Choosing a Skilled Nursing Facility

skilled nursingThere are many reasons why an older adult may enter a skilled nursing facility, including planned procedures, such as knee or hip replacement or cardiac surgery, or an unexpected health event. Knowing ahead of time what SNF to choose takes a lot of anxiety out of the process, leading to a more positive transition.

What Is a Skilled Nursing Facility?

Skilled nursing facilities (SNFs), also referred to as subacute rehab centers or nursing homes, provide round-the-clock nursing care and assistance with the activities of daily living. It has become increasingly common that SNFs are used for short-term stays after a hospitalization so that older adults can rehabilitate before returning home. SNFs differ from senior housing in that they provide a high level of medical care, supervised by a licensed physician. They offer a variety of amenities and services to help patients meet their care and rehabilitation needs including:

  • Skilled nursing care provided by RNs and LPNs
  • Physical and occupational therapy services
  • Speech-language pathology services including aphasia (communication) and dysphagia (swallowing) therapies
  • Respiratory therapy and pulmonary rehabilitation
  • Fall management and balance training
  • Tracheostomy care and airway maintenance
  • Medical social services
  • Dietary counseling

Skilled Nursing Facility Ratings

When researching skilled nursing facilities in your area, pay close attention to their Medicare 5-Star Rating (available at Medicare’s ratings are based on:

  • Health inspections
  • Staffing
  • Quality measures

A star rating is provided for each of these 3 categories, so you can see how each area scored. Then the 3 ratings are combined to calculate the facility’s overall rating.

While the Medicare star rating consists of a comprehensive inspection, performed by trained inspectors, there are some differences in how different states carry out the inspection process, even though the standards are the same across the country. There are also differences in state licensing requirements that affect quality. Make sure to visit each facility you are considering in addition to looking at their star rating to get a better overall feel for whether it is right for you or your loved one.

Visiting the Skilled Nursing Facility

Visiting skilled nursing facilities without scheduling an appointment can help you get a sense of how things are done on a daily basis. Take note of the following things during your visit:

  • Do you see anything about the facility or staff that makes you uncomfortable?
  • Do the patients appear content and well cared for?
  • What quality of life activities are available for residents?
  • Do you notice any odors or deodorizers that might be covering up odors?
  • Are call lights on for a long time before a nurse answers them?
  • What is the staff doing during your visit?
    • Do they make eye contact with you while you are on a tour?
    • Do they readily answer questions when asked?
    • How are they interacting with clients?
  • Do they have someone who can explain how services are paid for?
  • What types of therapies are offered?
  • What do clients do when they are not involved in physical therapy, speech therapy, occupational therapy, etc.?
  • What is their staff to client ratio?
  • What is the skill level of their staff?
  • How many RNs, LPNs and CNAs are on staff?
  • Are private telephone lines and TVs provided?
  • What types of meals are served? Can you see a sample menu?
  • When are visiting hours? Are there any restrictions?

In-home caregivers can provide assistance to clients while they are at a SNF and help them rest and adjust when they return home. Contact the expert home care staff at CareWorks Health Services to learn how we can assist you or your loved one during or after a stay in a SNF.

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Sources: Helpguide,, Centers for Disease Control and Prevention