What Is Nursing Home Care?

Moving into a skilled nursing facility for long-term care may present a difficult decision for you and your loved ones, but it can also offer numerous benefits. Key signs that your loved one may benefit from nursing home care include:

• Requiring more medical attention throughout the day
• Decreased mobility
• Eating poorly
• Not caring for themselves physically
• Struggling with medication schedules
• Needing frequent specialist care
• Suffering frequent falls
• Experiencing significant changes in wellness, routines and behavior

When making your decision, it may also be helpful to:

• Go through a typical day with your loved one and observe how well they’re managing.
• Ask others if they’ve noticed any type of decline or significant changes you should know about.

For a more detailed guide, see our full article that answers the question, When is it time to move from assisted living to nursing home care?

Nursing homes differ from assisted living facilities and home health care, so ensure you’re choosing the right care option for your loved one by comparing the services provided and considering their needs.

Nursing Homes vs. Assisted Living

If your loved one doesn’t require full-time medical care or supervision but can’t continue living independently at home, consider assisted living in lieu of a nursing home.

For a more detailed guide, see our full article on assisted living vs. skilled nursing.

Nursing Homes vs. Home Health Care and Home Care

Home care and home health care may suit seniors who can still mostly look after themselves and prefer to age in place. Both take place in a client’s residence, based on their needs and schedule. Home care provides non-medical support and home health care includes medical and non-medical assistance.

However, don’t confuse these options with hospice. This may take place in the home as well, but it provides end-of-life care with medical treatment for seniors who are expected to live about six months or less.

For further details, see our full articles on home health care vs. nursing homes and nursing homes vs. home care.

According to the 2023 Genworth Cost of Care Study, the nationwide median monthly cost of nursing home care is $8,669 for a semi-private room and $9,733 for a private accommodation.

Many older adults and caregivers worry about the cost of medical care. How your loved one pays for their long-term care in a nursing home depends on their financial situation and the types of services they require. They may rely on a variety of payment sources.

Financial Assistance for Nursing Home Care

If you’re counting on Medicare or Medicaid to pay for your loved one’s nursing home care, find out whether a facility is government certified. Coverage under these programs is limited with strict qualifications, but you can learn more by contacting your local Social Security Office.

Understanding Medicare Coverage of Nursing Home Care

Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet specific requirements. Key points include:  

• They must remain hospitalized for at least three days.
• Medicare will pay for up to 100 days of skilled nursing per benefit period.
• The first 20 days are covered in full.
• From day 21, beneficiaries must pay a daily coinsurance rate.
• After day 100, seniors are responsible for the entire cost.
• To qualify for another benefit period, seniors must have at least 60 consecutive days between hospital or skilled nursing facility stays.
• Coverage includes bed and board in a semi-private room, skilled nursing, rehabilitation therapies, medications, medical supplies and more.
• Coverage excludes assistance with daily activities and using medical equipment.

Financial Assistance for Ongoing Nursing Home Care

Seniors who need help paying for long-term nursing home care may qualify for:

• Medicaid
• The Program of All-Inclusive Care for the Elderly (PACE) in select areas
• Medigap supplements can cover daily coinsurance rates for days 21 through 100
• Long-term care insurance can provide more comprehensive benefits

For further details, see our full article on nursing home costs and ways to pay.

Follow these steps to find the most suitable nursing home for you or your loved one:

• Enter your ZIP code here in the Nursing Home Directory to find nursing homes in your area.
• Check ratings and reviews from other family caregivers.
• See government star ratings for nursing home quality.
• If you are certain you will be using Medicaid to pay for nursing home care, restrict your search to Medicaid-only nursing homes.
• Call numerous nursing homes to find what sets each one apart.
• Ask for references and call them.

For further details, see our full article on choosing a nursing home.

Ease the transition into a nursing home by talking with your loved one about skilled nursing options sooner rather than later, and always seek their input, especially when it’s time to choose a facility. 

Once your loved one moves into a facility, stay involved and in touch through regular visits or phone calls when you can’t visit. Get to know the staff that cares for your loved one and work with the ombudsman should any concerns arise about your loved one’s care.