Best Skilled Nursing Facilities

Promedica Senior Care provides the best overall skilled nursing facility with low hospital re-admission rates

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Skilled nursing facilities are not just for seniors. These facilities are often the best place for someone to recover after experiencing an injury or undergoing surgery, or for someone who needs to build strength before living independently. The best skilled nursing facilities provide a higher level of medical care for a short period before returning home.

It's important to differentiate a nursing home from a skilled nursing facility. The main difference is a nursing home is a permanent residence for people who need care around the clock, while a skilled nursing facility is a temporary residence for people who need medically necessary rehabilitation treatment before going home.

We researched more than 15 skilled nursing facilities with a nationwide footprint before selecting the best options. We took into account factors such as services offered, types of care, awards and recognitions, and states served.

Best Skilled Nursing Facilities of 2023

Best Overall : ProMedica Senior Care


ProMedica Senior Care

ProMedica Senior Care

Key Specs
  • Key Service Lines: Cardiac, diabetes, oncology, orthopedics, pulmonary, stroke, and wound care
  • Number of States: 26
  • Unique Feature: Transitional call program to follow up with former patients
Why We Chose It

We chose Promedica Senior Care as best overall because of its low hospital re-admission rates after stays and its specialized call program after short-term stays.

Pros & Cons
Pros
  • Transitional call program to check in on medical needs

  • Patient ratings exceed national averages for skilled nursing services

  • Low patient readmission after discharge

Cons
  • Facilities in only 26 states

Overview

ProMedica Senior Care is a nonprofit system that offers skilled nursing facilities in 26 states. The company accepts Medicare, Medicaid, and private insurance. It’s worth noting the skilled nursing facilities were formerly called HCR ManorCare before the company was bought out, but some locations retain the old name which can create some confusion.

ProMedica Senior Care services are available for care across a variety of specialties, including cardiac, diabetes, oncology, orthopedics, pulmonary, stroke, and wound care.

Patient ratings exceed national averages and ProMedica reports that most patients are discharged and able to return home without needing to seek re-admission at a hospital. These are positive metrics for ProMedica’s Senior Care patients after their short-term stays.

ProMedica also offers a transitional call program. After a short-term stay and discharge, staff periodically call former patients to ensure they are healthy and going to key medical appointments.

Although ProMedica Senior Care operates in just 26 states, its footprint is one of the larger ones we reviewed.

Best for Long-Term Care Services : Life Care Centers of America


Life Care Centers of America

Life Care Centers of America

Key Specs
  • Key Service Lines: Rehabilitation, Alzheimer’s, and dementia care
  • Number of States: 28
  • Unique Feature: "Continuum-of-care" where patients can access independent living and assisted living
Why We Chose It

Life Care Centers of America operates more than 200 facilities and provides a wide range of services for patients who require long-term care.

Pros & Cons
Pros
  • Long-term care services in more than 200 locations

  • Provides continuum of care for various care needs

  • Inpatient and outpatient rehabilitation services

Cons
  • Operates in only 28 states

  • History of lawsuit settlement for false insurance claims

Overview

Life Care operates more than 200 skilled nursing facilities in 28 states, offering services such as:

  • On-site rehabilitation
  • Around-the-clock skilled nursing services
  • On-site physicians
  • Fine dining

When you or a loved one needs long-term care, it’s a good idea to choose a facility that offers transitions to short-term care or a nursing home environment. Life Care offers this continuity of care with most locations providing “continuum-of-care” services, which means a person can access independent living and assisted living options.

Life Care facilities typically offer inpatient and outpatient rehabilitation, as well as Alzheimer’s and dementia care.

Life Care accepts Medicare, Medicaid, and private insurance policies that may vary by location.

It is worth noting in 2016, Life Care Centers of America agreed to pay $145 million to resolve a lawsuit regarding submitting false claims to Medicare and TRICARE, according to the Department of Justice.

Best for Range of Services : Good Samaritan Society


Good Samaritan Society

Good Samaritan Society

Key Specs
  • Key Service Lines: Orthopedic rehabilitation and memory care
  • Number of States: 24
  • Unique Feature: Caregiver support department provides adult respite care for caregivers
Why We Chose It

The Good Samaritan Society provides the best range of services, including short- and long-term skilled nursing services, outpatient and home-based services, and caregiver support.

Pros & Cons
Pros
  • Offers short- and long-term skilled nursing services

  • Outpatient and home-based services available

  • Caregiver Support department provides
    respite care for caregivers

Cons
  • Only in 24 states

Overview

The chief goal for skilled nursing facilities is to help a person return to their home when they are able to. Having a facility that can provide long-term services can be valuable, as a family already has an established relationship with the providers and staff.

