When you go to a skilled nursing facility (SNF), a team of staff from different medical fields (depending on your health needs) plans your care. Your SNF care is based on your doctor's orders and information the team gathers when they do daily assessments of your condition. Your doctor and the SNF staff (with your input) use the assessments to decide what services you need and your health goal (or goals). A health goal is the expected result of your treatment, like being able to walk a certain distance or to climb stairs.
Your daily assessments and skilled care start the day you arrive at the SNF. Medicare requires that your assessments be recorded periodically. The first recorded assessment must be within the first 8 days of your SNF stay, known as the 5-day assessment. Medicare also requires the SNF to record assessments done on days 14, 30, 60, and 90 of your covered stay. The SNF must do this until you're discharged or you've used all 100 days of SNF coverage in your benefit period.
An assessment includes collecting information about:
- Your current physical and mental condition
- Your medical history
- Medications you're taking
- How well you can do activities of daily living (like bathing, dressing, eating, getting in and out of bed or a chair, moving around, and using the bathroom)
- Your speech
- Your decision-making ability
- Your physical limitations (like problems with your hearing or vision, paralysis after a stroke, or balance problems)