A nursing home resident needs daily nursing care that is ordered by a physician and performed under the supervision of skilled medical personnel, but the services are needed only occasionally during the day rather than on a 24-hour basis. What level of care does this describe?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Intermediate care sits between skilled and custodial care: it requires occasional (not 24-hour) skilled nursing or rehabilitative care that is ordered by a physician and performed by or under the supervision of licensed nursing personnel. Skilled care, by contrast, is the highest level of long-term care, generally requiring skilled nursing or medical services around the clock. Custodial care involves no skilled component at all. The distinction matters in LTC insurance because policies typically state different daily benefit amounts and eligibility rules for skilled, intermediate, and custodial care, and claims are classified by the level of care actually received. Classifying the level correctly determines what the policy will pay.
Why the other options are wrong
- B) Custodial care is non-skilled help with daily activities; it involves no physician-ordered skilled nursing services.
- C) Skilled care is the most intensive level, generally requiring 24-hour-a-day skilled nursing or medical care, not merely occasional services.
- D) Home health care describes a setting — the insured's own home — not a level of care, and this scenario is set in a nursing home with physician-ordered skilled services.
Memory hook
Occasional supervised skilled care = intermediate. Around-the-clock skilled care = skilled care.