Moving a loved one to a nursing home or assisted living facility is a significant decision that involves careful consideration of many factors. From the facility’s location to the types of care and activities available, choosing the right nursing home requires thorough research and understanding to determine if it’s a good fit for your loved one.
In this guide, get to know what nursing homes are, why they play a crucial role in senior care, who lives in them and how much they cost.
What Is a Nursing Home?
Nursing homes are care facilities primarily for older adults who need either short- or long-term care. These facilities are often divided into two categories:
— Nursing homes. Nursing homes provide round-the-clock custodial care, which includes assistance with one or more activities of daily living, or ADLs, such as eating, preparing meals, bathing, dressing, going to the toilet and managing medications.
— Skilled nursing facilities. These facilities, on the other hand, provide specialized services, such as physical or occupational therapy, wound care or chronic disease management, which may be a good option for a loved one with complex medical needs. Licensed professionals provide care at skilled nursing facilities.
The two terms are often used interchangeably or under the umbrella of “nursing home,” even though they offer slightly different services.
[READ: Understanding the Impact of Health Conditions and Medications on Seniors]
What Type of Care Do Nursing Homes Provide?
Nursing homes provide a wide range of medical care and services, which can include:
— Dietary services and nutrition support
— Rehabilitative services, including short- and long-term care and treatment for disabilities
— Therapy services, such as speech, occupational or physical therapy
— Pharmaceutical services, including dispensing and administering medications
— Social services to support community engagement and overall well-being for residents
— Medical care, such as wound or catheter care
— Chronic disease management, such as diabetes control and blood pressure monitoring
— Psychological services to address mental health needs
Additionally, nursing homes often provide the following services:
— Laundry services
— Meal services, offered at least three times per day
— Assistance with ADLs, such as toileting, bathing and dressing
— Social activities, such as musical entertainment and art therapy
[READ: How to Choose a Nursing Home: Qualities to Look For.]
Nursing Homes vs. Other Long-Term Care Options for Seniors
provide support for older adults who can no longer live independently, offering a range of options to meet different needs, budgets and preferences. Choosing the right type of long-term care depends on various factors, including the level of medical assistance your loved one requires, any personal preferences and the facility location.
Nursing homes are a good option for those who need ongoing medical care in addition to assistance with ADLs.
“More than 1.4 million people live in over 15,500 Medicare- and Medicaid-certified nursing homes across the nation,” says Dr. Michael Tehrani, a geriatric physician and founder and CEO of MedWell Medical in Long Beach, California.
Below, compare various types of long-term care options and their average costs to help you understand the nuances and make an informed decision for your loved one.
Comparison of Long-Term Care Options
| Long-term care option | What it is | Average cost |
| Nursing home | Provides round-the-clock supervision and assistance with activities of daily living, offering a higher level of supervision and nursing care than assisted living | $9,733 per month (private room) $8,669 per month (semi-private room) |
| Skilled nursing facility | Provides short- or long-term care, including rehabilitation and medical services delivered by licensed medical professionals, and often serves patients recovering from hospitalization, surgery or illness who need intensive medical monitoring or rehab | $9,733 per month (private room) $8,669 per month (semi-private room) |
| Independent living or retirement community | Self-sufficient communities where older adults don’t require daily assistance and can age in place with minimal care; often includes amenities like social activities | $3,000-$4,000 per month |
| Assisted living | Offers assistance with daily personal care in a residential setting, and sometimes health care services are available | $5,350 per month |
| Continuing care retirement community | Provides a tiered approach to care for older adults, allowing residents to transition from independent living to on-site assisted living or nursing care as needs change — all within the same community | $3,450 per month (though pricing models vary, and entrance fees can be steep) |
| Memory care | Specialized unit or facility with intensive 24/7 extra care and supervision for people with Alzheimer’s and other types of dementia; includes structured activities and enhanced security | $6,000 to $8,000 per month |
[SEE: Nursing Home Red Flags You Should Watch Out For]
Who Qualifies for Care in a Nursing Home?
What qualifies someone for nursing home
care may vary by state. Before being admitted to a nursing home, the facility is required to conduct a thorough assessment — including a look at the individual’s medical, physical and cognitive abilities — to determine the right level of care for their needs. This includes assessing their level of independence, from eating to moving around to managing a medical condition, and usually requires sign-off from a medical professional, such as a geriatrician. However, this should ultimately be a joint decision among your loved one, their family members or caregiver and their medical provider.
It’s also a common misconception that nursing homes and skilled nursing facilities care only for the elderly.
In its May 2022 report, the National Center for Health Statistics noted that the majority of long-term care service users were age 65 or older, with 83.1% of nursing home residents being in that older age bracket. That means 16.9% of residents were younger than age 65 — a sizable minority.
Those younger residents (and some of the older residents) may not be planning to stay in a facility for the duration of their lives; rather, they may need rehabilitative care. Some younger people with certain disabilities that require constant care, such as severe developmental disabilities, may also live in a skilled nursing facility.
When to Consider Nursing Home Care
When an older adult can no longer live independently or home care isn’t meeting their needs, it might be time to consider a nursing home for your loved one.
