How Do You Get Someone Admitted to a Skilled Nursing Facility?

Oct 7, 2025 5 min read •

Senior Living elder care healthcare

According to the National Institute on Aging, preparing for the admission of a loved one into a long-term care facility is a process best started before a crisis occurs. Understanding the steps involved is critical for caregivers wondering how do you get someone admitted to a skilled nursing facility, which provides a higher level of medical care than assisted living. This process involves medical evaluations, gathering essential documents, and navigating financial options like Medicare and Medicaid.

Quick Summary

The process of admitting someone to a skilled nursing facility involves determining the medical need for daily skilled care, obtaining a physician's order, and gathering comprehensive medical and financial documentation. The process requires coordination between the patient, their family, healthcare providers, and the facility's admissions team.

Key Points

Medical necessity is required: A physician's order certifying the need for daily skilled nursing care is the first and most critical step for admission.
Medicare covers short-term stays only: For Medicare to cover a short-term SNF stay, the patient must have a qualifying hospital stay of at least three consecutive days and enter the SNF within 30 days of discharge.
Medicaid covers long-term care for low-income patients: To qualify for Medicaid-funded long-term care, individuals must meet state-specific medical needs criteria and adhere to strict income and asset limits.
Pre-admission evaluations are standard: Both Medicare and Medicaid require comprehensive patient assessments to determine the appropriate level of care and eligibility before or shortly after admission.
Choosing a facility requires research: Utilize online resources like Medicare's Care Compare to research and compare facilities based on quality ratings, staffing, and inspection histories before making a selection.
Discharge planners are key for hospital transfers: If the patient is being transferred from a hospital, the hospital's discharge planner will assist with coordinating the move and necessary paperwork.
Prepare essential documents in advance: Gather all critical paperwork, including medical records, insurance cards, financial information, and legal documents like a Power of Attorney, to facilitate a smoother admission.

What Is a Skilled Nursing Facility (SNF)?

A skilled nursing facility (SNF), also known as a nursing home, provides round-the-clock medical care and supervision for individuals who require a higher level of medical support than is available at home or in an assisted living community. A short-term stay in a SNF often follows a hospital stay for acute illness, injury, or surgery, focusing on rehabilitation with the goal of returning home. A long-term stay is for individuals with chronic conditions or permanent disabilities requiring continuous medical attention.

Step-by-Step Guide to the SNF Admission Process

Step 1: Assess the Medical Need and Obtain a Physician's Order

Before starting the search, the first step is to confirm the medical necessity for a SNF. A physician must evaluate the individual and provide a written order for admission, certifying that they require a specific level of skilled nursing care. This medical certification is a non-negotiable requirement for admission.

Gather medical information: Obtain a complete medical history, including a list of current medications, recent diagnoses, surgical reports, and physician's progress notes.
Evaluate daily care requirements: The patient's needs must require daily skilled services, such as physical therapy, occupational therapy, speech therapy, IV therapy, injections, or complex wound care.

Step 2: Navigate Financial Eligibility

Understanding payment options is crucial as costs for SNF care can be substantial. The primary payment sources are Medicare, Medicaid, and private funds.

For Medicare Coverage (Short-Term Stay):

Qualifying hospital stay: The patient must have had an inpatient hospital stay of at least three consecutive days (not including discharge) before being admitted to the SNF.
Timeliness: Admission to the SNF must occur within 30 days of the hospital discharge.
SNF certification: The facility must be Medicare-certified.
Benefit periods: Medicare covers up to 100 days per benefit period, with a daily copayment starting on day 21.

For Medicaid Coverage (Long-Term Stay):

Medical eligibility: A pre-admission evaluation (PAE) determines if the individual meets state-specific criteria for needing a nursing home level of care.
Income and asset limits: The individual must meet strict income and asset thresholds, which often require a "spend-down" of personal savings.
Application process: An application to the state's Medicaid program is required, often facilitated by an elder law attorney or social worker.

Step 3: Choose the Right Facility

Choosing a facility is a key step that requires thorough research and evaluation.

Use online resources: Medicare's Care Compare tool provides star ratings and details on staffing, health inspections, and quality measures.
Tour facilities: Visit potential SNFs, preferably unannounced, to observe staff interaction, cleanliness, and the overall atmosphere.
Inquire about special needs: If the individual has specific needs, such as dementia care or ventilator support, confirm the facility has specialized programs and experience.

Step 4: Gather Necessary Paperwork

Proper documentation is essential for a smooth admission process. The facility's admissions coordinator will require a comprehensive packet of information.

