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Nursing homes Health care

Kaiser Permanente uses a network of swift nursing facilities (SNFs) to present care since your stay is covered by Kaiser Permanente Medicare Advantage or a Kaiser Permanente public proclamation intend. Kaiser Permanente care giving out nurses play in past the doctor to endorse coverage for medically necessary stays in a SNF. Although you may be seen by rotate doctors and nurses, your Kaiser Permanente care team will continue to monitor your care even if you are in the SNF.

Payment for nursing home services

Not all services at a nursing home are covered by your Kaiser Permanente Plan.

  • Admission to an inpatient skilled nursing facility or nursing home is a covered benefit only when it is medically necessary and authorized in advance by Kaiser Permanente.
  • If your admission to the facility is not covered it is called a residential or custodial facility stay, where some services, such as laboratory tests, X-rays, or intermittent rehabilitation services may be covered.
  • Residential/custodial facility charges for room and board and other care related to custodial care are not covered by Kaiser Permanente or Medicare. For these admissions, the facility fee is the patient’s financial responsibility.

In-network facilities

For patients who meet the Kaiser Permanente and Medicare certified medical necessity criteria, care will usually be provided in a Kaiser Permanente in-network SNF.

Coverage requirements

Licensed professionals: The patient’s condition, or the complexity of the service, requires the judgment, knowledge, and skills of qualified licensed professionals.

Daily rehabilitation services: Coverage is based on an assessment of the patient’s restoration potential and meeting at least one of these expectations:

  • The patient’s condition will improve in a reasonable and generally predictable period of time, or 
  • Daily services are necessary to establish a safe and effective home or long-term care program, or 
  • Daily services are necessary to prevent the patient's condition from getting worse

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