Aging veterans with complex health issues often require skilled nursing care at home or in a skilled nursing facility.
Skilled nursing care is medical care provided by licensed health care professionals such as registered nurses (RN). The care can be short-term to help an individual recover from an illness or injury, or long-term for chronic medical conditions.
Types of skilled nursing care include:
- Wound care
- Respiratory care
- Brain and spinal cord injury care
- Pain management
- Prevent/reduce infections
- Diabetes care
- Catheter and colostomy care
- Parkinson’s disease care
- Prevent/reduce pressure sores
- Stroke or cardiac recovery
- Terminal illness care
- Ventilator and tracheotomy care
- Care for fractures or joint replacements
- Help with medical equipment and supplies
- Intravenous or intramuscular injections and intravenous feeding
- Tube feedings
- Monitoring vital signs
- Care plan management
- Patient observation and medical assessment
Short-Term Skilled Nursing Care
When a senior who has been hospitalized due to an illness or injury nears the end of their stay, an assessment will be conducted to determine if more time is needed for recovery. If the person needs additional care to regain their strength and abilities, rehabilitation (rehab) services will often be prescribed, such as skilled nursing care and various therapies. The services are generally provided by the hospital if the treatment is only for a few weeks. Other locations can include an outpatient rehab center, a skilled nursing facility or at home.
Long-Term Care Skilled Nursing Care
Skilled nursing facilities (SNF) are residential communities that provide long-term care to individuals with chronic health problems. Some facilities specialize in a particular type of care, such as Alzheimer’s disease and dementia.
The residents at a skilled nursing facility are closely monitored with around-the-clock access to nursing care. SNLs offer furnished private and shared rooms, along with many other services such as meals, housekeeping, laundry services, social activities, transportation; pharmaceutical, lab and radiology services and end-of-life hospice care.
Skilled Nursing Facility Staff
A skilled nursing facility will have a licensed physician on staff that supervises patient care. Other types of medical staff include nurses (registered nurses, licensed professional nurses (LPN) and licensed vocational nurses (LVN); certified nursing assistants (CNA), physical therapists, respiratory therapists and speech therapists. Aides help residents with personal care like bathing, dressing, eating, transferring and incontinence. SNLs will also have maintenance staff to keep the building and grounds clean and safe.
Licensing & Regulations
Most skilled nursing facilities are regulated by their state’s Department of Health Services and the U.S. Department of Health and Human Services Center for Medicare and Medicaid Service. The regulations cover resident care, staffing and the use of medical equipment, along with policies and procedures pertaining to facility operations.
Examples of federal regulations include:
- Having a sufficient number of nursing staff and adequate supervision
- Conducting a thorough assessment of the resident’s functional ability
- Creating care plans for each resident
- Providing assistance with daily living activities
- Preventing and healing pressure sores
- Ensure residents receive nutritious meals and sufficient fluids
- Provide treatment and devices for residents with vision and hearing impairments
- Maintaining the dignity and respect of each resident
Unannounced inspections are conducted at least once a year. If it is determined that the facility is in non-compliance with a regulation, the situation can be corrected by SNL administrators without penalty as long as the issue is not a threat to patient safety. If any situations are uncovered that are a threat to patient safety, various penalties can be imposed, such as fines and license suspension. Other types of penalties include appointing facility supervisors and suspending the admission of new residents.
The Nursing Home Reform Act
In 1986, a study of nursing homes found that residents were frequently neglected, abused and receiving inadequate care. In response to the findings, the 1987 Nursing Home Reform Act was passed into law. The act includes guidelines and standard for nursing home care. SNLs that receive state funding for Medicare and Medicaid services are required to comply with the quality of care criteria established by the NHRA.
Skilled Nursing Facility Costs
Skilled nursing facility care is the most expensive type of long-term care. The average cost of a room ranges from $6,844 per month (semi-private) to $7,698 per month (private).
How to Pay for a Skilled Nursing Facility
Medicare will usually cover a short-term stay in a skilled nursing facility (up to 100 days) for rehabilitation services following hospitalization. Individuals with low income who require long-term skilled nursing care may be able to qualify for Medicaid assistance. However, not all skilled nursing facilities accept Medicaid payments. The VA also has skilled nursing facility benefits for qualified veterans, spouses and surviving spouses.
Veterans Benefits Nursing Homes
Veterans benefits for long-term skilled nursing care include the VA Aid & Attendance pension and, for individuals enrolled in the VA health care system, VA nursing homes.
Aid & Attendance
Veterans, spouses and surviving spouses can get a special, tax-free benefit from the VA called Aid & Attendance to help pay for a skilled nursing facility. The veteran must have served 90 days of active duty with one day during an eligible period of war, but does not need to have a service-connected disability to qualify. There are several other benefit requirements, including needing help with at least two activities of daily living.
Aid & Attendance pays a maximum of $1,153 per month for a surviving spouse, $1,794 per month for a single veteran, $2,127 per month for a married veteran and $2,846 for two married veterans. It is a reimbursement for home or facility care, including a skilled nursing facility.
VA Nursing Homes
Some veterans may qualify for admission to a VA skilled nursing facility if they are enrolled in the VA health system. Eligibility requirements include the veteran’s service connected status, level of disability and income. The veteran may need to pay for part of the facility cost depending on their service-connected disability status and financial situation. The VA also contracts with community nursing homes to provide skilled care to veterans. Eligibility is based on the same criteria for admission to a VA nursing home.
Finding a Skilled Nursing Facility
Skilled nursing facilities can be found online through various registries and senior resource websites. Before visiting a facility, create a list of questions to ask regarding staffing, services, fees, and resident policies. When you’re at the facility, inspect the premises for cleanliness, safety and security. Also look around to see if the residents are happy and getting the help that they need.
If you would like to find out more about the VA Aid & Attendance benefit and how it can pay for skilled nursing care, call us today at 877-427-8065 and ask to speak to a benefit consultant.