Nursing Homes Explained
In a nursing home, residents have 24-hour access to trained staff, so they can be continuously monitored for medical needs and can receive help with the activities of daily living. Your loved one may need long-term residential care in a nursing home or short-term care in a skilled nursing facility following surgery, hospitalization, or an illness.
There are two levels of nursing home care. In a skilled nursing facility (SNF), residents are under the 24-hour care of licensed or registered nursing staff, while in an intermediate care facility residents are cared for by certified nursing assistants.
Note: If your loved one doesn't need full-time medical supervision and is able to live more independently, search for assisted living instead.
Jump to: Cost of nursing homes | What skilled nursing facilities do | What intermediate care facilities do | What convalescent homes do | Nursing home regulations and requirements | How to find a nursing home
At $3,000 to $10,000 a month, nursing homes are expensive, there's no doubt about that. In some cases, for some periods of time, nursing home care may be covered by Medicare. Some nursing homes also accept Medicaid. The finer details are complex; be sure to check out our guide to paying for nursing home care.
Note: If you expect Medicare or Medicaid to pay for your loved one's nursing home, make sure this is established ahead of time. It's illegal for a facility that participates in these programs to require a resident to pay privately for a period of time before accepting government-mandated coverage.
A skilled nursing facility, or SNF, provides round-the-clock medical supervision in addition to help with tasks of daily living, such as bathing, dressing, and toileting. Your loved one may need to be in a skilled nursing facility if he's on a respirator, requires regular physical or occupational therapy, is recovering from surgery, or has wounds that need ongoing medical care. A skilled nursing facility provides 24-hour staffing by licensed or registered nurses. The staff at most skilled nursing facilities includes a social services team and a rehabilitation team, in addition to nurses and care staff. Most skilled nursing facilities provide both short-term acute care and rehabilitation and long-term care.
Intermediate care facilities, as the name implies, are one step down from a skilled nursing facility in terms of level of care. An intermediate care facility provides inpatient care for seniors who don't require continuous nursing care but do need nursing supervision and supportive care. If your loved one primarily needs some basic nursing services and ongoing help with activities of daily living, then an intermediate care nursing home rather than a skilled nursing facility may be the best choice. There are also specialized intermediate care facilities for the developmentally disabled.
The term convalescent home is the name used by many nursing homes and skilled nursing facilities. The range of services provided by a convalescent home can vary from facility to facility, so if you're considering a particular convalescent home, compare it to other skilled nursing facilities in your area. Convalescent homes are usually Medicare-certified for skilled nursing care.
When your loved one is assigned to a nursing home, certain rules and regulations apply. Most nursing homes have a contract that you sign before your loved one moves in. It's important to know what's covered in a nursing home agreement and what to watch out for. In many cases there are special agreements you can make ahead of time, and clauses in some contracts you may wish to avoid. If you're concerned about specific issues, you can discuss them ahead of time with the staff. For example, many people are concerned about the use of restraints. The good news is that use of restraints in nursing homes is declining steadily, with only 5.9 percent of patients nationwide restrained according to the latest figures. Restraining devices such as rails, belts, and vests are now illegal under federal law except when used for medical or safety reasons, such as preventing a patient from pulling out an IV.
To start your search, type your zip code here in the Nursing Home Directory to find nursing homes in your area. Be sure to look for ratings and reviews from other family caregivers. You'll also see the government's star ratings for nursing home quality.
Be sure to call numerous nursing homes to get a feel for the facility and what sets each one apart. There are numerous refreshing trends in nursing home care -- including the emergence of smaller, homier nursing homes where care is provided in smaller, more personalized home-style settings. It's always a good idea to ask for references and call them.
To help guide your process, be sure to use our nursing home checklist.