What is the difference between a Skilled Nursing Facility and Nursing Facility?
The distinction is based on whether skilled care or custodial care is provided.
Generally, Medicare doesn’t pay for long-term care. Medicare pays only for medically necessary skilled nursing facility or home health care. However, the skilled nursing care and home health aide services are only covered on a part-time or “intermittent” basis. Patients must meet certain conditions for Medicare to pay for these types of care when they get out of the hospital. Most long-term care is to assist people with support services such as activities of daily living like dressing, bathing, and using the bathroom. Medicare doesn’t pay for this type of care called “custodial care.” Custodial care (non-skilled care) is care that helps patients with activities of daily living. It may also include care that most people do for themselves, for example, diabetes monitoring.
SKILLED NURSING FACILITY (SNF) DEFINED
- An SNF is an institution or a distinct part of an institution (see §201.1), such as a skilled nursing home or rehabilitation center, which has a transfer agreement in effect with one or more participating hospitals (see §201.2 for transfer agreements and §205 for definition of a participating hospital) and which:
Is primarily engaged in providing skilled nursing care and related services for residents who require medical or nursing care; or rehabilitation services for the rehabilitation of injured, disabled, or sick persons, and - Meets the requirements for participation in §1819 of the Social Security Act and in regulations in 42 CFR part 483, subpart B. A qualified SNF is one that meets all the requirements in the above definition. For Medicare purposes, the term SNF does not include any institution which is primarily for the care and treatment of mental diseases or tuberculosis.
NURSING FACILITY OR NURSING HOME DEFINED
A nursing facility or nursing home is residence facility that provides a room, meals, and help with activities of daily living and recreation. Generally, nursing home residents have physical or mental problems that keep them from living on their own. They usually require daily assistance.
The distinction is based primarily on whether skilled medical or nursing care or rehabilitation is required.