Operating facilities in 24 states, some of the conditions The Good Samaritan Society highlights for care include balance therapy for those who experience frequent falls and post-surgery recovery rehabilitation.

In addition to offering short- and long-term care options for skilled nursing services, the organization also offers senior living for a higher level of care as well as lower-level care options, including outpatient therapy and home-based services.

The Good Samaritan Society also has a Caregiver Support department, which includes adult respite care for caregivers. In terms of inpatient rehabilitation services, it offers physical, occupational, and speech therapy.

Best for Medicare : Brookdale Senior Living


Brookdale Senior Living

Brookdale Senior Living

Key Specs
  • Key Service Lines: Orthopedic rehabilitation and memory care
  • Number of States: 42
  • Unique Feature: Offer occupational, physical, and speech therapy, along with quality dining, educational and social activities, and more
Why We Chose It

Brookdale has a multitude of information on its website about paying for skilled nursing services with Medicare.

Pros & Cons
Pros
  • Specialized page explaining how Medicare can help pay for skilled nursing

  • Representatives are available at each Brookdale facility to answer Medicare-related questions

  • Operates in 42 states

Cons
  • Not all states have skilled nursing facilities

Overview

While most skilled nursing facility websites advertise they accept Medicare, few go into detail about how they will work with you to coordinate Medicare benefits.

Brookdale Senior Living earned a spot on our list because it has a page on its website that discusses how to use Medicare to pay for skilled nursing services. Brookdale Senior Living has specialized representatives at its facilities who can further explain the details of Medicare coverage.

Brookdale Senior Living also accepts private insurance and can provide advice regarding assistance programs and how to help pay for skilled nursing if needed on a longer-term basis. The organization offers a number of types of care, including assisted living, memory care, and retirement communities.

Brookdale provides short- and long-term skilled nursing. Therapy services include occupational, physical, and speech therapy. Special offerings include quality dining, educational classes, social activities, and computer and Wi-Fi access. Its “Ageless Spirit” program provides ways to explore spirituality, such as meditation.

With more than 740 senior living communities, Brookdale has a large, 42-state footprint. It does not operate in Alaska, Hawaii, Iowa, Maine, Nebraska, North Dakota, South Dakota, and Wyoming. Not all facilities offer skilled nursing services.

Best for Medicaid : The Ensign Group


The Ensign Group

The Ensign Group

Key Specs
  • Key Service Lines: Orthopedic and stroke rehabilitation
  • Number of States: 14
  • Unique Feature: Hire in-house therapy teams for better continuity of care
Why We Chose It

The Ensign Group’s skilled nursing services care for a large Medicaid population.

Pros & Cons
Pros
  • Nearly half of the clients use Medicaid for payment

  • In-house therapy teams provide continuity of care

Cons
  • Only in 13 states

  • May operate under different names, in different states

Overview

The Ensign Group is an organization that operates 227 healthcare facilities. Skilled nursing facilities represent the largest part of the company's portfolio, although it does have 24 assisted living communities should a person need to transition their care level.

An estimated 47.7% of The Ensign Group’s transitional skilled services come from Medicaid payments, which means the organization is adept at navigating Medicaid payments and explaining how to pay for care. Another 25.8% come from Medicare payments, according to the company’s 2019 annual report.

The group hires in-house therapy teams, which helps establish continuity of care for residents. Therapy services include physical, occupational, and speech and language pathology.

One of the major drawbacks of The Ensign Group is that it only operates in 13 states: Arizona, California, Colorado, Idaho, Iowa, Kansas, Massachusetts, Nebraska, Nevada, South Carolina, Texas, Utah, Washington, and Wisconsin. However, the company continues to acquire additional facilities and properties. Some centers may operate under different names after they're acquired, which can prove confusing at times.

Final Verdict

Our research indicates ProMedica Senior Care offers the best overall long-term care services with low hospital readmission rates after stays and a specialized call program after short-term stays. In addition, its services are available for care across a variety of specialties and they exceed national averages in patient ratings.

Skilled nursing facilities often provide an important transition from the hospital to home. Some only perform skilled nursing duties, while others may offer these services plus assisted living or nursing home-like care. Choosing a facility that offers a variety of care options and programs can help a person receive continuity of care should they need more or less assistance.

