How to Certify as a Skilled Nursing Facility

A "skilled nursing facility," or "SNF," is a nursing home certified to participate in, and be reimbursed by, Medicare. Each state licenses its SNFs, and in order to be eligible for Medicare funds, these SNFs must be certified, subjecting them to federal laws and regulations. Services provided by SNFs vary greatly. In addition to nursing services, SNFs offer physical, occupational and speech therapy, social work services, recreational therapy and room and board. Nursing homes are one of the most highly-regulated industries in the United States. As of 2005, there were a little more than 16,000 nursing homes in the U.S.

SNF Certification

• 1

  Make sure that your SNF has LPNs, or licensed practical nurses, on duty twenty-four hours a day. An RN, or registered nurse, must be on duty at your facility for at least eight hours a day, seven days a week. Medicaid does not require SNF administrators to be licensed, and there are no standardized training and licensing requirements for them, but most states have their own requirements they must follow.

• 2

  Make sure that the residents you provide services for are eligible. Medicaid provides funds for residents who require skilled nursing care or rehabilitation services following a hospitalization of at least three consecutive days. Medicaid does not cover nursing care if only custodial care is needed. A physician must certify that a possible SNF resident needs daily skilled nursing care or other skilled rehabilitation services related to the hospitalization, and that these services can be provided only on an outpatient basis.

• 3

  In order to retain their certification, SNFs must always be ready for regular inspections by state surveyors, who make sure that SNFs remain compliant with both state and federal regulations. Surveyors use the MDS, or "minimum data set," which is a comprehensive assessment tool federally mandated by the U.S. government. The MDS helps SNF staff identify and assess each resident's functional capabilities. It also helps a nursing home's residents meet or cope with their medical and other needs.

• 4

  Other factors in SNF certification

  Medicaid laws clearly state that the resident's rehabilitation potential is not a deciding factor in determining if skilled services are required. A resident's health must be such that he or she requires the involvement of skilled personnel. Examples of "daily" skilled services include the overall management and evaluation of the resident's care plan is needed, the observation and assessment of the resident's continuing condition, Levin tube and gastrostomy feedings, therapeutic exercises of activities, and gait evaluation and training.