Life & Order: My Parent's Health is Declining. What Now?

Prepared. Aware. Ready.

LO Sprenger0220

February 2020 Issue
By Mariah Navarre & Emily Fairchild

What is skilled nursing? Skilled nursing is a collection of services, including, but not limited to, nursing, physical therapy, occupational therapy and speech therapy. These services are aimed to return a patient back to their prior level of functioning before an injury, or illness.

How do I qualify for a skilled nursing stay? If you are admitted into the hospital, or have had a recent stay in the hospital in the last 30 days, and you and your medical team agree that you need 24-hour nursing care and rehabilitation prior to returning home, then you may be a good candidate. Your hospital case manager, or the case manager at the facility you choose, can run your insurance and let you know if you qualify. To qualify for skilled nursing benefits from Medicare, the patient must have a 3-night stay at a hospital before being covered. If the patient has a managed care insurance, a pre-authorization is required.

Does insurance cover a skilled nursing stay? Many insurances will provide partial coverage up to 100 days. Your parent’s insurance company should be able to provide information about availability of length of stay and co-pays. 

Does long term care insurance cover a skilled nursing stay? The long term care policy that your parent has determines if it will cover skilled nursing care. Your provider should be able to tell you what your policy covers. 

What is the difference between assisted living and skilled nursing? Assisted living is more of a permanent residence, where residents do not require 24-hour nursing care, but do require supervision with anything from activities of daily living to medication administration. Skilled nursing is more of a temporary acute healthcare setting, where residents require constant nursing care and therapy. 

Does skilled nursing or assisted living take the place of the hospital? No. Neither are the same as a hospital, and if you need to go to the hospital, you are encouraged to go. A hospital provides a higher level of care than skilled nursing or assisted living. 

Is there one floor plan for skilled nursing and assisted living? No. There are various floor plans for both skilled nursing and assisted living with varying prices so you can find the one that fits your parent’s budget and lifestyle. There is no one-size-fits-all facility, so it is best to explore different options before choosing a place where your loved one feels most comfortable. 

Want to learn more? If you have any further questions, or would like to set up a tour at Sprenger Health in Port Royal, SC, please contact: Emily Fairchild, Assisted Living Administrator at 843-781-7721 or Mariah Navarre, Director of Admissions & Marketing at 843-781-7702. 

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