Medical records: Up-to-date records, physician orders, and recent test results.
Legal documents: Powers of Attorney (POA) for healthcare and finances, advance directives, and a living will.
Insurance information: Medicare, Medicaid, or private insurance cards and policy information.
Personal and financial information: Identification, Social Security number, financial disclosure, and contact information for family and emergency contacts.

Step 5: Complete the Admissions Paperwork and Coordinate Transfer

Once a facility is chosen and the necessary documents are compiled, the final step is to complete the admission paperwork with the facility staff. A transfer date and time will be scheduled.

Sign agreements: The individual or their legal representative will sign contracts detailing the provided services, costs, and resident rights.
Arrange transportation: Coordinate safe transportation to the facility, which may require a medical transport service depending on the patient's condition.

The Role of Discharge Planners in Hospital-to-SNF Transfers

If the admission follows a hospital stay, the hospital's discharge planning or social work office is a vital resource. Hospital staff will assist in coordinating care and arranging the transfer to the SNF. This is especially helpful during a medical crisis when a quick, expedited placement is needed. The discharge planner will work with the family and the chosen SNF to ensure a seamless transition and that all immediate documentation is transferred.

Comparison Table: SNF vs. Assisted Living


Feature	Skilled Nursing Facility (SNF)	Assisted Living Facility (ALF)
Level of Care	High-level medical care, 24/7 licensed nursing supervision.	Non-medical support with daily living activities (ADLs), such as bathing, dressing, and eating.
Medical Needs	Accommodates complex medical needs like IV therapy, wound care, ventilator use, and extensive rehabilitation.	Manages basic health needs, including medication reminders and monitoring of vital signs.
Environment	Clinical, hospital-like setting with specialized medical equipment. Rooms can be private or semi-private.	Residential, home-like setting with apartments or private rooms. Communal dining and social areas.
Payer Source	Primarily covered by Medicare (short-term), Medicaid (long-term), or private pay.	Mainly funded by private pay or long-term care insurance. Medicare typically does not cover long-term costs.
Staffing	Licensed nurses (RNs, LPNs) and certified nursing assistants (CNAs) are on-site 24/7.	Trained caregivers are available 24/7, but licensed nurses may have a more limited presence.

Conclusion

Getting someone admitted to a skilled nursing facility is a complex process that requires careful navigation of medical, financial, and logistical requirements. By understanding the criteria for admission, the roles of different healthcare professionals, and the available financial options, families can make informed decisions. Proactive planning and a thorough evaluation of facilities using resources like Medicare's Care Compare can help ensure a smoother transition and a better care outcome for the individual needing skilled services.

How to Prepare for Emergency Admission

In emergency situations, the process is accelerated, but the core requirements remain the same. Contacting the local Area Agency on Aging (AAA) can help expedite placement by connecting families with available resources. The hospital's discharge planner will be instrumental in this process, ensuring necessary medical documents and assessments are completed quickly. Having legal documents, like a Power of Attorney, prepared in advance can significantly streamline the emergency admission. Families should gather all available medical history and medication information to provide to the admissions team immediately.

Medicare Care Compare is an official U.S. government website that provides information on nursing home quality.

Frequently Asked Questions

A skilled nursing facility (SNF) offers 24/7 medical care from licensed nurses for individuals with complex medical needs or those recovering from a major health event. Assisted living provides assistance with daily activities in a more residential setting for seniors who need some support but not intensive medical supervision.

Yes, but Medicare coverage for a short-term rehabilitation stay typically requires a qualifying three-day hospital stay. Some insurance plans, like Medicare Advantage, may waive this requirement, and long-term care admissions via Medicaid or private pay do not have this prerequisite.

Required documents typically include a physician's order for admission, full medical records (including history, physicals, and medication lists), proof of insurance, and legal paperwork like Power of Attorney or advance directives.

Funding can come from several sources. Medicare covers short-term, post-hospitalization stays, while Medicaid is the primary payer for long-term care for eligible, low-income residents. Many people also rely on private pay, long-term care insurance, or a combination of these options.

A 'spend-down' is when an individual with assets above Medicaid's financial limits uses their personal savings to pay for nursing home care until their assets fall below the state's eligibility threshold, allowing them to qualify for Medicaid coverage.

The Medicare Care Compare website is a key resource for comparing certified nursing homes based on quality ratings, health inspection results, and staffing data. It is also recommended to tour facilities in person and speak with residents and staff.

If a loved one requires emergency placement, the process is expedited. Hospital discharge planners will work to arrange a quick transfer. Contacting the local Area Agency on Aging can also provide resources for emergency admission situations.

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.