Nursing Home vs Skilled Nursing Facility

If you or a loved one has an illness, you may need ongoing treatment from a medical care team. This care is usually delivered in a facility with 24-hour nursing staff working under the direction of a medical doctor. There’s more than one kind of nursing care facility, however, and knowing the difference between them can be crucial to getting the care you need.

The basic division in nursing care is between nursing homes and skilled nursing facilities. Despite their similar-sounding names, each plays a somewhat different role in providing therapy and other care services. This guide goes over the differences between nursing homes and skilled nursing facilities, including the types of care they provide, the likely cost differences and who should consider each type of facility. Here’s a surface-level overview of how these two care options compare:

Nursing home staff can help residents with the activities of daily living, including hygiene and personal care, dressing and mobility assistance. Mental and physical therapy services are geared toward maintaining as high a standard of living as possible. Care plans are developed in coordination with residents’ own doctors. Personal services may include hair and beauty care, nail care services, wound prevention and care and limited transportation services for medical appointments. A member of the nursing home staff might attend to residents during trips to maintain 24-hour supervision. Health-oriented services offered by most nursing homes include:

• Health services
• Rehabilitative services geared toward maintaining physical, mental and psychosocial well-being
• Medically oriented social services from staff social workers
• Pharmacy services
• Dietary assistance
• Activities programs to keep residents engaged
• Dental care
• Housekeeping and maintenance services
• Personal hygiene support
• Specialized rehab treatment for mental illness or intellectual disability

Nursing homes usually have a number of amenities for residents to enjoy. While every facility has its own amenities, things you’re likely to find in a typical nursing home include:

• Library
• TV room
• Garden and patio
• Spa/Jacuzzi
• Shared dining
• Gym or fitness center
• Onsite pharmacy and medication cart

According to the 2021 Genworth Cost of Care Study, nursing home care averages $7,908 monthly for a semi-private room and $9,034 for a private room. These costs vary considerably between states and between specific facilities. Government and private insurance may cover some or all of the expenses, depending on the details of the care provided and your provider. Costs not expressly included in your care plan may have to be paid out of pocket, especially nonmedical costs of lodgings and meals.

Skilled nursing facilities are intended to provide care for only a limited duration, usually between 30–90 days. As a result, they tend to be less focused on amenities and more focused on recovery and therapeutic care needs. They may have a memory care wing attached for long-term residents with dementia, which is almost always a secure location with locking doors and windows to prevent wandering behavior. Services you can expect to find in most skilled nursing facilities include:

• Treatment to maintain vision and hearing abilities
• Ambulatory assistance
• Wound care
• Incontinence care
• Physical and occupational therapy
• Physician, emergency and other medical care
• Speech pathology
• Infection control
• Transportation assistance offsite

Some skilled nursing facilities have a doctor’s office on the property, which may have a doctor permanently in residence or on a part-time basis. Doctors can direct the treatment approach of the care team, including in-person supervision of treatment in the event of an emergency.

The cost of post-acute care varies around the country, and even from one patient to another. Medicare includes some benefits to help pay for necessary skilled nursing care, though there are time limits:

• Days 1–20: Medicare pays the full cost for covered services. You
  pay nothing.
• Days 21–100: Medicare pays all but a daily coinsurance for
  covered services. You pay a daily coinsurance.
• Days beyond 100: Medicare pays nothing. You pay the full cost
  for covered services.