How do I get someone into a skilled nursing facility?

Oct 16, 2025 4 min read •

senior care Skilled Nursing Admissions Process

According to the Centers for Medicare & Medicaid Services (CMS), the number of Medicare beneficiaries who received skilled nursing facility (SNF) services increased significantly over the last decade. This article explains the crucial steps for how do I get someone into a skilled nursing facility, covering eligibility, paperwork, and financial considerations.

Quick Summary

Getting a loved one into a skilled nursing facility requires a doctor's order, a medical assessment to confirm the need for daily skilled care, and careful navigation of financial and insurance requirements. If the person is not in a hospital, you must work with their primary care physician to coordinate the medical records, state-specific forms, and the facility's admissions team. Eligibility is key, and understanding payment options like Medicare, Medicaid, and private insurance is essential to a smooth transition.

Key Points

Medical Need is Primary: A physician's order and medical assessment confirming the need for daily skilled care is the first step toward admission.
Hospitalization Matters for Medicare: For Medicare to cover a short-term SNF stay, a qualifying 3-day inpatient hospital stay usually precedes admission.
Research and Vet Facilities: Use official tools like Medicare's Nursing Home Compare and visit multiple facilities to find the best fit.
Financial Planning is Crucial: Understand payment options like Medicare, Medicaid, private pay, and long-term care insurance, as coverage varies significantly.
Gather Extensive Paperwork: Prepare medical history, insurance information, and legal documents like a Power of Attorney for healthcare before starting the process.
Seek Professional Help: Social workers, geriatric care managers, and elder law attorneys can provide invaluable assistance with the admissions and financial processes.

Understanding Skilled Nursing Facilities

A skilled nursing facility (SNF) is not a permanent residence, but a specialized short-term care setting for rehabilitation after an illness, injury, or surgery. The goal is to help a patient recover and regain independence, so they can either return home or move to a lower level of care, like an assisted living facility. The services provided in an SNF require a high level of medical and rehabilitative expertise from licensed professionals, including physical, occupational, and speech therapists, as well as registered nurses.

For most people, the pathway to an SNF begins with a qualifying inpatient hospital stay. However, admission from home is also possible, though it requires a different set of steps. Most modern nursing homes provide both short-term skilled care and long-term custodial care in the same building, which can sometimes cause confusion.

The SNF vs. Nursing Home Distinction

While often used interchangeably, "nursing home" and "skilled nursing facility" describe different primary purposes. Here is a comparison to clarify:


Feature	Skilled Nursing Facility (SNF)	Nursing Home (Long-Term Care)
Primary Goal	Short-term rehabilitation and recovery.	Permanent residence for long-term care and support.
Length of Stay	Typically 100 days or fewer, but duration is based on medical necessity.	Can be permanent, providing continuous care for chronic conditions.
Level of Care	High-level medical care, including physical therapy, IV administration, and wound care.	Custodial care, including assistance with activities of daily living (ADLs), medication management, and meals.
Insurance Coverage	Often covered by Medicare Part A for the first 100 days after a qualifying hospital stay, with specific cost-sharing.	Not covered by Medicare for long-term custodial care. Typically paid for out-of-pocket, by Medicaid, or with long-term care insurance.
Focus of Services	Focused on intensive, short-term rehabilitation to help a patient transition back home or to a less-intensive setting.	Focused on daily living assistance and residential support for those who cannot live independently due to chronic conditions or disabilities.

The Admission Process Step-by-Step

Step 1: Medical Evaluation and Qualification

The first and most critical step is to obtain a physician's order certifying the need for daily skilled care. This is based on a medical assessment that documents the patient's health status, including any functional decline, and confirms they require a skilled level of care. If the person is being discharged from a hospital, the hospital's social worker or case manager will help coordinate this. If the person is at home, their primary care doctor will perform the assessment.

Step 2: Information Gathering and Facility Search

Once the medical need is established, you must gather all relevant medical documentation. This includes a medical history, physical exam results, recent test results (like a negative TB test, which is often required), and a list of current medications. You should also prepare financial and insurance information, including Medicare, Medicaid, or long-term care insurance details.

