Generally, during the first 20 days of care in a skilled nursing facility, Medicare will cover 100%. For days 21-100, a daily co-insurance rate is required. Medicare Part A covers skilled nursing care up to 100 days.
Medicare will cover skilled care only if all of the following are true:
- You have Medicare Part A* (Hospital Insurance) and have days left in your benefit period.
- You have a qualifying hospital stay. This means an inpatient hospital stay of 3 consecutive days or more. You must enter the SNF within a short period of time of leaving the hospital.
- Your doctor has ordered the services you need for SNF care, which require the skills of professional personnel such as registered nurses, licensed practical nurses, physical therapists, occupational therapists, speech-language pathologists, etc.
- You require the skilled care on a daily basis and the services must be ones that can only be provided in a SNF on an inpatient basis.
- You need these skilled services for a medical condition that:
– was treated during a qualifying 3-day hospital stay, or
– started while you were getting SNF care for a medical condition that was treated during a qualifying 3-day hospital stay.
Participating Insurance Companies
- Blue Cross
- Pacific Care
- United/Secure Horizons
- Worker’s Compensation
Daily Rates for Private Pay Skilled Nursing Care
The following room rates have been set by the Governing Body of Vineyard Post Acute:
$8625 per month for Semi-Private Accommodations
$8343 per month for a Four-bed Ward
Daily rate includes:
Room and board:
- Three meals per day served in designated areas
- Special diets upon a physician’s order
- Daily housekeeping service
- Administration of medications as prescribed by either attending/alternate physician
- Assistance with feeding
- Recreational and occupational programs
- Social services consultation
- Furnished rooms in accordance with State and Federal regulatory agencies
- Tray service, plus snacks
- Daily assistance with activities of daily living (ADLs), i.e., dressing, bathing, ambulation, personal hygiene and needs
- Bed and bathroom linens
- 24-hour supervision by licensed Nursing personnel (R.N. or L.V.N.) and Certified Nursing Assistants
- Planned activities
- Drug regimen review
- Discharge planning and referral service
PLEASE NOTE: The daily room rate does NOT include the following: Physician visit charges, dentist visit charges, medication and sundry items, resident care medical supplies and materials, incontinent care supplies/linens, special physician ordered therapies such as physical therapy, occupational therapy, respiratory therapy, diagnostic tests, and other specialized care procedures, etc.