Which statement best describes eligibility for a Skilled Nursing Facility in OASIS?

• A. Any licensed long-term care facility qualifies.
• B. Requires certification by state agency only.
• C. The facility must be Medicare certified and provide skilled care.
• D. Facilities may be hospice-approved.

Answer: (C)

Eligibility for a Skilled Nursing Facility setting in OASIS hinges on Medicare certification and the provision of skilled care. A facility must be certified to participate in the Medicare program and actually deliver skilled nursing services (and related therapies) under a physician’s plan of care in order for it to be recognized as a skilled nursing facility setting. Licensing by a state agency alone does not guarantee Medicare coverage, since Medicare participation requires CMS certification. Similarly, hospice approval pertains to a different benefit and does not qualify a facility as a Skilled Nursing Facility for Medicare-funded skilled services.