Your Complete Guide to Nursing Homes

What is a nursing home?

Nursing homes, or skilled nursing facilities, provide nursing care and long-term housing for seniors. Elderly nursing home residents often have significant physical or mental health conditions that require long-term, 24-hour nursing and personal care. These nursing facilities offer the highest level of care for seniors who need medical care but don’t require hospitalization.

Nursing homes also provide short-term, rehabilitative care after a hospital discharge. Rehabilitation programs at nursing home facilities help seniors who are recovering from an illness or accident regain mobility, strength, and function until they can return to normal activities.

Many people mistakenly use the “nursing home” as a catchall term for any type of senior living community, but that’s not the case. Independent living, assisted living, memory care, and nursing homes each offer a very specific type of care to meet seniors’ needs. Unlike the others, nursing homes offer access to skilled nursing care services.

Read on to learn more about how nursing homes are defined and how they stand apart from other senior care types.

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What’s the difference between nursing home facilities and other senior care types?

Nursing homes are residential facilities that offer a higher level of daily medical oversight, plus skilled nursing care that’s not available in other types of senior living facilities. While many residential senior care communities offer help with personal care and daily activities, nursing homes provide advanced on-site skilled nursing services. This type of care is ideal for seniors who need specialized medical care throughout the day but don’t need to be hospitalized.

Nursing homes vs. other senior care types

*Note: some services may vary depending on a state’s specific regulations

Nursing homes vs. assisted living

Nursing homes and assisted living differ in important ways, although some people may think they are synonymous. Both nursing homes and assisted living facilities offer senior housing, meal services, and help with personal care. However, seniors in assisted living communities are generally active and relatively independent, although they may need help with certain daily tasks. Nursing home residents typically have debilitating health problems or serious chronic conditions that require 24-hour care, skilled nursing services, or rehab therapies.

Like assisted living, nursing homes also offer social activities for residents, although options may be more limited than in assisted living facilities. This is because nursing homes often focus on medical care, while assisted living communities aim to improve quality of life through personal support and social engagement.

It’s important to note that some assisted living facilities may offer rehabilitative therapies, like that of a nursing facility, to their existing residents. However, these services typically aren’t offered initially, as new residents are screened to make sure they’re in a healthy, stable condition before moving in. Nursing services are typically only offered after a person establishes residence in a community and grows to need such care after an illness, injury, surgery, or hospital stay.

Nursing homes vs. memory care

Both nursing homes and memory care facilities offer 24-hour care and supervision, assistance with activities of daily living, and prepared meals. Nursing home care services cater exclusively to people with severe health problems, while memory care specializes in caring for people with memory loss. Memory care facilities might offer nursing or rehabilitative services as well, sometimes even having on-site skilled nursing units.

There are many differences between nursing homes and memory care:

• While nursing homes focus on residents’ physical and mental health, memory care aims to enhance the quality of life for people who have Alzheimer’s disease or another form of dementia.
• Memory care facilities provide specialized care from caregivers with dementia care training.
• Memory care activities are tailored to the individual and led in a secure environment designed to reduce confusion and prevent wandering.

Nursing homes vs. home care

Home care offers care for seniors who wish to age in place in their home. It can be full-time or part-time as support or respite for family caregivers. Home care aides are trained in a variety of senior care services. They can help with personal care, light housekeeping, cooking, pet care, transportation, and much more.

Home health is different from home care and must be prescribed by a physician. Unlike home health care, general home care doesn’t include the skilled nursing care provided at nursing homes. However, it’s possible to combine home care with home health care to receive skilled nursing care at home from licensed health care professionals. Home health services can provide long-term care or short-term rehab therapies, nursing care, wound care, injections, and more.

Even when combined with home health, home care may not be sufficient for seniors in need of 24-hour care or more intensive therapies. Home care costs may also be too much for seniors who need round-the-clock care, as fees are charged by the hour. Plus, caring for an aging loved one at home may require difficult or costly modifications to make the home safe and accessible, including additions such as ramps, wider doorways, chair lifts, and walk-in showers.

Is a nursing home right for my loved one?

Whether your loved one will benefit from a nursing home largely depends on their needs. Many people use the term “nursing home” to describe all types of senior living. However, senior living has greatly evolved over the years, and nursing homes are no longer the only senior care option. Seniors and families can choose from a wide variety of senior care services and senior living communities to find the best fit for their needs, lifestyle, and budget.

Nursing home services are for seniors in need of skilled nursing or rehab care, seniors who are seriously ill, or seniors recovering from injury or illness. Nursing home residents often need a higher level of care than what assisted living facilities offer or what can be provided at home.

When is it time for nursing home care?

For many families, moving a family member to a nursing home may be a difficult decision. However, when it’s no longer safe for a senior loved one to live on their own, considering all the senior care options may be the most caring thing to do.

