In 2016 my stepfather passed away from a serious heart condition that progressed much faster than doctors had predicted it would, leaving my mother a widow. She was a half a day’s drive away from me, and I was the only one that could help her. At first she wasn’t too concerned, her COPD and congestive heart failure were not that bad; she could still drive and get herself to the doctor, go shopping, and go out to eat whenever she wanted. Still, I moved her closer to me to give her the support that she needed knowing that her medical conditions were expected to get much worse.

But after just two years her conditions were getting much more severe than either of us expected. She had to give up her portable concentrator because even at the highest setting the flow wasn’t adequate to fill her needs. She could no longer bathe herself, cook for herself or stay awake for more than a few hours per day. Any movement at all was taxing to her and her oxygen saturation rate dropped dangerously low with every movement. 

I was terrified of losing her but I also respected that she did not want to go to a nursing home. I can tell you that, looking back, I should have moved her into a long term skilled nursing home the moment that she could not use the portable concentrator. I had actually looked at several nursing homes in the area and discovered that there was a difference in what they offered. I also learned that I had to ask very specific questions when I was interviewing nursing homes to ensure it would be a good fit for mom’s specific needs. Each section below represents what questions I needed to ask in order to find the best nursing home for my mother.

 

What Medical Conditions Do You Typically Accept in Long Term Care?

Long-term skilled nursing facilities and short-term skilled nursing rehab is not the same thing. The latter is for recovering from an illness, surgery, or hospitalization. Long-term care, also known as a Nursing Home, is what this article is regarding and it tends to be more permanent. 

Nursing homes are subject to many regulations, at both the state and local level. And while the staff at a nursing home may be medical professionals trained in many things, they aren’t able to administer care at a level beyond a facility’s capabilities. It’s also helpful to understand that some facilities will provide care for some conditions that others will not. Generally speaking though, most long term SNFs tend to accept residents with the following conditions:

 

What Conditions Might Be Too Challenging for Your Long-Term Care Facility?

As I stated earlier, long-term care nursing homes all differ just a little on what they can and cannot do. But, for the most part, if your loved one suffers from any of these following conditions then they will likely not be accepted:

 

How Do You Handle Outside Medical Appointments for Your Nursing Home Residents?

 senior or elderly old lady woman transportation

Long-term skilled nursing facilities typically have policies that allow family members to take residents to medical appointments, but there are some important considerations and limitations to be aware of.

The Good News

Most long-term skilled nursing facilities allow family members to take residents to medical appointments, encourage family involvement in healthcare decisions, provide the necessary documentation for these appointments, and maintain communication regarding appointment outcomes.

Important Considerations

While generally accommodating, facilities usually have specific protocols for family members taking residents to appointments. Most require 24-48 hours' advance notice, sometimes more, as they need time to prepare medications and documentation. They may also need to reschedule facility-based care or therapies that would conflict with the outside appointment.

Sign-out procedures are an important part of the process. Most facilities require a formal sign-out process with documentation of who is taking responsibility for the resident and when they expect to return. This helps the facility maintain accountability for all residents' whereabouts and safety.

Medical stability is always a key consideration. The facility may assess whether the resident is stable enough to leave for an appointment. Some medically fragile residents may require a staff escort to accompany them. For residents with cognitive impairments, the facility might require specific authorized caregivers to transport them to ensure safety and proper communication.

Medication management during outings is carefully handled. Staff will prepare any medications needed during the time away and provide clear instructions for administration. There are often special considerations and stricter policies for controlled substances to ensure compliance with regulations.

Timing limitations may also apply. Some facilities have policies about return times, preferring residents not to return after certain hours. They may have concerns about late returns disrupting medication schedules, and meal timing considerations often apply as well.

Several legal and practical considerations come into play when family members transport residents. The person taking the resident must have legal authority if the resident lacks decision-making capacity. There may be insurance concerns regarding transportation in personal vehicles. Additionally, any findings or recommendations from the appointment should be shared with the facility to maintain continuity of care in the resident's treatment plan.

 

How Does Your Skilled Nursing Facility Handle Necessary Regularly Scheduled Treatments?

There are some medical conditions and diseases that require patients to attend regularly scheduled treatments. It’s important to speak with the nursing home prior to selecting one to determine how they plan on handling these important treatments. Here are just a few examples of conditions that would require such treatments:

Chronic Kidney Failure

For advanced chronic kidney disease (CKD), particularly stages 4 and 5, several specific treatments become necessary as kidney function declines. 

Hemodialysis is the most common treatment for end-stage renal disease (stage 5 CKD). It typically requires three sessions per week, with each session lasting 3-5 hours. 

It’s a good idea to discover what the SNF’s care plan and transportation schedule is and if they can support your loved one’s needs.

