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⭒ CANHR Advocate Did You Know Articles

Important services can be considered optional at Skilled Nursing Facilities

Services such as physical therapy, occupational therapy, speech therapy, speech pathology, audiology, social work services and special treatment program services are optional services that a Skilled Nursing Facility is not required to provide. Skilled Nursing Facilities that provide optional services may be an important determination in choosing the facility. To find out if a facility is licensed to provide these optional services, contact your local Department of Public Health Licensing and Certification District Office.

The Nursing Home Admission agreement is required to outline what services and supplies are covered by the facility’s basic rate and identify charges for optional services and supplies upon admission. Although the facility may not provide these optional services, residents still have the right to receive these services. Depending on your insurance provider, some of these services can be covered if they are medically necessary.

If any of these services are needed, make certain that they are included in your plan of care by your healthcare provider. Request a care plan meeting and have your physician write a prescription/order that the needed service is medically necessary. If the service is not considered medically necessary, it can still be included in your plan of care but you may be responsible for paying for these services privately. The facility is required to make written arrange- ments for obtaining all necessary diagnostic and therapeutic services prescribed by the attending physician, podiatrist, dentist, or clinical psychologist subject to the scope of licensure and the policies of the facility. If the service cannot be brought into the facility, the facility shall assist the patient in arranging for transportation to and from the service location. (22 CCR §72301)