Skilled Nursing Facilities – provide patients with a much needed intermediary step between discharge from a hospital and returning home or to a residential or community environment. Patients who suffered acute illnesses are often referred to skilled nursing facilities to receive physical/occupational/speech therapy and other rehabilitative services. Skilled nursing facilities are staffed with physicians, nurses, and caregivers, and with the exception of Home Health, there are no other alternatives that provide that level of expertise. Furthermore, skilled nursing services are covered by Medicare with generally no out of pocket expense to the patient. But the clinical environment can be stressful and unpleasant, and unfortunately because of the setting, some patients experience pessimistic emotions toward their rehabilitation and even additional health complications other than the condition that caused their stay in the first place. This is generally a function of low caregiver to patient ratios at nursing facilities.

It is not uncommon that some people are caught off-guard when they expect to be entitled to the full 100-120 days’ of Medicare-covered nursing services, but then their rehabilitation reaches a “plateau.” It is at that point when the nursing facility deems that no further improvement can be made for the patient’s rehabilitation, and the facility cannot justifiably seek reimbursement for their services from Medicare or other health insurance providers. The most organized of skilled nursing facilities are able to provide advance notice to patients and their families that the rehabilitation plateau is approaching. Some skilled nursing facilities are open to allowing the patient to stay on a private-pay basis, as an Intermediate (Nursing) Care patient.

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For a list of Skilled Nursing Facilities in Hawaii, please visit the Office of Health Care Assurance Medicare Section website.