Seniors in need of nursing home care may be severely ill, incontinent, bedridden, or on a feeding tube. They typically require 24-hour specialized care from licensed health care professionals, such as a registered nurse. It might be time for a nursing home if your aging loved one requires the following:

• Round-the-clock medical oversight or skilled nursing care. If your family member is gravely ill or has a serious, progressive medical condition, they may need specialized care from the licensed health care professionals at a nursing home.
• Rehab care after a hospital stay. Seniors recovering from injury or illness may benefit from rehabilitative care at a skilled nursing facility. However, skilled nursing facilities aren’t the only option for rehab. Individuals can choose between a skilled nursing facility or rehab center, depending on their specific needs. In some cases, it may also be possible to receive rehabilitation care at home or at an assisted living community.
• Significant help with mobility and transfers. Seniors who are bedridden or need significant assistance with mobility or transfers and/or nursing care for bedsoresmay require a nursing home.
• Significant help with activities of daily living like eating, bathing, and grooming.Elderly adults who can’t feed themselves, suffer from urinary or fecal incontinence, or are unable to maintain their hygiene on their own may benefit from nursing home care.
• Protection from falls. Falls are leading cause of serious head injuries and hip fractures in elderly adults. Nearly three million older adults end up in the emergency room each year because of fall injuries, according to the CDC. If your loved one falls frequently or is at increased risk for falls, they may need care from specialized staff who know how to minimize fall risks.

In addition to thinking about your loved one’s needs, consider your own well-being when assessing whether it’s time to move your family member to a nursing home:

• Can you provide the level of care your senior loved one needs at home? Seniors who have a serious health condition or cognitive impairment may need full-time care from licensed health care professionals that a caregiver simply can’t offer at home.
• Can you provide full-time care? More than 60% of caregivers have to juggle caring for a senior loved one with a career and other family responsibilities, according to AARP’s most recent survey on caregiving in the U.S. In some cases, caring for an elderly family member who needs 24-hour care while also maintaining a job may not be possible without significant help. Hiring an in-home caregiver can provide support and respite for family caregivers, but it may be costly, depending on how much care is needed.
• Is caregiving affecting your health? Caring for an aging loved one can put a caregiver at risk for stress, depression, and chronic conditions, like diabetes or heart disease. The AARP survey indicates that one in five family caregivers rate their health as fair or poor, and 23% of the survey respondents say it’s difficult to care for their own health while caring for a loved one.
• Are you feeling burned out? If you feel like you can’t care for an aging parent any longer, it may be time to consider senior care options.

What are nursing home qualification requirements?

Before you determine whether a nursing home is the right choice for your aging loved one, it’s important to understand the requirements for admission at a nursing home facility. Eligibility for nursing home care varies by state. This means a senior may qualify for nursing home care in Kansas, but not in New York. It’s important to contact your Medicaid or government county agency to understand your state’s requirements.

In general, seniors who qualify for nursing home care are severely debilitated or have serious chronic conditions. A physician determines a senior’s need by performing a physical examination and obtaining a medical history. The physician must document any medical needs for skilled nursing or rehabilitative services, as well as the need for assistance with daily activities and continuous supervision, or care for serious cognitive impairment. The evaluation also helps determine which medications and treatments should be provided at a nursing home facility.

Elderly adults who are eligible for nursing home care will need to fill out state and admission forms before moving in. Seniors who don’t qualify for a nursing home but need help with personal care or medication management may find an assisted living facility or memory care community good senior care options instead.

How much does a nursing home cost?

Nursing home costs depend on certain factors, including location and the level of care your loved one needs. The median monthly cost of nursing home care in the U.S. is about $7,908 for a semi-private room and $9,034 for a private room, according to Genworth’s most recent Cost of Care Survey. Nursing home costs vary greatly by state. For instance, seniors living in East Coast states, Hawaii, or Alaska will pay more for nursing home care than those living in the Midwestern or Southern states.

The cost of nursing home care is high because these facilities are staffed with medical professionals that provide 24-hour oversight and a level of care that is higher than at other types of senior living. Residents at these facilities often have a variety of chronic medical needs and typically require more help with personal care.

How do nursing home costs compare with the cost of other senior care types?

Because nursing homes offer a higher level of medical care, the cost of care at nursing homes is significantly higher than costs of other care types. And although increased security, specialized staff, and more one-on-one time for residents add to the cost of memory care, nursing home costs are still much higher in comparison.

It’s important to note that the cost of care at senior living facilities varies based on many factors, including location, level of care needed, community amenities, type of room or apartment, and whether accommodations are private or shared. The cost information below is the monthly median cost, according to Genworth’s most recent Cost of Care Survey and A Place for Mom internal data from 2023.

Sources: Genworth Cost of Care Survey and A Place for Mom internal data from 2023

How do you pay for nursing home care?

