Skilled Nursing Services for Enhanced Recovery

The Basics of Skilled Nursing Services

Skilled nursing services play a vital role in providing comprehensive care to individuals who require specialized medical attention and assistance with daily activities. These services are typically offered in skilled nursing facilities (SNFs), which are inpatient rehabilitation and medical treatment centers utilized for care after a hospital stay following an accident, severe illness, or surgery [1].

Understanding Skilled Nursing Facilities

Skilled nursing facilities (SNFs) are regulated by the U.S. Department of Health and Centers for Medicare & Medicaid Services (CMS). They provide a higher level of medical care compared to nursing homes and offer rehabilitation services to help patients regain their ability to perform activities of daily living [2]. These facilities are staffed with licensed health professionals, such as registered nurses (RNs), licensed practical nurses (LPNs), speech/language pathologists, and physical/occupational therapists, who deliver skilled nursing care under direct supervision [1].

Importance of Skilled Nursing Care

Skilled nursing care refers to the specialized care or treatment that can only be performed by licensed nurses or other qualified healthcare professionals. Skilled nursing services encompass a wide range of tasks and responsibilities, including administering medication, managing intravenous (IV) therapies, dressing wounds, monitoring vital signs, providing pain management, and assisting with various medical procedures.

The significance of skilled nursing care lies in its ability to provide comprehensive and individualized care to patients with complex medical needs. Skilled nurses are trained to assess patients' conditions, develop care plans, and communicate with other healthcare professionals to ensure comprehensive and coordinated care. They continually monitor patients' conditions, vital signs, and medical equipment, while also providing emotional support to patients and their families during the recovery process.

By receiving skilled nursing care in a specialized facility, patients can benefit from a multidisciplinary approach to their healthcare. Skilled nursing facilities not only provide medical care but also offer various therapeutic services, such as physical, occupational, and speech therapy, to help patients regain their independence and improve their quality of life.

In the next sections, we will explore the curriculum and benefits of the Skilled Nursing Facility Essentials Program, as well as delve into the coverage options for skilled nursing services, including insurance options and the difference between Medicare and Medicaid coverage.

Skilled Nursing Facility Essentials Program

To ensure the delivery of high-quality care in skilled nursing facilities, healthcare personnel can benefit from the Skilled Nursing Facility Essentials program. This certificate program, offered by MedBridge, aims to provide a strong foundation for nurses and healthcare personnel working in skilled nursing facilities.

Curriculum Overview

The Skilled Nursing Facility Essentials program offers a comprehensive curriculum that covers key topics relevant to care in skilled nursing facilities. The program consists of 15 hours of online video lectures and patient demonstrations, along with case-based quizzes to enhance clinical reasoning skills.

Topics covered in the program include:

• Overview of regulatory processes in skilled nursing facilities
• Roles and responsibilities of nurses in healthcare teams
• Assessment of risk factors in older adults
• Physical assessment of older adults
• Nursing delegation in long-term care settings
• Safe patient care practices
• Communication and teaching skills in long-term care

By completing this program, nurses, therapists, certified nursing assistants, and qualified medication aids working in skilled nursing facilities, as well as those in acute care and home care settings, can enhance their knowledge and skills in providing quality care to older adults.

Benefits for Healthcare Personnel

The Skilled Nursing Facility Essentials program offers several benefits for healthcare personnel. By completing this program, healthcare professionals gain a strong foundation in the principles and practices of skilled nursing care. The program equips them with the necessary knowledge and skills to deliver competent and safe care to the older adult population.

Some of the benefits of the program include:

• Enhanced clinical reasoning skills through case-based quizzes
• Access to online video lectures and patient demonstrations for a comprehensive learning experience
• Home exercise program (HEP) resources for patient education
• Increased understanding of regulatory guidelines and processes in skilled nursing facilities
• Improved communication and teaching skills in long-term care settings
• Expanded knowledge of risk factor assessment and physical assessment of older adults

By completing the Skilled Nursing Facility Essentials program, healthcare personnel can enhance their professional development and contribute to the provision of high-quality care in skilled nursing facilities.

