Once you graduate, pass your licensure exam and obtain your state license as a Nurse Practitioner, your next step is to find a position. There are many options for Nurse Practitioners to start their career. One area that can be a flexible option for many is working in a Skilled Nursing Facility (SNF). Could this be the right position for you?
SNF Patient Population
There are over 1.5 million people living in nursing homes in the United States. The number of people admitted to nursing homes has increased since 1994. By the end of 2020, the number of people aged 65 and older living in nursing homes is expected to triple.
Nursing home patients are sicker and their acuity higher than they have been in the past 10 years. These frail, sick patients are more likely to be hospitalized. Hospitalization can cause irreversible decline in the function of elderly patients. Additionally, unnecessary hospitalization of nursing home patients is a costly and a critical problem in our healthcare system.
Nurse practitioners (NPs) can play a valuable role in caring for patients, reducing unnecessary hospital admissions, and supporting physicians’ practice. They have been shown time and time again to be an invaluable resources to the patient as the facility.
An NP on site can provide quick assessment and treatment when a patient has a change in condition. The NP can intervene and treat the patient as needed, instead of transferring the patient to the hospital for assessment. They can be a valuable asset to the facility’s team and the patient outcomes.
Pros vs Cons
Working in the SNF setting can be a rewarding experience. You’ll have the ability to connect with patients, become a resource for the facility nursing staff, and impact patient care. This setting also allows NPs to work with autonomy and to the full scope of their practice.
There are many pros of working in a SNF. Most positions allow for flexibility of schedule along with great experience in internal medicine and primary care. NPs in SNFs are part of the leadership team that can effect positive patient care and outcomes. This is accomplished by ensuring evidence based interventions are being practiced and upholding SNFs accountable to providing quality care.
Some of the cons of working in SNFs are not having readily available diagnostic testing options and resources available. This can come as a surprise to Nurse Practitioners who are used to practicing in an acute hospital setting. Additionally, working with a range of nursing experience (RN, LPNs) in the SNF setting can also be a huge adjustment.
Other cons include navigating a variety of electronic medical records, as well as relying on paper charts from hospital transfers. One of the greatest challenges seen by many NPs new to the SNF setting is learning billing codes for reimbursement. Medical billing and coding for SNFs can seem complicated at first. During your interviews, be sure to ask what system in place to easily submit visit billing.
Since reimbursement for services received in an SNF are subject to an increasing number of regulatory restrictions. It is important to ensure that you are billing correctly, in a timely fashion, and capture visits to demonstrate productivity.
Greatest Challenge
Billing codes shouldn’t be what you spend time on working in the SNF / Post Acute setting. Your focus should be caring for your patients at the bedside.
Take the guess work out of billing codes requirements or what additional add on codes you could be using. Have a better understanding of billing codes, documentation requirements, and add on codes available for the care you are providing. Take the credit (via reimbursement and RVUs) for the work you are doing! Reach out today to the NPs at Nursing Decoded and we will share with you our tips and tricks for RVUs!
I would imagine working in a snf with the same patients builds relationships that you wouldn’t have in a hosp of continuously rotating patients. Kiddos to all in the medical field. Not an easy profession!
That is one of the rewarding parts of working in the SNF setting!
So informative! I’m not a nurse, but greatly appreciate all they do 🙂
Great information for NPs!
It is so true on the number of people going into nursing homes and I agree 💯 that billing codes are important but taking care of the elderly is top priority. Yet learning and getting the billing codes down is vital. What a great opportunity to sign up and take the course (on their own time) to know more. Great job! Thank you for sharing this info. I found it very interesting and knowledgeable.
Patients should always be the top priority! That’s why if you can learn the billing, you can then focus on the patients!
Very informative! My mom just retired after 37 years of nursing.
This is a great idea to have NP on site! It could really help.
Sounds like such a challenging yet rewarding job. God Bless Our Nurses!
I had no idea that this was part of what Nurse Practitioners have to do!
Good for you. Glad to seeing a nursing blog.
From a retired ARNP
I appreciate seeing the pros and cons. A pro for a skilled nursing facility for me would be the relationships with consistent patients.
Nursing is such a rewarding career to get into, with so many different potential avenues to take. My dad was in a nursing home, and I am thankful for the caring & knowledgeable nurses he had to take care of him.
Great information! There are so many things a nurse can do, this is great information for just one of the many opportunities
Love all our nurses do! Great information in this post.
We’ve developed far better relationships with NPs than our doctors. I would feel better security knowing our loved ones in nursing homes had an NP on site at all times.
It can make a difference!
In my opinion, Nurses have the toughest job! They are so valuable and a great advocate for the patient.
So surprising that this is required of this position!
I had no idea there were so many different jobs that nurses can get. Thank you for sharing.
Sounds challenging yet rewarding!
My mom worked on a skilled unit for decades until retirement.
Great info!
My daughter is a nurse working in a private office. I’ll have to ask her about this!