Skilled nursing facility vs nursing home: what's the difference?
'Skilled nursing facility' and 'nursing home' are often used as if they mean the same thing. They don't. The same physical building can offer both, but they describe very different services, with very different price tags and very different payers. Getting the distinction right is one of the most important things a family can do in the first 48 hours after a hospital discharge.
Skilled nursing facility (SNF) — short-term, medical, Medicare-covered
A skilled nursing facility provides short-term rehabilitation and skilled medical care after a hospital stay — typically IV antibiotics, wound care, post-surgical recovery, or physical, occupational and speech therapy. The average SNF stay is 20–38 days. Medicare Part A pays up to 100 days per benefit period if you had a qualifying 3-day inpatient hospital stay and need daily skilled care.
Nursing home (long-term care) — indefinite, custodial, mostly Medicaid
Long-term nursing home care is for residents who need 24/7 help with bathing, dressing, eating, mobility and medication management for the foreseeable future. There is no time limit. Medicare does not pay for this care. About 62% of long-stay residents are on Medicaid, 22% are private-pay, and the remainder use long-term care insurance or VA benefits.
Same building, different beds
Roughly 95% of US SNFs are physically inside a nursing home. A facility usually has dedicated SNF rehab beds (often in a separate wing with a gym and therapy space) and long-term care beds. The same admission paperwork may not cover both — confirm in writing which bed type your loved one is being admitted to and what happens when Medicare days run out.
Cost comparison (2024 medians)
SNF (Medicare-covered): $0 for days 1–20, around $204/day co-pay for days 21–100, then nothing after 100. SNF (private-pay or after Medicare): about $300–$500 per day, or $9,000–$15,000 per month. Long-term nursing home: about $9,000 per month semi-private, $10,300 private. Costs vary by more than 3× between states.
How to choose a SNF after a hospital discharge
Hospitals must give you a written list of nearby SNFs but cannot tell you which to pick. Filter to 4- or 5-star CMS ratings, prioritise the Staffing sub-rating, and ask about the rehab therapy hours actually delivered per day (not just 'available'). Tour if you have 24 hours; otherwise rely on the CMS Five-Star and family reviews. If your loved one will likely transition to long-term care, pick a facility that offers both so they don't have to move.
How to choose a long-term nursing home
Stable staffing matters more than amenities. Look for a 4- or 5-star overall rating with no weak sub-category, low antipsychotic use, low staff turnover, and a Medicaid-certified bed so you don't have to move if assets spend down. See our guide on questions to ask when touring a nursing home and our state-by-state directory.
Frequently asked questions
Authoritative sources
The figures and rules in this guide are drawn from the following official and independent sources. Open any link to verify the latest published numbers.
- Skilled nursing facility (SNF) care
Medicare.gov
- SNF 3-Day Rule billing
CMS.gov
- Nursing home Five-Star ratings
Medicare.gov Care Compare
Related guides
About this guide
Written and reviewed by the Nursing Home Match editorial team. We update guides at least annually and verify every figure against the official sources listed above. This guide is general information, not personal, medical, financial or legal advice. Always confirm details on Medicare.gov Care Compare (United States) or My Aged Care (Australia), or speak to a qualified adviser before making decisions.