Today’s nursing facilities have evolved in their ability to care for high-acuity, post-acute patients who have been discharged from the hospital, but still require a high level of medical supervision and care. A growing number of Texas skilled nursing facilities offer skilled and rehabilitative care for individuals who require relatively short periods of assistance following injury, accident, disease or hospitalization.


Skilled nursing facilities (SNFs) are facilities that have been certified by the federal Medicare program and must meet certain requirements, including:

  • Must have a transfer agreement with a hospital in case a resident/patient requires emergency care.
  • Have skilled nursing and rehabilitation staff to manage, observe and evaluate care. In addition to registered and licensed nurses, the SNF must have available licensed physical and occupations therapists, speech-language pathologists and audiologists to meet the needs of residents/patients.


Rehabilitative care focuses on returning patients to full independence and functionality. For example, rehabilitative treatments can help patients regain abilities recently lost as a result of a stroke, such as speech and/or motor skills. Likewise, patients who have suffered orthopedic injuries or surgeries benefit from intense recuperative care that is not available or realistic in the hospital setting. Services might also include various types of therapy (e.g., physical, occupational or speech therapy). Dietary consultation, laboratory, x-ray and pharmaceutical services may also be included in rehabilitative settings.


Rehabilitative care by SNFs are unique in that they incorporate the latest medical equipment and technology, yet remain comfortable and home-like. Because the overall goal is to help patients re-learn and re-acquire functional status so that they can return home and remain independent, most rehab settings are designed to be inclusive of the items, activities and potential obstacles found in the home and community.

Payment for SNF services for those over 65 years of age is made by the Medicare program. Typically Medicare skilled care is for 20 to 100 days for beneficiaries who require skilled and rehabilitative services following a hospital stay of at least 3 days. Medicare does not pay for routine nursing services such as assistance with toileting or transfers. Skilled and rehabilitative services must be required and certified by a physician to be related to the hospitalization and the services can only be provided on an inpatient basis at the SNF.

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