Complete Guide to Nursing Homes
There are a lot of myths and misconceptions about nursing homes. For example, one myth is that living in a nursing home is like living in a hospital, and another is that once you move into a nursing home, you can never leave. However, the reality of modern nursing homes is quite different.
In this guide, we’ll clear up the confusion and help you understand when and why a nursing home might be the right care choice for your loved one. We will clarify why a nursing home is NOT Assisted Living. We’ll cover what nursing homes are, how nursing homes compare to other types of senior living, like an assisted living facility, and how to find the best nursing home near you.
Find Your Local Senior Living Advisor for Nursing Homes
What Are Nursing Homes?
Nursing homes are not assisted living communities. Also, they are not skilled nursing facilities (SNF), which is usually only for temporary residents. Nursing Homes provide the highest level of health care out of any senior living option. Standard services at nursing home facilities include:
- 24-hour support and supervision
- Assistance with activities of daily living (ADLs), such as bathing, toileting, and grooming
- Medication management
- Escort and transfer assistance
- Care coordination
- Nutritious meals and snacks
- Social activities and outings
- Complimentary transportation
What differentiates nursing homes from other forms of senior living is that they are the only type of senior care facility licensed to provide medical care services, such as skilled nursing and rehabilitative therapy.
Nursing homes are designed to provide comprehensive care in a private or semi-private room. Residents aren’t confined to their beds and can freely move around and interact with each other. There are also common areas where entire families can come visit and spend time with their loved ones.
They are always commercially zoned and may or may not be on the same campus as an independent living community thereby creating what is often categorized as a CCRC (continuing care retirement community).
Short-Term vs. Long-Term Nursing Home Care
Nursing homes offer a range of different options, depending on the level of care your loved one needs and for how long.
For example, for short-term stays you will want to look for a Skilled Nursing Facility (SNF). These are perfect for short-term rehabilitative services, such as physical, occupational, and speech therapy- when a skilled care service is identified following a hospital stay and is typically covered by their Medicare benefit. They are geared toward seniors who temporarily need additional support after being discharged from a hospital and who will discharge to home or a home-like environment after their skilled service benefit needs have been met, usually less than 21 days.
There are also nursing homes that offer long-term, palliative care for seniors with ongoing medical conditions that require constant care and supervision. For example, perhaps your loved one needs daily specialized treatment for kidney disease or a heart condition that can’t be provided at home. Remember, assisted living communities do not provide this kind of medical care or rehabilitation.
Finally, there are nursing homes that focus on providing hospice care to ensure the comfort of seniors with terminal illnesses who are approaching the end of life.
Nursing Homes vs. Assisted Living
These days, many people who are initially searching online for nursing homes in their area are actually a better fit for an assisted living community. But what is the difference?
Assisted living communities are for seniors who don’t need regular medical care, but do require assistance with activities of daily living (ADLs). Residents live in private apartments with senior-friendly features like bathroom grab bars, barrier-free doorways (to accommodate wheelchairs / walkers), and alert buttons. They receive assistance with ADLs, enjoy three daily meals (plus snacks), and can participate in a wide array of different community activities – such as book clubs, exercise classes, game nights, field trips, etc.
Many assisted living communities also include on-site amenities like a library, beauty salon, gardens or walking paths, gym, etc. Residents may keep their own car, but many often prefer to make use of the community’s transportation service/public transit to shop or attend medical appointments.
Nursing homes offer many of the same services and amenities as assisted living communities, but are for seniors who have more comprehensive care needs or need daily medical care and 24/7 supervision by licensed medical professionals.
As previously mentioned,nursing homes are the only form of senior living that can provide 24/7 medical services. Like memory care communities for residents with Alzheimer’s or other dementia related illnesses, many nursing homes also include increased safety measures for residents with memory issues / dementia.
The level of medical care provided in an assisted living facility versus a nursing home is also reflected in the price. According to the 2021 Genworth Cost of Care Survey, the national monthly median cost for assisted living is $4,429. Meanwhile, the national monthly median cost for a private room at a skilled nursing facility is $9.086.
Nursing Homes vs. Senior Living
It used to be that the term “nursing home” was interchangeable with “senior living.” However, in modern parlance, the two terms mean different things.
