapists, occupational therapists, speech-language pathologists, etc.
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You require the skilled care on a daily basis and the services must be ones that can only be provided in a SNF on an inpatient basis.
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You need these skilled services for a medical condition that:
– was treated during a qualifying 3-day hospital stay, or
– started while you were getting SNF care for a medical condition that was treated during a qualifying 3-day hospital stay.
Daily rate for skilled nursing care includes room and board:
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Three meals per day served in main dining or rehabilitative dining areas
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Tray service, plus snacks
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Special diets upon physician order
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Daily assistance with activities of daily living (ADLs), i.e., dressing, bathing, ambulation, personal hygiene and needs
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Daily housekeeping service
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Bed and bathroom linens (less incontinent care linens)
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Administration of medications as prescribed by either attending/alternate physician
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24-hour supervision by licensed nursing personnel (R.N. or L.P.N.) and Certified Nursing Assistants
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Assistance with feeding
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Planned activities
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Recreational and occupational programs
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Drug regimen review
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Social services consultation
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Discharge planning and referral service
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Rooms furnished in accordance with state and federal regulatory agencies