It’s overwhelming enough helping your mom get discharged from the hospital after a fall. But what if her doctor doesn’t think it’s safe for her to return home? As you scramble to find somewhere for her to go, you’re inundated with unfamiliar senior living terminology: What is a skilled nursing facility? What is a nursing home? Are they the same?
The answer isn’t so straightforward. In some situations, medical professionals use the terms “nursing homes” and “skilled nursing facilities” interchangeably. In others, they can mean two distinct levels of care.
Read on to learn about the subtle differences between the two types of senior care.
[READ: How to Choose a Good Nursing Home: Expert Tips]
Nursing Home vs. Skilled Nursing Facility: Is There a Difference?
Nursing homes and skilled nursing facilities differ in two ways: the level of care provided and how long residents stay.
— Nursing home care is long-term custodial (nonmedical) care. This care includes aid with activities of daily living, such as bathing, dressing and eating, as well as basic health care that unlicensed professionals can provide, such as administering eye drops. These professionals can also supervise a resident self-administering over-the-counter medication, such as Tylenol. The type of care unlicensed professionals can provide varies by state.
— Skilled nursing care is short-term medical care that requires more advanced training to provide. Health care professionals, such as nurses or therapists, may give IV medications or provide physical therapy after surgery, for instance. They can also conduct additional health monitoring or assessments.
“Nursing home” is the actual umbrella term and the most common term used by the public, says Evan H. Farr, a certified elder law attorney at Farr Law Firm P.C. in Virginia, Maryland and Washington, D.C. It is also the term used by the Centers for Medicare & Medicaid Services (CMS) with their Nursing Home Compare Tool.
The confusion begins because not everyone’s care needs are one-size-fits-all. While some long-term nursing home residents only need custodial care, others need both skilled nursing care and custodial care for the remainder of their lives. Often, a short-term skilled nursing stay leads to longer-term nursing and custodial care.
“Fewer facilities offer (just) nursing home or custodial-only care,” adds Mark Sanchez, administrator for United Hebrew, a campus of elder care facilities in New Rochelle, New York. “Most modern nursing homes offer a wide range of services that go well beyond basic care, including medical, personal, social and lifestyle support. These services are intended to help seniors with complex needs.”
[READ: Nursing Homes vs. Assisted Living.]
Qualifying for a Skilled Nursing Facility
To qualify for a skilled nursing facility, your family member will need a recommendation from a medical provider or documentation that they need nursing tasks to manage their lifestyle or health condition.
Does Medicare pay for skilled nursing care?
Yes, Medicare does pay for skilled nursing care, within specific limits.
Medicare covers up to 100 days of skilled nursing services.
| Duration of stay | What you pay |
| Days 1-20 | $0 after the initial benefit period payment ($1,736 in 2026) |
| Days 21-100 | $217 per day in 2026 |
| Day 101 and beyond | 100% of costs |
The requirements for Medicare coverage include:
— A three-day inpatient hospital stay within the past 30 days
— Available days in the benefit period
— A medical provider determining that you have skilled nursing needs
Medicare does not cover ongoing care needs, indefinite skilled nursing needs or custodial care alone.
Does Medicaid pay for skilled nursing care?
Yes, Medicaid can pay for skilled nursing care.
Medicaid, unlike Medicare, is a joint federal and state program for low-income individuals. If your loved one qualifies for Medicaid, they may use these funds as a means to help pay for some of their long-term care needs as well.
[READ: How to Pay for Nursing Home Costs.]
Is a Skilled Nursing Facility or a Nursing Home a Better Fit?
To determine if a skilled nursing facility or a nursing home is the best fit, start off with a thorough assessment of what type of senior care your family member needs.
Skilled nursing is ideal for seniors who are recovering from acute illness, acute injury or a surgery, says Dr. Dona Uncheselu, a medical director at Parkview Physicians Group Palliative Care at Parkview Health in Fort Wayne, Indiana. The goal is for seniors to recover their strength back to their baseline and return to their previous residence.
Going back to our example, let’s say your mom fell because of worsening hip pain and has experienced continued difficulty keeping her balance. Your mom’s fall was severe enough to require a hip replacement. After surgery at a hospital, her doctor recommends short-term skilled nursing facility care, such as physical therapy and IV pain medication.
A nursing home is better for those who cannot care safely for themselves at home, do not have a caregiver and need assistance with activities of daily living.
Let’s say your mom fell because of hip pain and balance issues, but she also needs help with multiple tasks, including medication management, grooming and toileting. Although the fall only caused minor scrapes and bruises, her doctor thinks she won’t be able to get around the house on her own and needs more supervision. In this situation, your mom would mainly benefit from custodial care in a nursing home.
You might also consider:
— Any underlying medical conditions your loved one has and how they interact with one another. Having heart failure and chronic kidney disease at the same time, for instance, requires intense care management.
— The need for skilled services, such as intravenous medications or colostomy care
— How able you are to participate in any rehabilitation, such as physical therapy
— Whether recovery is expected and what your recovery timeline looks like
— A medical provider’s recommendations
See the table below for differences between a skilled nursing vs. a nursing home level of care:
| Category | Skilled Nursing Care | Nursing Home |
| Primary purpose | Short-term medical and rehabilitative care after an acute event or hospital stay | Long-term custodial care and daily living support for chronic needs |
| Length of stay | Days to weeks | Long-term or indefinite |
| Services provided | Specialized therapy, nursing interventions, IV medications | Help with dressing, bathing and other activities of daily living |
| Medicare coverage | Yes, after a qualifying hospital stay with variable coverage up to 100 days.
“Room and board, medical care and rehabilitation therapy are typically covered about 60% to 80% by Medicare or other private insurances,” Uncheselu says. |
No |
| Medicaid coverage | Usually, depending on your state’s eligibility requirements | Sometimes, depending on your state’s eligibility requirements |
How much does skilled nursing cost compared to a nursing home?
When it comes to the spectrum of care available, people often start at a lower level of care, such as an assisted living community, an adult family home or group home, to save money. A nursing home, on the other hand, tends to be one of the most expensive care options. For example, a private room in a nursing home can run more than $9,000 per month, according to Genworth and CareScout’s 2024 Cost of Care survey.
Cost data for skilled nursing facilities and nursing homes is usually reported as a blended average of the two, meaning published rates don’t clearly separate skilled nursing from custodial care. This is because most of this care takes place within the same building. While custodial care generally requires fewer medical resources and may cost less, the only way to know exactly what you will pay is to get a personalized quote from a senior living community.
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What Is a Skilled Nursing Facility vs. a Nursing Home? originally appeared on usnews.com
Update 12/31/25: This story was previously published at an earlier date and has been updated with new information.