Skilled nursing services offered in these facilities encompass various aspects of care, including comprehensive care services and specialized therapy programs. The responsibilities of licensed nurses and the collaborative nature of the healthcare team further contribute to the effective delivery of skilled nursing care. The certification and accreditation of skilled nursing facilities, such as those provided by the Joint Commission, ensure adherence to quality standards in nursing care.

Coverage of Skilled Nursing Services

When considering skilled nursing services, it's important to understand the insurance options available to cover the cost of care. Two common insurance programs that provide coverage for skilled nursing care are Medicare and Medicaid.

Insurance Options for Skilled Nursing Care

Private medical insurance policies generally cover short-term stays at skilled nursing facilities due to medical necessity, but they usually do not cover long-term care. However, long-term care insurance policies can be added to existing coverage or applied for separately to cover long-term care expenses.

Medicare vs. Medicaid Coverage

Medicare is a federal health insurance program primarily available to individuals aged 65 and older. Medicare covers short-term rehabilitation and recovery at skilled nursing facilities for up to 100 days. During the first 20 days, Medicare provides full cost coverage, and for days 21-100, there is a daily cost that can range from $170 to $185. After day 100, all costs become the responsibility of the patient. It's important to note that Medicare does not cover long-term care at skilled nursing facilities [5]. Medicare Part A covers inpatient hospital care, including skilled nursing facility stays, rehabilitation center stays, hospice care, and certain home healthcare services [6].

Medicaid, on the other hand, is a joint federal and state program that provides healthcare coverage to individuals with low income. Medicaid covers long-term care at skilled nursing facilities without a time limit on coverage periods. This coverage includes room and board, necessary therapies, medical devices, personal care items, and more. Unlike Medicare, Medicaid is available to individuals below a certain income level, not just senior citizens [5].

It's important to review your insurance coverage and understand the specific criteria, limitations, and requirements of your insurance plan regarding skilled nursing services. Additionally, different states may have variations in Medicaid eligibility and coverage, so it's crucial to consult with your local Medicaid office for detailed information.

By understanding the insurance options available, you can make informed decisions regarding the coverage of skilled nursing services. Whether you rely on Medicare, Medicaid, or private insurance, it's essential to assess your needs and choose the option that best suits your situation.

Services Offered at Skilled Nursing Facilities

Skilled nursing facilities offer a range of services to meet the diverse needs of their residents. These services are provided by a team of skilled healthcare professionals who are trained to deliver comprehensive care and specialized therapy programs.

Comprehensive Care Services

At skilled nursing facilities, comprehensive care services are designed to address the individual needs of each resident. These services may include:

• Custodial care: Assistance with activities of daily living, such as bathing, dressing, and grooming.
• Nutrition therapy: Provision of healthy, nourishing foods tailored to address personal dietary needs and support optimal health [7].
• Wound care: Treatment and care of wounds resulting from various causes, including amputation, accidents, illness, or surgery. This also includes prevention, detection, and treatment of pressure ulcers, skin tears, and bruises.
• Cardiac care: Specialized care for individuals with heart conditions, including monitoring, medication management, and cardiac rehabilitation.
• Pulmonary rehabilitation: Rehabilitation programs for individuals with respiratory conditions, focusing on improving lung function and overall respiratory health.
• Post-stroke recovery: Specialized therapies to help individuals recovering from a stroke restore mobility, improve speech and swallowing, and relearn skills necessary for daily tasks.
• Pain management: Assessment and treatment of pain to ensure resident comfort and well-being.

