Nursing Home vs. Home Care

Q: Is a nursing home like a hospital?

Although nursing homes are staffed by registered nurses and licensed therapists supervised by a physician, they don’t conduct surgical procedures. Many nursing home residents have relocated from hospitals to rehabilitate from a serious illness or surgery.

Q: Who pays for nursing home care?

Care can be paid out of pocket or by some insurance providers. However, the vast majority of nursing home residents’ fees are paid by <a href="https://www.medicaid.gov/medicaid/long-term-services-supports/institutional-long-term-care/nursing-facilities/index.html">Medicaid</a> if the facility is registered and licensed. You may qualify if your level of income and assets fall within the program’s guidelines for your state.

Q: Who pays for home care?

Medicare typically pays the home care provider for each 30-day period the senior requires home care. Medicare beneficiaries who live in an area covered by the <a href="https://www.medicaid.gov/medicaid/long-term-services-supports/program-all-inclusive-care-elderly/index.html">Program for All-Inclusive care for the Elderly (PACE)</a> may also qualify for additional support if their condition puts them at risk of entering a nursing home.

Q: Are home care and home health care the same?

No. However, there is a crossover, which may account for the confusion. Home care is a nonmedical service where staff assists with ADLs and some duties around the home, such as light housekeeping. Although home health care agencies can also provide these services, their primary purpose is medical. Staff is often registered nurses and licensed therapists who conduct limited medical care in the home.

Date Updated: July 26, 2024

Written by:

Rachel Lustbader

Rachel Lustbader is a writer and editor with a background in healthcare and technology. Her work has been published on websites including HealthCare.com, BiteSizeBio.com, BetterHelp.com, Caring.com, and PayingforSeniorCare.com. She studied health science and public health at Boston University.

Both of Rachel’s grandmothers had very positive experiences in senior living communities, and Rachel saw firsthand the impact that kind, committed caregivers and community managers can have on seniors’ and their family members’ lives. With her work at Caring, Rachel hopes to help other families find communities, caregivers, and at-home products that benefit elderly loved ones and make life less stressful for family caregivers

Aging has an array of benefits, such as more free time to enjoy family, friends and hobbies, but it also brings health issues for many. According to the Administration for Community Living, if you’re turning 65 today, you have a 70% chance of needing long-term care services to help you recuperate from a health condition. It also estimates 35% of those seniors will spend at least a year in a nursing home, so choosing the right one is a major decision. However, the majority of seniors are more likely to receive care at home and often for periods of five years or more, which makes finding the best home care provider just as important.

You might be confused about the type of care most suited to your needs. It’s normal to want to choose home care, as you won’t need to relocate. However, if you need more than help with activities of daily living (ADLs), such as bathing and toileting, you might find nursing home care is better for your long-term health prospects. This is because these facilities have staff to attend to your medical needs 24/7, which isn’t a common service given by home care providers. This doesn’t mean home care isn’t an option, as limited medical care can be provided, such as some therapies, wound care and managing medications intravenously.

To help you make a more informed decision, this guide will explain how the two care types differ. It also discusses the country’s average cost for both and the types of care nursing homes and home care providers deliver.

	Nursing Home	Home Care
Setting	Social and medical	Social and light medical
Living Accommodation	Private or semi-private room	Senior's own home
Housekeeping	Room cleaning, linens and laundry inclusive of the fee	Staff visit to conduct light housekeeping, which may include laundry
Typical Services Provided	Help with ADLs, managing medications, occupational/physical/speech therapies, wound care, etc.	Help with ADLs, light housekeeping, transportation for medical appointments, limited medical care in some cases
Average Monthly Cost*	$7,908 for a semi-private room, $9,034 for a private room	$4,957 for home care, $5,148 for home health care
Typical Resident	Seniors with long-term health conditions, also short-term health issues linked to hospital stays and help with ADLs	Seniors who need help with ADLs and those who can receive home-appropriate medical care (if home health care)

*Source: Genworth’s 2021 Cost of Care Survey

Nursing Home

Nursing homes provide hospital-like services, although not surgeries. Staff work 24/7, including registered nurses under the supervision of a physician, licensed nurses and licensed therapists. These facilities are best suited for seniors with long-term health conditions requiring around-the-clock care and those with short-term issues, such as rehabilitating from a hospital stay.

Amenities are limited, but games such as bingo and cards are common. Semiprivate and private rooms are available, all with en suite bathrooms and emergency call systems. The median monthly fee for a private room in the United States is $9,034, while a semi-private room is $7,908. Meals are freshly prepared by chefs and served in dining rooms, although some residents may eat in their rooms out of necessity.

Home Care

Home care allows seniors who need help with ADLs to be cared for at home. The similarly named home health care also helps with ADLs while simultaneously providing limited medical care, such as managing intravenous equipment and delivering occupational/physical/speech therapies.

Visiting staff may also conduct light housekeeping, which may include laundry and shopping for groceries. They may also drive the senior to medical appointments. As the senior is at home, they retain access to all their home comforts. According to statistics, 97% of home care recipients require assistance with bathing and 91% need help getting in and out of bed. The country’s average cost for home care is $4,957 per month, while home health care is $5,148.