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Medicare will cover skilled care with the following requirements:
- You have Part A and have days left in your benefit period.
- You have a qualifying hospital stay.
- Your doctor has decided that you need daily skilled care given by, or under the direct supervision of, skilled nursing or therapy staff. If you’re in the SNF for skilled rehabilitation services only, your care is considered daily care even if these therapy services are offered just 5 or 6 days a week, as long as you need and get the therapy services each day they’re offered.
- You get these skilled services in a SNF that’s certified by Medicare.
- You need these skilled services for a medical condition that was either:
You need these medical services for:
- A condition that was treated during a 3 day qualifying hospital stay
- A condition that started during SNF care for a condition that was treated during a 3 day qualifying hospital stay
You pay:
- Days 1–20: $0 for each benefit period.
- Days 21–100: coinsurance is due per day of each benefit period. (**See the Business Office Manager for the exact amount)
- Days 101 and beyond: all costs.
Daily rate for skilled nursing care include room and board:
- Three meals per day served in main dining or rehabilitative dining areas
- Tray service, plus snacks
- Special diets upon physician order
- Daily assistance with activities of daily living (ADLs), i.e., dressing, bathing, ambulation, personal hygiene and needs
- Daily housekeeping service
- Bed and bathroom linens (less incontinent care linens)
- Administration of medications as prescribed by either attending/alternate physician
- 24-hour supervision by licensed nursing personnel (R.N. or L.P.N.) and Certified Nursing Assistants
- Assistance with feeding
- Planned activities
- Recreational and occupational programs
- Drug regimen review
- Social services consultation
- Discharge planning and referral service
- Rooms furnished in accordance with state and federal regulatory agencies
PLEASE NOTE: THE DAILY ROOM RATE DOES NOT INCLUDE THE FOLLOWING: PHYSICIAN VISIT CHARGES, DENTIST VISIT CHARGES, MEDICATION AND SUNDRY ITEMS, RESIDENT CARE MEDICAL SUPPLIES AND MATERIALS, INCONTINENT CARE SUPPLIES/LINENS, SPECIAL PHYSICIAN ORDERED THERAPIES SUCH AS PHYSICAL THERAPY, OCCUPATIONAL THERAPY, RESPIRATORY THERAPY, DIAGNOSTIC TESTS, AND OTHER SPECIALIZED CARE PROCEDURES, ETC.
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