Next, research facilities in your area. Use resources like the Eldercare Locator or Medicare's Nursing Home Compare tool to find and compare certified SNFs. Consider a facility's location, services, ratings, and whether they accept your loved one's insurance.

Step 3: Contacting and Visiting Facilities

Contact the admissions coordinator at your top-choice SNFs to inquire about bed availability and the admission process. It is highly recommended to visit the facilities with your loved one, if possible, to observe the atmosphere and interact with staff. Be prepared with a list of questions to ask during your visit regarding care plans, staffing, and activities.

Step 4: Completing Admissions Paperwork

The admissions paperwork can be extensive and includes legal documents such as advance directives (living wills), Durable Power of Attorney (POA) for healthcare, and financial disclosure forms. It is important to read everything carefully and ask questions. An elder law attorney can provide valuable guidance during this stage, particularly regarding financial matters.

Step 5: The Financial Assessment and Payment Planning

Understanding payment is a major part of the admission process. For a temporary, post-hospital SNF stay, Medicare Part A is often the primary payer. However, Medicare does not cover long-term custodial care. For longer stays, Medicaid is the largest payer for nursing home care, but it is a means-tested program with strict income and asset limits that vary by state. Other options include private funds, long-term care insurance, or veterans benefits. A financial assessment will be conducted to determine eligibility for any state or federal programs.

Step 6: Transitioning to the Facility

After a facility is chosen and the paperwork is complete, the admission team will coordinate the move, including transportation and scheduling the arrival. Ensure all necessary personal items and medical information are organized and ready. The facility will prepare the room and introduce your loved one to staff members, easing the transition into their new environment. Upon arrival, a formal care plan will be developed with input from the attending physician, nursing staff, and family members.

Important Considerations for Getting Admitted from Home

If the individual is not in a hospital, the admission process requires more proactive involvement from the family. A primary care physician's assessment is needed to establish medical necessity, and families must independently research and contact SNFs for admission. Some facilities may have waitlists for non-emergency admissions, so contacting them early is crucial.

Conclusion

Getting someone into a skilled nursing facility requires a thorough and informed approach. Starting with a doctor's medical assessment to confirm the need for skilled care is essential, followed by gathering critical documents and researching certified facilities. By understanding the payment options, from Medicare for short-term rehab to Medicaid for longer stays, families can navigate the complex financial landscape. With careful planning and communication with healthcare professionals and facility staff, you can ensure your loved one receives the appropriate level of care. For further guidance on your specific state's Medicaid policies, contact your state Medicaid office.

Visit the Eldercare Locator website for help finding local resources and services.

Frequently Asked Questions

A skilled nursing facility (SNF) is for short-term rehabilitation after a hospital stay, while a nursing home is for long-term, permanent residence providing daily custodial care. The level of medical intensity and insurance coverage differs significantly between the two.

Yes, Medicare Part A covers up to 100 days of skilled nursing care per benefit period, provided there was a qualifying 3-day inpatient hospital stay. However, patients may have cost-sharing responsibilities, especially after day 20.

If the individual is at home, a primary care physician must perform a medical assessment and provide a doctor's order for skilled care. Families must then contact SNF admissions coordinators directly to find a facility with an open bed.

You will need a physician's order for admission, medical history and physical exam results, medication list, proof of recent vaccines and tests (e.g., TB), legal paperwork like Power of Attorney, and financial/insurance information.

Medicaid is a major payer for long-term nursing home care for those with limited income and assets. While it covers long-term care, Medicare typically covers the short-term skilled portion. Some individuals may use a "spend down" strategy to qualify for Medicaid if their assets are initially too high.

A stay in a skilled nursing facility is temporary and typically lasts less than 100 days, with the exact length determined by medical necessity. It is not intended for long-term residency.

Unless you have a legal guardianship, you cannot force someone to go. It is best to have an open, honest discussion about the reasons for the move, involving family members and professionals to help them understand the benefits and address their fears. For patients with dementia, this can be more challenging.

References

Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider regarding personal health decisions.