Specialized Therapy Programs

Skilled nursing facilities also offer specialized therapy programs to help residents achieve their optimal level of functioning and independence. These programs may include:

• Physical therapy: Rehabilitation programs designed to improve mobility, strength, and balance. Physical therapists work closely with residents to develop personalized treatment plans.
• Occupational therapy: Therapy aimed at helping individuals regain or develop skills necessary for daily activities and independent living. Occupational therapists focus on enhancing functional abilities and promoting independence.
• Speech therapy: Evaluation and treatment of communication and swallowing disorders. Speech-language pathologists work with residents to improve speech, language, cognition, and swallowing abilities.
• Intravenous (IV) therapy: Administration of medications, fluids, or nutrition intravenously.
• Injections: Administration of medications through injections as prescribed by healthcare professionals.
• Catheter care: Management and care of urinary catheters to prevent infections and ensure proper functioning.
• Continual monitoring of medical signs: Regular monitoring of vital signs, such as blood pressure, heart rate, and oxygen levels, to ensure the well-being of residents.
• Use of medical equipment: Expertise in the use of medical equipment, such as ventilators, feeding tubes, and mobility aids, to support the care needs of residents.

These services provided at skilled nursing facilities ensure that residents receive comprehensive care and access to specialized therapies tailored to their specific needs. The skilled nursing staff works collaboratively to deliver these services and promote the overall well-being and recovery of residents.

Role of Skilled Nursing Staff

Within skilled nursing facilities, the skilled nursing staff plays a crucial role in providing high-quality care to residents. This section will explore the responsibilities of licensed nurses and the collaborative nature of the healthcare team within these facilities.

Responsibilities of Licensed Nurses

Licensed nurses are at the forefront of delivering skilled nursing services. They are responsible for a wide range of tasks and duties aimed at ensuring the well-being and health of residents. Some of their key responsibilities include:

• Administering medications: Licensed nurses are trained to administer medications and monitor their effects on residents. They follow prescribed medication schedules and ensure residents receive the correct dosages.
• Managing medical procedures: Licensed nurses are skilled in performing various medical procedures such as wound care, IV therapy, and catheterization. They follow strict protocols to maintain a sterile environment and prevent infections.
• Monitoring vital signs: Licensed nurses regularly monitor residents' vital signs, including blood pressure, heart rate, and oxygen levels. They assess any changes or abnormalities, promptly reporting them to the healthcare team for further evaluation.
• Developing care plans: Licensed nurses work closely with physicians and other healthcare professionals to develop individualized care plans for residents. These plans outline specific goals, interventions, and strategies to address residents' unique needs.
• Collaborating with healthcare professionals: Licensed nurses collaborate with physicians, therapists, and other members of the healthcare team to ensure comprehensive and coordinated care. They communicate vital information, share updates on residents' conditions, and contribute to interdisciplinary care discussions.

Licensed nurses play a vital role in assessing residents' conditions, identifying potential complications, and providing early intervention to prevent the progression of health problems. Their expertise and dedicated care contribute to the overall well-being and recovery of residents.

Collaborative Healthcare Team

Skilled nursing facilities operate as collaborative healthcare teams, where licensed nurses work alongside other healthcare professionals to provide comprehensive care. This team-based approach ensures that residents receive the highest level of medical attention and support.

The healthcare team within skilled nursing facilities may include:

• Physical therapists: These professionals specialize in helping residents regain or improve their physical abilities through targeted exercises and therapies. They collaborate with licensed nurses to develop personalized rehabilitation plans.
• Occupational therapists: Occupational therapists focus on enhancing residents' ability to perform daily activities and regain independence. They work closely with licensed nurses to address functional limitations and develop adaptive strategies.
• Speech and language pathologists: These professionals assist residents with speech, language, and swallowing difficulties. They collaborate with licensed nurses to implement strategies for effective communication and safe eating.
• Other medical professionals: Skilled nursing facilities may also employ social workers, dietitians, and pharmacists who contribute to the overall care and well-being of residents.

