Choosing a Nursing Home
SNF/NF: Skilled Nursing Facility/Nursing Facility. A health facility that is licensed by the Department of Health Services to provide continuous skilled nursing care and supportive care to patients whose primary need is for the availability of skilled nursing care or supportive care on an extended basis. A SNF/NF provides 24 hour inpatient care and as a minimum, includes physician, skilled nursing, dietary, pharmaceutical services and an activity program.
All facilities must be licensed to operate as a nursing facility in California.
A SNF/NF is usually dually certified to participate as a skilled health facility (SNF) under the Medicare program and as a nursing facility (NF) under the Medicaid (Medi-Cal) program.
Depending on the certification status of the facility, there are many variations on skilled/nursing facilities:
NF: Nursing Facility: May be licensed only, with no certification for Medicare or Medicaid (Medi-Cal), or it may be certified for Medi-Cal only. The lack of certification for Medicare will mean that the resident’s rehabilitation and therapy services will not be reimbursed by Medicare. Lack of certification for Medi-Cal means that it is a private pay only facility.
DP/SNF: A distinct part of a hospital or other nursing facility that is certified for Medicare. Nursing homes that are certified for Medicare generally have a “distinct part” of the facility with a number of beds that are set aside for higher acuity Medicare patients. In addition, many acute care hospitals have a unit set aside as a skilled nursing unit, that may be certified for Medicare.
DP/NF: Distinct Part Nursing Facility. A distinct part of an acute care hospital, where beds are set aside for residents needing post acute care. Some acute care hospitals have distinct nursing facility parts that are certified for Medi-Cal reimbursement.
Medi-Cal Subacute: The Medi-Cal Program contracts with certain facilities to provide adult subacute or pediatric subacute care.Subacute care is not a licensing category, but a Medi-Cal reimbursement program initiated to provide medically necessary care to certain Medi-Cal beneficiaries whose needs are greater than can be met by a nursing facility. There are fewer than 100 Medi-Cal Subacute providers in California. The majority of these are DP/NFs, i.e., distinct parts of acute care hospitals, although some freestanding nursing facilities (FS/NFs) have been approved to provide subacute care.
ICF:
Intermediate Care Facilities. Provides skilled nursing care and supportive care to those residents who do not require continuous, i.e., 24 hour, nursing care. These facilities, while licensed by the Department of Health Services as nursing facilities, provide a lesser level of care than skilled nursing facilities and are not certified for Medicare reimbursements. Some ICFs receive Medi-Cal reimbursements, although at a lower rate than Skilled Nursing Facilities.
ICF/DD:
Intermediate Care Facility/Developmentally Disabled. Provides 24 hour care, habilitation, developmental and supportive health services to DD residents whose primary need is for developmental services, and who have a recurring but intermittent need for skilled nursing care. Licensed by the Department of Health Services, these facilities are certified to accept Medi-Cal.
Smaller ICF/DD facilities include:
ICF/DD-Nursing: Small (6-15 beds) residential home for DD residents needing nursing care.
ICF/DD-Habilitative: Small (6-15 bed) residential home for DD residents needing habilitative care.
RCFE:
Residential Care Facility for the Elderly. A housing arrangement where 75% of the residents are sixty years of age or older and where varying levels of care and supervision are provided. With special exceptions and waivers, RCFEs can accept hospice, dementia and other residents with special medical conditions. They are not medical facilities, however, and are not licensed to provide medical care. RCFEs are licensed and regulated by the Department of Social Services and are not certified to accept Medi-Cal or Medicare reimbursements. Some Continuing Care Retirement Facilities are licensed as both RCFEs and as Nursing Facilities.
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