Pros and Cons of a Skilled Nursing Facility

There are plenty of options for where to live in later life, including remaining at home, moving to a senior apartment, joining a retirement community or moving to assisted living. Some seniors also spend time at a skilled nursing facility.

Each option has its own set pros and cons. For example, retirement communities provide seniors with neighbors of a similar age, but having few young people around can feel like a bit too much at times. Today, we’re looking at the pros and cons of a skilled nursing facility.

The topic is crucial, as skilled nursing facilities aren’t discussed nearly as often as options like nursing homes or assisted living. Yet, they can be the best possible choice for some seniors.

What is a Skilled Nursing Facility?

Let’s begin with definitions.

Assisted living provides seniors with support for the activities of daily living. Facilities tend to focus on being home-like and social wherever possible, helping seniors to feel safe and settled.

A nursing home is a step up, where staff provide medical care, rather than just supporting people with daily living tasks. As a result, nursing homes tend to be more expensive than assisted living facilities. They often have a more clinical feel to them as well.

A skilled nursing facility is the highest level of medical care that you can get outside of a hospital. Such facilities have a full-time staff of medical professionals, so there’s always someone on hand, even in the middle of the night.

However, while seniors may stay in nursing homes for multiple years, skilled nursing facilities are typically used as short-term rehabilitation centers. So, a senior will often spend less than a month at a skilled nursing facility after a fall, then return home.

Benefits of Skilled Nursing Facilities

They Provide Medical Support

We can’t talk about the pros and cons of a skilled nursing facility without touching on the obvious – the medical care. A skilled nursing facility does provide comprehensive medical care, often similar to what the senior would get in a hospital.

This support is critical.

After all, if a senior has a serious health condition or is recovering from an injury, they’re likely to need medical support.

The services provided include helping with diabetes management, blood transfusion, complex wound care and dressing, catheter care, and more. Many of these are tasks that family caregivers do not have the skills to do safely for their loved ones.

They’re An Excellent Transition Environment

Skilled nursing facilities help people to get back on their feet with health – acting as a bridge between the hospital and home. Indeed, many seniors will get discharged from hospital straight to a skilled nursing facility.

This is a useful approach, as hospitals aren’t the best environment for recovery. They focus on urgent care instead – and patients are often quite weak when they leave.

A skilled nursing facility helps to bridge the gap, so that seniors end up stronger and better able to support themselves before they go back home. Many even provide rehab services, which are perfect for seniors who have had a fall or a serious injury.

They Give Caregivers A Break

Caring for seniors at home quickly takes its toll. This is true even when they don’t need a large amount of support.

If the senior is at a skilled nursing facility, then you get a much needed break. Plus, they’ll only be referred to such a facility when their health has stabilized, so you don’t have much to be stressed about.

Disadvantages of Skilled Medical Facilities

A Hospital Stay is Normally Required First

Most of the time, a senior needs to have a 3-night hospital stay, then be referred to a skilled nursing facility. Some types of insurance may waive the hospital stay requirement, but this often won’t be the case.

There’s also no guarantee that the hospital will refer your loved one onto a skilled nursing facility. They may simply discharge the senior back home.

This is an area that some caregivers struggle with, especially if the senior needs more support than can be provided at home. The requirements for skilled nursing home entry also mean that your loved one may not be eligible, even if you think they should be.

They Can Be Confusing

It’s often not clear how long your loved one will be staying at a skilled nursing facility or the specific care that they’ll receive.

The average stay is somewhere around 20 days for Medicare Advantage patients and 38 days for Medicare patients. However, the length of stay may also be influenced by the specific facility, your loved one’s needs, and a variety of other factors.

You might find that the nursing facility wants to discharge your family member much earlier than you expect. This can be frustrating if they’re still not in good shape. You may not have much say in the matter either, especially if the decision is partly based on funding, rather than health.

The Quality Can Vary

Skilled nursing facilities can vary in quality, sometimes dramatically.

