What’s the Difference Between Skilled Nursing and a Nursing Home?

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Understanding the terminology used in the long-term care industry is an important first step in determining viable care options. When it comes to senior care, some are used interchangeably. Skilled nursing facility, nursing home, and convalescent home are all terms used to describe a residential facility that provides on-site 24-hour medical care.

Confusion often arises surrounding the use of the term “skilled nursing.” It is helpful to consider that skilled nursing is a description of the type of service that is offered. The need for skilled nursing services does not automatically necessitate placement in a facility, because skilled services are available in a variety of senior care settings.

What is Skilled Nursing Care?

Skilled nursing care is a high level of medical care that must be provided by trained individuals, such as registered nurses (RNs) and physical, speech, and occupational therapists. These services can be necessary over the short term for rehabilitation from an illness or injury, or they may be required over the long term for patients who need care on a frequent or around-the-clock basis due to a chronic medical condition. Examples of skilled nursing services include wound care, intravenous (IV) therapy, injections, physical therapy, and monitoring of vital signs and medical equipment.

Skilled Nursing Care in the Home

As more seniors choose to age in place, home health agencies have responded by offering skilled services provided by licensed nurses or therapists in clients’ homes. When prescribed by a doctor, these short-term skilled care services can be covered by Medicare, some private health insurance policies, veterans benefits, and long-term care insurance policies. Utilizing a home health care provider enables an individual to receive highly effective medical treatment, while remaining as independent as possible in the comfort of their own home.

Read: How to Pay for In-Home Care

Skilled Nursing Care in Assisted Living Facilities

Seniors who require more assistance than what can be provided in the home may need to consider a move to an assisted living facility (ALF). Assisted living facilities provide a wide range of services to individuals who want to maintain some level of independence but require support with activities of daily living (ADLs).

Assisted living facilities vary widely in the levels of care available, and state licensing often determines the tiers of medical care that can be provided. Residents’ care plans are created, overseen and regularly reviewed by RNs and licensed practical nurses (LPNs). Some level of security, personal care and nursing staff is available around the clock, but the purpose of assisted living is to provide supervision and support with ADLs, not 24/7 skilled care. If a resident’s care needs exceed what the ALF can provide, they must either hire a home health agency to come in and provide these additional services in their apartment or consider moving to the next level of residential care: a nursing home.

What Are Nursing Homes?

Nursing homes, now more commonly known as skilled nursing facilities (SNFs), serve as licensed healthcare residences for individuals who require a higher level of medical care than can be provided in an assisted living facility. Skilled nursing staff consisting of RNs, LPNs, and certified nurses’ aides (CNAs) are available to provide 24-hour medical attention. Skilled nursing facilities are commonly used for short-term rehabilitative stays. Extending stays into longer-term care must be medically necessary for the treatment of a serious medical condition and is largely dependent on state and federal benefit regulations. In order to be certified by the Centers for Medicare and Medicaid Services (CMS), skilled nursing facilities must meet strict criteria and are subject to periodic inspections to ensure that quality standards are being met.

Evaluating Care Options

When researching elder care, whether you are looking for skilled nursing services or a nursing home, be sure to ask about certifications and regulations and who enforces them. You can find an overview of all care types and local providers in your area using the AgingCare.com Senior Living Guide.

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4 Comments

Medicare does not cover custodial care in skilled nursing facilities/nursing homes, but Medicaid does if they individual qualifies for Medicaid. Assisted Living facilities are only covered by private pay, long term care insurance or veterans aid and attendance.
There are almost no nursing homes in existence today that are not skilled. Assisted living facilities came into being years ago and took the place of "unskilled" nursing homes.
Assisted living communities have a nurse on staff but they also have med techs who are trained to dispense medicine to the residents. My mother is in a memory care unit at an AL. A resident can live there the rest of their life as long as they do not require IV's, feeding tubes at end of life. Hospice can come in to assist the family during this time.