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Here is the "official" definition of skilled care:

Skilled care is a type of intermediate care in which the patient or resident needs more assistance than usual, generally from licensed nursing personnel and certified nursing assistants. This care is not the same as long-term care in which a resident may not need the services of a licensed nurse on a daily basis. The resident/patient does need longer-term care than what the acute care hospital services can provide. Reasons may include long-term IV therapy, IV line access and care, chemotherapy, physical therapy, long-term wound care rehabilitation, respiratory treatments, nutritional therapy with feeding tubes, and continuous positive motion machines to exercise limbs in which prosthetic joints have been inserted. According to Medicare, there are a certain number of allowable “skilled care” days in each billing year that are covered. Skilled care can be offered in a wide variety of facilities, such as a “skilled” unit in an acute care hospital, a LTAC (Long-Term Acute Care) rehab unit or hospital, and sometimes at the patient’s own home provided for by Home Health nursing staff. The term refers to the level of care a patient needs and not the facility in which it is provided, acute care being the highest level, skilled care at the intermediate level and chronic care or long-term care being the lowest level of care.
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You need to work with their MD's to get the chart written for a mulitude of skilled care needs so that it can pass Medicaid medical necessity review if this is what this posting is about. If it's the case that they are living at home and now need to be in a facility, there likely isn't enough in their chart to show that. I'd get them to become a patient of an MD who is the medical director of a NH or other skilled facility so they can evaluate them and get the chart done to pass review. Good luck.
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