Signs to look for that may signify it’s time for more intensive care include:
— Worsening medical condition
— Cognitive decline or signs of memory loss
— Noticeable changes in behavior
— Lack of mobility
— More frequent falls or other injuries
— Overall increased frailty
— Not maintaining proper nutrition
— More frequent hospitalizations or doctor’s office visits
— Difficulty managing household tasks
— Difficulty keeping up with personal hygiene
— Difficulty managing finances
Beyond the state of the individual’s health, it also may be time to consider a nursing home if your loved one has inadequate support at home or their caregiver is overwhelmed. For older adults who live alone or lack sufficient in-home assistance, for instance, a nursing home can help ensure they’re receiving necessary round-the-clock care. Likewise, caregiver burnout is a common challenge — particularly if your loved one’s overall condition worsens and requires more intensive, continuous support.
If you’re feeling stressed, overwhelmed or physically unable to provide the necessary level of care for your loved one, transitioning to nursing home care may be more sustainable and mutually beneficial for both of you.
[Signs It’s Time for Memory Care]
How Long Is the Average Stay in a Nursing Home?
Because of the wide variability of care needs across such a diverse population, it can be difficult to determine how long you’ll need care in a nursing home.
The Administration on Aging, however, reports that women on average need long-term care services and support for 3.7 years, while men average 2.2. years. Although approximately one-third of people age 65 today won’t need long-term care support at all, about 20% of people the same age will need it for longer than five years, the AOA reports. (Those figures include all kinds of long-term care, including assisted living communities, nursing homes and at-home care.)
For nursing homes specifically, long-term residents average a stay of two years or more, according to the National Care Planning Council.
Because aging in America can be a socially isolating experience, Dr. Tanya Gure, section chief of geriatrics at the Ohio State University Wexner Medical Center in Columbus, routinely talks with her patients about their plans for the future, especially if they’re about to undergo an elective surgical procedure or foresee that they might need extra short-term care at some point.
“This is a resource they can utilize so that when they go back home, they are more capable of facing what they find there,” she says.
Nursing Home Costs
According to Genworth Financial’s 2023 Cost of Care survey — the most recent data available — the median cost of skilled nursing in a private room at a nursing home will set you back $116,800 per year, versus just over $104,000 for a semi-private room. But prices can vary greatly depending on where in the country the community is located and which services a senior is using.
For example, Genworth Financial reports that Alaska, Connecticut and Hawaii have high daily costs for private nursing homes at $1,137, $545 and $401 per day, respectively. In Alaska, that adds up to a whopping $415,005 per year.
At the other end of the spectrum, Missouri, Oklahoma and Louisiana are among the least expensive areas, with per-day private room costs of $215, $225 and $246, respectively. The annual total ranges from $78,475 to $89,790 per year in those states.
How to Pay for Nursing Home Care
A popular misconception is that Medicare, the federal health insurance program for people age 65 and older, pays for residency in a long-term care facility. In fact, Medicare does not cover custodial care in a nursing home facility. However, Medicare does pay for the first 100 days in a nursing home or skilled nursing facility, if certain criteria are met. For instance, the patient must have been hospitalized for at least three consecutive days before transferring to the nursing home, referred to as a “qualified inpatient hospital stay.”
If you meet all of the qualifying conditions, Medicare coverage for skilled nursing care includes:
— Days 1 to 20: Medicare will cover 100% of care in a skilled nursing facility for the first 20 days. You pay $0 during this benefit period.
— Days 21 to 100: There is a daily copayment, which is $204 per day in 2024. This amount may change in 2025.
— After day 100: Once you reach day 101, Medicare coverage ends. You will be responsible for 100% of costs, and other forms of payment need to be in place.
The coverage rules for Medicare Advantage plans are different, so check your specific coverage plan for details.
Because Medicare doesn’t pay for long-term care, people who need nursing home care must pay privately. Finding a way to pay for long-term care can be a big problem for many people, especially given the high costs associated with such care.
Long-term care insurance policies may be an option to pay for nursing home care, but these policies can be prohibitively costly for many. Some insurance companies also allow life insurance policies to cover long-term care expenses. But in most cases, people pay out of pocket until their resources are used up, at which point Medicaid, a joint federal and state program providing coverage to low-income individuals, kicks in to cover costs. In fact, Medicaid is the payment source for the majority of nursing home residents, with 62% using this means, according to the NCHS. But the rules vary from state to state, so it’s important to talk with an advisor to understand your options.
How to Find the Best Nursing Homes Near You
As you’re looking at nursing homes, consider U.S. News’ Best Nursing Homes ratings. U.S. News ratings appear in two categories: short-term rehabilitation and long-term care. You can search by location to find the closest, highest-performing nursing homes near you.
If you’re looking for a nursing home or a long-term care facility for a loved one now or if you will in the near future, take care to do some extra diligence to ask about their procedures and policies regarding infection control and how staff are working to keep residents safe from contagious diseases, such as the flu and pneumonia. Tehrani also recommends asking how the facility handles medical emergencies.
More from U.S. News
The Most Unique Nursing Home Activities for Seniors
How to Choose and Questions to Ask a Hospice Provider Near You
Does Medicaid Pay for Assisted Living? What You Need to Know
Nursing Home Statistics: What to Know in 2025 originally appeared on usnews.com
Update 10/23/24: This story was previously published at an earlier date and has been updated with new information.