Compare the Best Skilled Nursing Facilities

 Site Key Service Lines   Number of States Unique Feature
ProMedica Senior Care: Best Overall Cardiac, diabetes, oncology, orthopedics, pulmonary, stroke, and wound care 26 states Transitional call system to follow up with former patients
Life Care Centers of America: Best for Long-Term Care Services Rehabilitation, Alzheimer’s, and dementia care 28 states "Continuum-of-care" where patients can access independent living and assisted living
Good Samaritan Society: Best for Range of Services Orthopedic rehabilitation and memory care 24 states Caregiver support department provides adult respite care for caregivers
Brookdale Senior Living: Best for Medicare Orthopedic rehabilitation and memory care 42 states Offer occupational, physical, and speech therapy, along with quality dining, educational and social activities, and more
The Ensign Group: Best for Medicaid Orthopedic and stroke rehabilitation 14 states Hire in-house therapy teams for better continuity of care

Guide to Choosing a Skilled Nursing Facility

What Is a Skilled Nursing Facility?

A skilled nursing facility is a place where a person receives care from trained and licensed medical professionals to help them treat, improve, or manage a patient's medical condition.

A person may need skilled nursing care after undergoing an operation, such as a hip replacement, or after experiencing a stroke. Some of the services may include:

  • Medication administration
  • Occupational therapy
  • Physical therapy
  • Speech-language pathology
  • Wound care

What Accreditations Should I Look for When Selecting a Skilled Nursing Facility?

Accreditation means that a facility has an independent organization evaluate its facility to confirm they are providing high-quality care. There are several organizations that may award accreditation to a skilled nursing facility. These include:

  • Commission on Accreditation of Rehabilitation Facilities (CARF) aging services accreditation
  • The Joint Commission, which offers a “Gold Seal of Approval” for skilled nursing facilities

When evaluating a skilled nursing facility, you can ask whether it is accredited.

The Medicare website has a section called “Nursing Home Compare” that has, among other information, reviews about skilled nursing facilities. You can evaluate facility sites by complaint information, skilled nursing facility inspection, and quality measures to help you choose the best facility for you or a loved one. The site also rates the facilities on a scale of 1 to 5 stars.

Frequently Asked Questions

What Is the Difference Between a Skilled Nursing Facility and a Nursing Home?

The key difference is that a nursing home is a more permanent residence for people who need around-the-clock care, while a skilled nursing facility is usually intended for rehabilitation treatment and then returning people to their home or a nursing home-type environment.

Does Insurance Cover Skilled Nursing Facilities?

Medicare Part A pays for a hospital stay or inpatient care at a skilled nursing facility when a Medicare-certified facility is chosen and a doctor certifies that a person needs skilled nursing care.

Health insurance policies outside of Medicare will often cover skilled nursing facilities, depending on factors such as:

  • Your insurance policy type
  • Whether the skilled nursing facility is in-network or out-of-network
  • The type(s) of care you require

Some people purchase a separate long-term care policy that may help cover costs for skilled nursing facility care.

What Are the Out-of-Pocket Costs Associated With Skilled Nursing Facilities?

Medicare pays for skilled nursing facility care by “benefit period.” After 60 days without inpatient hospital care or skilled nursing facility care a new benefit period begins. For each hospital stay and subsequent skilled nursing facility stay, Medicare will pay up to a certain number of days.

The out-of-pocket costs through Medicare for a skilled nursing facility include:

  • $0 for the first 20 days in a benefit period
  • $185.50 co-insurance for days 21 through 100 of a benefit period
  • All expenses after day 100

When Should a Skilled Nursing Facility Be Considered?

Skilled nursing facilities are beneficial when a person requires rehabilitation, ranging from physical to occupational therapy. This often occurs after surgery, an injury, or a health event such as a stroke.

An alternative could be in-home care, but skilled nursing care can provide more in-depth services and around-the-clock care. A doctor can help determine which option is needed.

How Long Can You Stay in a Skilled Nursing Facility?

Your overall health and insurance coverage will help determine the length of stay. The skilled nursing facility and your doctor should communicate with you if you need further care. Often, insurance companies may continue to pay as long as a doctor re-certifies that the care is still needed.

Methodology

We reviewed more than 15 of the country’s largest skilled nursing facility companies in the U.S. and considered the range of services offered, insurance accepted, presence of programs designed to help residents return home, and awards and recognitions, if applicable. Facilities that offer recreational, social, and educational amenities can significantly improve patients' quality of life while living in these facilities. We also gave preference to skilled nursing facilities that operate in multiple states.

Caregiver assisting senior man on wheelchair

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Article Sources
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  1. U.S. Securities and Exchange Commission Form 10-K.The Ensign Group, Inc. 2019 annual report.