Senior living is a catchall phrase for living communities designed for seniors (ages 55+). It includes independent living, assisted living, continuing care retirement communities (CCRCs), memory care facilities, and yes – nursing homes.
As a whole, modern senior living communities use social-based models that focus on providing for the emotional, social, and physical needs of residents. In the case of nursing homes, they also include medical services.
|Amenities||Independent Living||Assisted Living||Memory Care||Nursing Home|
|Assistance with ADLs|
What About Skilled Nursing Home Care?
Perhaps your loved one doesn’t want to have to stay in a skilled nursing facility after being discharged from the hospital. Or, other than needing daily medical care, they prefer to live independently in their own private residence. In such cases, they might be able to receive skilled nursing care right in their own home. Provided they have the financial means to do so, seniors and their families can hire licensed home health aides to help with various medical procedures, such as:
- Health monitoring
- Occupational, physical, and speech therapy
- Blood draws and injections
- Feeding tubes and catheters
- IV drips
- Wound care
The national median cost of hiring a home health aide is currently $4,576 per month. Keep in mind that the types of home nursing care services that are available will vary depending on state laws, as well as the agency. Furthermore, custodial services – such as assistance with ADLs, cooking, cleaning, etc. – are separate from skilled nursing services and will cost extra.
|Amenities||Skilled Nursing Facility||Nursing Home Care|
|Assistance with ADLs||Yes||Not typically available (unless part of the medical condition).Would have to arrange separately/pay extra.|
|Meals||Yes||Not typically available. Would have to arrange separately/pay extra.|
|Activities & Entertainment||Yes||Yes|
When Is a Nursing Home the Right Senior Living Choice?
With all the different types of senior care available, when is a nursing home a good option for your loved one? The first consideration is the level of care your loved one needs – specifically, do they only need assistance with activities of daily living, or do they require regular skilled nursing? If they don’t need skilled medical care, then you should look into senior living options like memory care or assisted living.
If your loved one does need medical care, the next question is for how long? For example, have they been discharged from the hospital after extensive surgery? In that case, temporary admittance to a nursing facility or short-term respite stay in an assisted living facility focused on rehabilitative care can help ensure their full recovery.
Meanwhile, if they can still live independently, but need regular assistance to manage a chronic condition, a home health aid can be a good fit. However, if your loved one can no longer manage independently and needs daily palliative care, then moving them into a residential nursing home might be the best option to ensure their comfort and well-being.
You can take our senior needs assessment quiz to help you determine which types of senior living might be the best choice for your loved one’s care and lifestyle needs.
Compare Nursing Homes
You want to move your aging loved ones into a nursing home where they will feel happy, safe, and comfortable. As such, here are some key questions you should consider when you evaluate different living facilities:
Quality of Care
- What kind of training do caregivers and staff have?
- Which ADLs do they provide assistance with?
- Is the facility equipped to provide appropriate care for your loved one’s specific health needs?
- How do staff handle difficult behaviors?
- What type of needs assessments do they require for new residents?
- What type of safety measures do they have in place (in the event of severe weather, a fire, etc.)?
- What is the basic monthly fee?
- Is there a deposit or entry fee for new residents?
- How far in advance will families be notified about potential changes in cost?
- What is their process for handling payment issues/disputes?
- What financing options does the nursing home accept (Medicaid, Long-Term Care Insurance, etc.)?
- What is their payment structure for additional fees for services or activities?
- What types of rooms are available (i.e., private or semi-private)?
- How often are rooms cleaned?
- How do staff keep residents engaged and well-socialized?
- What building amenities do they offer (i.e., activity rooms, secure gardens, etc.)?
- Are animals allowed in the facility (for example, could you bring a beloved pet in to visit)?
- Are they able to accommodate different food allergies or dietary restrictions?
When touring different nursing homes, make sure to explore the facility, stay for lunch, and observe daily activities. Is the building well-maintained? Are the rooms comfortably sized? Do residents seem to be healthy, calm, and engaged? Do they receive personalized attention when they interact with staff members?
See if you can connect with any of the current residents (and their families) to hear about their experiences. Also, make sure to visit the appropriate state regulatory agency (most likely the health department) to look up the community and review their survey or inspection reports for issues that could impact your loved one. Finally, do a search online for reviews.