Some of them will be well-staffed, will respond to crises quickly, and will communicate well with family members. Other times, this isn’t the case at all.

The issue isn’t surprising. Healthcare staff are often overworked and underpaid. There may not even be enough staff to cope with the current patients, which can present serious problems when there is a crisis.

Skilled nursing facilities may also vary in their specialty areas. You’ll want one that has experience with whatever health problem your family member is dealing with.

You’ll often be able to choose the skilled nursing facility the senior visits – or at least express a preference. However, you will need to speak up. If you don’t make your opinions known, the facility may be chosen for you.

Private Rooms Aren’t Guaranteed

Some skilled nursing facilities provide private rooms. Other times, the senior may have to share a room.

Private rooms are normally best, as they give the senior privacy. Their sleep may be improved as well, as there will be no interruptions from a roommate.

If your loved one gets a good roommate, then sharing a room mightn’t be a big issue. However, this often isn’t the case. Many people have bad experiences with roommates, which makes their whole experience much more difficult.

Most of the time, insurance will only cover a private room if that’s all that is available. If the facility has a mixture of private and shared rooms, then the senior may end up in a shared room.

Some Are Part Of Chains

Some skilled nursing facilities are locally owned, while others are part of large chains that are often owned by a parent corporation.

Locally owned facilities tend to be better at customizing care, as they have less strict guidelines and staff don’t need to go up the ladder to get approval. There’s also the risk that individual needs slip through the cracks somewhat when seniors are at a chain-based skilled nursing facility.

They Won’t Always Be Appropriate

Skilled nursing facilities are most suitable for seniors who are recovering after an injury or a serious medical event. They may occasionally be used for longer stays, but this is less common.

They’re not well suited for seniors who are stable, but need regular help with the activities of living, like bathing or cooking. For such seniors, assisted living tends to be a better fit.

Seniors with intermittent health needs might instead benefit from returning home and using home health services. This way they get the health support that they need, within a familiar and comforting environment.

How Do You Pay For Skilled Nursing Facilities?

In talking about the pros and cons of a skilled nursing facility, we also need to highlight the financial side of things.

Short-term stays are often covered by Medicare, but this often just means a stay of 20 days or so. Even then, there are many criteria that need to be met and some seniors will not be eligible.

If the senior’s stay isn’t covered by Medicare or if they wish to stay behind the 20 days, the costs can quickly get extreme. Sometimes you may be paying around $220 per day – and that’s not even for a fully private room. After all, we’re talking about 24/7 care by skilled professionals. There’s no way such care would be cheap.

The cost of skilled nursing facilities is partly why loved ones may be discharged before you think they’re ready to be. Unfortunately, funding does still play a major role in the decision.

Is A Skilled Nursing Facility Necessary?

Seniors are generally sent to skilled nursing facilities because they need the medical support. This means that, most of the time, a skilled nursing facility is exactly what the senior needs.

Still, as we’ve highlighted, there are pros and cons to a skilled nursing facility. Sometimes such a facility mightn’t be the best choice, especially if the senior has plenty of support at home or if they fare badly when they’re away from family.

Thankfully, hospitals aren’t able to force anyone to go to a skilled nursing facility. Anyone with the capacity to make their own medical decisions can choose whether or not to go to a facility.

If the senior has been deemed unable to make such decisions, then the person with powers of attorney (POA) gets to decide instead.

Final Thoughts

Choosing the right facility always makes a huge difference to the senior’s experience. Look for places with good reviews – preferably ones that are run locally rather than through a large corporation. 

Also, be aware that a discharge from a skilled nursing facility doesn’t necessarily mean that your family member is healthy. They may still have various needs that must be met at home.

Some seniors also recover better than others. Stubborn seniors, for example, sometimes refuse to participate in rehabilitation exercises and may even be discharged for this reason.

Plus, recovery from illness and injury tends to take longer as people age. It may take seniors weeks or months to recover their normal function. Some may never gain back the strength that they had before.