 

Chemotherapy for Cancer Patients

elderly woman with cancer

Chemotherapy regimens generally follow specific protocols with treatments administered in cycles. These cycles commonly range from weekly treatments to once every 3-4 weeks, depending on the specific drugs and cancer type. Some protocols require multiple consecutive days of treatment followed by a recovery period.

Patients with cancer often need scheduled chemotherapy or radiation therapy sessions, which can range from daily treatments to weekly or monthly appointments depending on the protocol.

Most chemotherapy administration occurs in outpatient oncology centers or hospital-based infusion centers rather than within skilled nursing facilities. This is because administration typically requires specialized oncology nurses, emergency response capabilities for potential reactions, and specific handling protocols for hazardous drugs.

For residents in long-term skilled nursing facilities who require chemotherapy, the facility would need to coordinate transportation to and from these specialized treatment centers. After treatment, the nursing home should also provide supportive care to manage side effects and complications.

When you inquire about how a long term nursing facility will handle chemotherapy, remember to also find out what the supportive care will be. Chemotherapy can create quite a few side effects that need to be managed properly and handled with care.

Multiple Sclerosis Requiring Regular Infusion Treatments

Infusion treatments for multiple sclerosis (MS) are an important part of disease management for many patients. Several disease-modifying therapies for MS are administered via infusion with varying frequencies. Most skilled nursing facilities do not administer these specialized MS infusion treatments on-site. Instead, facilities typically coordinate transportation to outpatient infusion centers or hospitals where neurologists oversee the treatment.

For residents receiving these treatments, skilled nursing facilities should focus on providing pre-infusion preparation and post-infusion monitoring and care. It’s important to find out what pre-treatment and post treatment monitoring and care will be provided by the skilled nursing facility

For residents with MS in long-term care, medication management needs to extend beyond infusion treatments to include symptom management medications, which the facility does typically administer directly. This should also include medications for fatigue, spasticity, pain, bladder dysfunction, and other MS symptoms.

Do You Accept Medicaid?

senior man are using wheelchair for motion

It should come as no surprise that managing a long-term medical condition or chronic illness can get expensive. And, over the course of time, it is not uncommon for those who once had some financial reserves, to drain all of the savings that represented a lifetime of savings. 

As we mentioned in a previous post, “How Much Does a Skilled Nursing Home Cost” the cost of skilled nursing varies widely across the US. In 2025 the current costs ranged anywhere between $30,000 per month and $6,500 per month, just depending on where you live. Overall, however, the cost averages to about $9,000 per month. And since Medicare does not cover long-term care (more info about that here), the only insurance that will cover it is long-term care insurance or a whole life policy with a long-term care rider. Long-term care insurance is really a financial vehicle of the past and very few providers cover those policies anymore. Those that do charge exorbitant prices for those policies. 

So, what is one to do when the money dries up and there is no insurance to pick up the tab? There is Medicaid. Most, but not all, nursing homes will accept Medicaid. We have a whole article here dedicated to that subject if you are interested in that process. But let’s assume that your loved one has or will soon need Medicaid, you need to ask questions pertaining to whether or not the nursing facility will accept Medicaid.

In addition to finding out whether Medicaid is accepted, you need to make sure that the units that the facility has that are dedicated to Medicaid residents are suitable for you or your loved one. Most facilities will have separate “Medicaid units”. Since Medicaid only pays for a single bed in a shared room, these units have two beds and sometimes a curtain divider or something similar for privacy. A Medicaid recipient is then required to live in a shared unit with someone they likely don’t know for perhaps the rest of their life. The exception to this rule is that Medicaid will pay for a private (non-shared) room if the skilled nursing facility is Medicaid approved but doesn’t have any shared rooms. So, if Medicaid is going to be the only pay option then trying to find a suitable unit should be something that you would want to explore.

In addition, many facilities limit the number of units they make available for Medicaid recipients. So, it is also important to ask about the waiting list because there is high demand for these units, particularly in densely populated areas. In these areas the waiting list itself may be something to ask about first. If your loved one is very ill and has immediate needs but also requires Medicaid to pay for the unit, then asking questions about the type of care they provide may be pointless if the waiting list is over a year in length.

Wrapping it Up

In conclusion, there are many, many long-term Skilled nursing homes to select from across our nation. And while many are very similar in their appearance , the types of care they provide may vary quite a bit. It’s important to be aware of the type of care needed in order to compare it against the type of care provided. Long-term skilled nursing can be just that; long. And moving a senior from one care facility to another comes with its own set of unique challenges, particularly for those seniors that are fragile. So being selective about the facility and doing some due diligence will have a profound impact on how happy you and the senior will be with the skilled nursing facility that you end up choosing.