How Much Do Nursing Homes Cost?
The cost of nursing home care will vary dramatically across the United States, depending on your location. Here is how the average monthly cost breaks down state by state:
|State||Avg. Cost||State||Avg. Cost||State||Avg. Cost||State||Avg. Cost||State||Avg. Cost|
The above numbers are just averages, and the actual price of specific nursing home facilities can vary widely — even within the same city.
When considering nursing home costs, a lot of seniors assume that Medicare will help them pay for care. However, this is not always the case, as Medicare coverage for skilled nursing depends on several factors, including the type of care and the duration of care.
For example, short-term skilled nursing care – such as following a stay in the hospital – is almost always covered by Medicare. Generally, the program will pay 100% of approved costs for the first 20 days and partially cover another 80 days of medically necessary skilled nursing care.
However, the rules are different for long-term residential nursing homes. While Medicare might help cover medical care, such as doctor services, prescription medications, and medical supplies that your loved one needs while living in a nursing home setting, custodial care services (i.e., assistance with ADLs) room & board, etc., are generally not included.
We recommend reading our nursing home cost guide [A/N: include a link when available] to learn more about the various factors that will influence the cost of nursing homes in your area, as well as different ways to finance nursing home care.
Find your local senior care advisor
Now that you know the difference between a nursing home and assisted living, you might have discovered you are actually seeking assisted living or another kind of senior living setting. Finding, vetting, and moving your aging parent or loved one into any kind of senior living community can feel like an overwhelming challenge. Fortunately, a local senior care advisor can provide personalized guidance throughout the process.
It can be difficult for seniors to move into a new environment, but working with a senior care advisor to create a plan can go a long way toward ensuring a positive outcome. It’s important to note, they do not specialize in nursing homes. Instead, they are experts in long-term private pay assisted living, memory care, independent living and even home care.
Unlike national placement agents, local senior care advisors are personally familiar with all senior living options in your area and can help guide you through finding the right placement for your aging parent or loved one. If you are seeking assisted living, memory care, independent living, or even home care – they can set up and take you on tours of the best options. A local senior care advisor lives and works in the region they represent. This affords them the knowledge to assess different facilities, answer your questions, help ease your loved one’s concerns, and assist you in figuring out the best financing option for your situation.
FAQ About Nursing Homes
A nursing home is a senior living option for older adults who need regular medical care provided by licensed nurses. Nursing homes can offer both short-term rehabilitation programs (to help older adults recover from an illness or accident) and long-term residential care (for seniors living with a chronic or progressive illness).
Residents in both assisted living and nursing home communities enjoy increased security, assistance with activities of daily living (ADLs), meals, activities, and opportunities to socialize. However, assisted living facilities do not provide medical care services. Assisted living is appropriate for seniors who need custodial care, but who don’t require regular medical assistance. Nursing homes are the only form of senior living licensed to provide skilled nursing / rehabilitative care and are best for seniors with more severe health conditions who need regular medical care.
Memory care is a specialized form of assisted living for adults who have been diagnosed with cognitive issues such as Alzheimer’s disease or dementia. In addition to ADL support, meals, housekeeping, etc., memory care communities offer personalized activities designed to promote cognitive health. However, they cannot provide skilled medical care services.
Nursing homes generally do not provide the same level of specialized socialization or cognitive-focused activities as memory care. However, they are an appropriate care choice for seniors with dementia who also have serious problems with their health and require skilled nursing care.
The cost of nursing home care depends on many factors, such as the location, care requirements, etc. According to the 2020 Genworth Cost of Care Survey, nursing home costs can range from $60,955 to over $448,950 per year, but the national median cost of a semi-private room at a skilled nursing facility is currently $7,756 per month.
Nursing homes generally provide the highest level of care out of any senior living option. In addition to skilled nursing/rehabilitative services, residents at nursing home facilities also enjoy various amenities like:
- Senior-friendly, ADA-compliant building design
- Private/semi-private rooms
- Three daily meals (plus snacks)
- 24-hour support with activities of daily living (ADLs)
- 24/7 oversight from trained medical staff
- Activities and social events