Today I summarize recent trends in skilled nursing facilities (SNFs) as outlined in MedPAC’s 2011 Report to Congress.
SNFs furnish short-term skilled nursing and rehabilitation services to beneficiaries after a stay in an acute care hospital. These services include physical and occupational therapy and speech–language pathology services. Examples of SNF patients include those recovering from surgical procedures, such as hip and knee replacements, or from medical conditions, such as stroke and pneumonia.
Most SNFs are part of nursing homes that furnish long-term care, which Medicare does not cover. Medicaid finances mostly long-term care services provided in nursing homes but also covers copayments for dual-eligible beneficiaries who stay 21 or more days in a SNF. Medicare-covered SNF patients are typically a small share of a facility’s total patient population but a larger share of the facility’s payments.
In 2009, 15,068 SNFs furnished covered care to just under 5 percent of fee-for-service (FFS) beneficiaries (1.6 million). In fiscal year 2010, Medicare spent $26.4 billion on SNF care. Medicare covers up to 100 days of SNF care after a medically necessary hospital stay of at least three days
Three-quarters of beneficiaries live in a county with five or more SNFs, and less than 1 percent live in a county without one. Available SNF bed days increased 4 percent between 2008 and 2009. However, since 2004, the share of SNFs admitting medically complex patients decreased.