Through effective collaboration and communication, the healthcare team ensures that residents receive comprehensive and individualized care. This multidisciplinary approach allows for a holistic understanding of residents' needs, resulting in improved outcomes and enhanced recovery.

In skilled nursing facilities, the role of licensed nurses and the collaborative efforts of the healthcare team enable the delivery of skilled nursing services that support residents' health, well-being, and recovery. Their dedication and expertise contribute to the overall success of these facilities in providing high-quality care to those in need.

Certification and Accreditation in Skilled Nursing

Certification and accreditation play a vital role in ensuring the quality and standard of care provided in skilled nursing facilities. These certifications provide an assurance to patients, families, and healthcare professionals that the facility meets specified criteria and maintains a commitment to excellence in nursing care.

Joint Commission Certifications

The Joint Commission is a renowned organization that offers certifications and accreditations for various healthcare settings, including skilled nursing facilities. For nursing care centers, The Joint Commission provides several certification options to address different aspects of care.

• The Nursing Care Center Accreditation program combines a patient- and resident-centered quality framework with collaborative on-site evaluation. It helps facilities identify and address vulnerabilities to safeguard patients and residents [8].
• The Corporate Advantage for Nursing Care Centers program is designed for multi-facility nursing care corporations. It focuses on identifying processes and systems across sites that impact quality or safety, providing coordinated access to Joint Commission personnel and accreditation resources.
• The Post-Acute Care Certification addresses the unique care needs of higher acuity or short-stay patients. It emphasizes effective care transitions to minimize the risk of unnecessary hospitalizations.
• The Memory Care Certification focuses on improving care for patients and residents with cognitive impairment. It addresses safety of the environment, specialized care and service programming, advanced staff training, and availability of support groups for families [8].

These certifications by The Joint Commission demonstrate a facility's commitment to meeting rigorous standards and continually improving the quality of care provided to patients and residents.

Quality Standards in Nursing Care

Quality standards are a crucial aspect of skilled nursing care. Accreditation bodies, such as The Joint Commission, develop and enforce these standards to ensure that nursing facilities adhere to best practices and provide excellent care.

Quality standards cover a wide range of areas, including but not limited to:

• Patient Safety: Ensuring a safe environment, implementing infection control measures, and preventing medication errors.
• Clinical Care: Delivering evidence-based care, monitoring patients' conditions, and managing chronic illnesses effectively.
• Staff Competency: Ensuring that staff members are qualified, trained, and competent in providing care to patients and residents.
• Care Transitions: Facilitating smooth transitions between different levels of care and ensuring continuity of care.
• Patient and Family Engagement: Involving patients and their families in care planning, decision-making, and setting goals.

By adhering to these quality standards, skilled nursing facilities demonstrate a commitment to delivering high-quality care and promoting positive outcomes for their patients and residents.

Accreditation and adherence to quality standards are important considerations when selecting a skilled nursing facility. They provide reassurance that the facility has undergone rigorous evaluation and meets the necessary criteria to provide exceptional nursing care.

References

[1]: https://www.hebrewseniorlife.org/blog/difference-between-nursing-homes-and-skilled-nursing-facilities‍

[2]: https://www.harrogatelifecare.org/news/skilled-nursing-care-what-is-it/

‍[3]: https://www.springhills.com/resources/skilled-nursing-services

‍[4]: https://www.medbridge.com/certificate-program/23173-skilled-nursing-facility-essentials/

‍[5]: https://www.bellavistahealth.com/blog/2021/5/21/does-insurance-pay-for-skilled-nursing-facility-care

‍[6]: https://www.healthline.com/health/does-medicare-cover-skilled-nursing-facility

‍[7]: https://www.bellavistahealth.com/blog/types-of-services-offered-at-a-skilled-nursing-facility

‍[8]: https://www.jointcommission.org/what-we-offer/accreditation/health-care-settings/nursing-care-center/learn/accreditation-options-and-certifications/