Once you’ve determined that your loved one is eligible and a nursing home is the right choice for them, it’s time to understand your options for financing care. There are many ways to pay for nursing home care, including:

• Medicare. Long-term nursing home care isn’t covered by Medicare. However, Medicare does cover the costs of short-term care or rehab services at skilled nursing facilities. This may help cover the cost of care for seniors recovering from an injury or illness after a hospital stay.
• Medicaid. Seniors with limited income and resources may qualify for financial assistance for long-term care at a nursing home under Medicaid. However, eligibility requirements vary by state. It’s important to contact your state’s Medicaid office to understand the requirements in your area.
• Veterans benefits. A veteran or their widowed spouse may benefit from the VA Aid and Attendance program. If your loved one is eligible, they may receive a supplemental income to help pay for senior care at a nursing home. The VA also provides a pension to eligible veterans that may help cover the costs of a nursing home.
• Bridge loan. Short-term loans can help fund senior care at a nursing home while you’re waiting for long-term care benefits, proceeds from the sale of a home, or other assets.
• Home equity. You may be able to sell your parent’s home, rent it, or apply for a reverse mortgage to convert equity into funds to pay for a nursing home.
• Long-term care insurance. Ask your loved one if they’ve purchased long-term care insurance. This type of insurance often can be used to cover long-term care costs at a nursing home facility.
• Life insurance. Check if your loved one’s life insurance policy may be sold or surrendered for a lump sum to help fund long-term care.

How do I choose a nursing home facility near me?

Finding a nursing home for your loved one may feel overwhelming. You may have many different facilities to choose from, so how do you know which one is right? Experts suggest starting with your family member’s prioritized needs and consider these key factors:

• Medical services. When you’re visiting nursing homes in your area, it’s important to understand the types of medical care offered, as services may vary from one facility to the next. Ask specific questions about the care offered based on your loved one’s condition.
• Food service. Ask how many meals are provided daily or weekly. Find out if they can accommodate dietary preferences and restrictions, such as low sugar or gluten free.
• Recreational activities. Check what kind of activities are offered and how often.
• Staff expertise. Find out about the staff members’ training and experience. Nursing homes typically have doctors, nurses, therapists, dietitians, and other licensed health care professionals on-site. Also be sure to ask how many nurses and other staff are available per resident during the day and night.
• Facility safety and cleanliness. When visiting a facility, pay attention to whether common areas are clean and free of unpleasant odors. Notice whether the facility looks well maintained and if it has adequate lighting, clearly marked exits, and accessible features, such as grab bars in hallways and bathrooms.
• Level of privacy. Find out if room accommodations are private or shared. Sharing a room can help save money but comes at the cost of more limited privacy.
• Care plans. How are care plans developed and how often are they updated? What happens if your family member’s health changes?

Ultimately, there’s no substitute for visiting and experiencing a typical day at the nursing home. Touring a facility provides opportunities to see the building, assess cleanliness, witness staff interactions with residents, observe meal time, and talk to other residents.

As you tour different facilities, be sure to ask whether the nursing home you’re visiting is Medicare or Medicaid certified and licensed, if you plan on using your benefits to help cover your care costs there. You can also check the facility’s rating on the Medicare website.

How do I move a loved one to a nursing home?

Moving a parent to a nursing home can be an emotional and sometimes stressful experience. You may feel guilty or anxious about the move and wonder whether your senior loved one will adapt and receive the care they need. Your family may not agree with your decision, or you may be struggling with how to talk with your parent about moving.

Take a step-by-step approach to ease anxiety and make the move smoother for your family and your aging loved one.

Talk to your loved one about nursing home care

Elder care is a difficult but important topic that many families ultimately can’t avoid. It’s essential to have regular conversations about senior care before an emergency situation arises. Plan ahead so you and your family have time to think about options and discuss what you need to prepare.

However, if your aging parent needs immediate help, it’s time to hold a family meeting. Consider your family dynamics to decide who to include. If your senior loved one is in good mental health, it’s a good idea to involve them. Set aside dedicated time, without distractions, to discuss needs and potential solutions. It’s important to be open to having a series of conversations before your family agrees on the right senior care choice.

Plan for moving day

If you’re stressed about moving day, plan ahead and consider finding expert assistance to help with this major transition. A senior move manager specializes in helping seniors downsize, relocate, and move. Delegating what can be an emotional task may help reduce tension, prevent family conflicts, and ease the burden on families and caregivers.

Whether they share a room or have a private space, they’ll want to bring at least some personal items. Personal items like toiletries, clothing, photos and keepsakes, jewelry, and eyeglasses are key. They may also want to bring certain items for entertainment, like books, hobby supplies, and a computer or tablet.

Before you settle on what to take when you’re moving a family member to a nursing home facility, it’s important to understand the space your loved one will be moving into. Before moving day, be sure to ask staff at the facility whether the following items are provided to your loved one:

• Bedding and towels
• A TV in the room
• A mini fridge in the room
• Laundry and housekeeping services
• Internet access

Before they arrive, make your loved one’s new space feel more like home with familiar items and photos of family and friends. Arrange their belongings in a way that reminds them of their previous home, but avoid cluttering the room. Instead, try to create a calming, comfortable space for your loved one.

Before moving day, remember to also:

• Set up mail forwarding with the U.S. Postal Service.
• Cancel current utility services.
• Inform friends and family about your loved one’s move.
• Add the community’s contact information to your devices.

How do I find a nursing home near me?

Given all the options and factors to consider, determining whether a nursing home meets your loved one’s needs may seem like an overwhelming task. Consider reaching out to one of our Senior Living Advisors for guidance. Advisors cannot refer you to a specific nursing home, but they can help you consider your aging relative’s needs, expectations for care, and your financial resources to find the right care option.