What’s the Difference Between a Skilled Nursing Facility and a Nursing Home?
On the surface, a skilled nursing facility and a nursing home may appear rather the same. In fact, some care facilities actually function as both, with a distinct floor or section of a building dedicated to each.
The difference between a skilled nursing facility and a nursing home comes down to the type of care offered, a nursing home level of care versus skilled nursing.
What is a Nursing Home?
A nursing home is a residence for anyone who doesn’t meet the requirements to be in a hospital but can’t be cared for at home. Most nursing homes employ nurse’s aides on hand 24 hours a day. Care in a nursing home includes personal hygiene, activities of daily living such as getting dressed, going to the bathroom and eating meals, and recreational activities.
These tasks can be carried out either in a nursing home or in a patient’s home. If the patient chooses to remain in their own home, the custodian can also assist with light tasks, such as purchasing groceries, doing laundry, preparing meals and driving the patient to doctor’s appointments.
However, unlike skilled nursing facilities, nursing homes do not offer medical care that meets all the residents’ precise needs. Residents at nursing homes with specific medical needs often travel to healthcare facilities that offer such care.
Most nursing homes, however, do employ full-time nurses to administer to patients. The majority also provide access to doctors and nurses for patients who need reliable medical attention. Keep in mind, too, that nursing homes provide permanent custodial help, while a skilled nursing facility is more often temporary, to resolve a specific medical need or to allow recovery outside a hospital setting.
What is Skilled Nursing and What are Some Examples?
Skilled nursing is an elevated level of care demanding advanced training and certifications. Skilled nursing care must be delivered by or under the immediate supervision of licensed health professionals, including registered nurses (RNs), licensed practical nurses (LPNs), speech/language pathologists and physical/occupational therapists.
Prime examples of skilled nursing services include physical, occupational and speech therapy, wound care, intravenous (IV) therapy, injections, catheter care, continual monitoring of medical signs, and the use of medical equipment to support the patient’s care needs and monitoring of vital signs and medical equipment.
Other types of skilled care would include stroke recovery, rehab after an operation, serious memory issues, around-the-clock care and terminal illness.
It’s useful to take into account that skilled nursing is a description of the type of service that’s offered. Consequently, skilled nursing is provided at both skilled nursing facilities as well as nursing homes. It can also be offered in a senior’s home as part of home health services.
Moreover, skilled nursing is mostly regulated by the state Department of Public Health and the federal Centers for Medicare & Medicaid Services. To be certified by both, skilled nursing communities must meet stringent criteria and are put through intermittent inspections to certify that quality standards are being met. Again, keep in mind that skilled nursing facilities typically serve as a transition between a hospital and a more permanent residence, whether it’s private independent living or assisted living.
Does Medicare Cover a Skilled Nursing Facility and/or Nursing Home?
Medicare Part A covers up to 100 days in a skilled nursing facility after a qualifying hospital stay. The Part A deductible covers the first 20 days per benefit period, after which the patient pays a share of the cost for each added day of the stay. The person would begin paying the full cost after 100 days.
Medicare does not cover long-term custodial care in a nursing home, though Medicaid or private long-term health insurance may do so. However, Medicare does continue to cover medical care for nursing home residents.
Skilled Nursing vs Nursing Home FAQ
What is the main difference between a skilled nursing facility and a nursing home?
The difference comes down to the type of care offered rather than the building itself. A nursing home provides custodial help with daily activities like bathing, dressing and eating, while a skilled nursing facility provides medical care delivered by licensed professionals such as RNs, LPNs and therapists. Some facilities even house both types of care in separate sections of the same building.
What kind of care is provided in a nursing home?
Nursing homes offer personal hygiene assistance, help with daily activities like dressing, eating and using the bathroom, and recreational activities. Many also employ full-time nurses and can arrange access to doctors, though they do not provide medical care tailored to every resident’s specific needs. Residents needing specialized medical treatment often travel to outside facilities for that care.
What is skilled nursing care and who provides it?
Skilled nursing is an elevated level of care that must be delivered by or under the direct supervision of licensed health professionals, including registered nurses, licensed practical nurses, speech pathologists and physical or occupational therapists. Examples include wound care, IV therapy, injections, catheter care and ongoing monitoring of vital signs and medical equipment. It also covers services like stroke recovery, post-surgical rehab and care for serious memory issues.
Is skilled nursing only available at skilled nursing facilities?
No, skilled nursing describes a type of service rather than a specific location. It can be provided at skilled nursing facilities, at nursing homes, or in a senior’s own home through home health services. The setting depends on the patient’s needs and available resources.
Is a stay in a nursing home or a skilled nursing facility usually permanent?
Nursing homes generally provide permanent custodial support for residents who cannot live independently or be cared for at home. Skilled nursing facility stays, on the other hand, are typically temporary, meant to address a specific medical need or support recovery after a hospital stay. Many patients transition from a skilled nursing facility to independent or assisted living once they recover.
Who regulates skilled nursing care and facilities?
Skilled nursing care is mostly regulated by each state’s Department of Public Health along with the federal Centers for Medicare and Medicaid Services. Facilities must meet strict criteria to earn certification from both bodies. They also undergo periodic inspections to confirm that quality of care standards continue to be met.
Summary
The biggest difference, as noted, is that a skilled nursing facility provides a higher level of specialized care. Nursing homes are planned around offering more generalized care which doesn’t automatically involve a higher level of certification or training. Of course, facilities that offer a higher level of care will have staff that obtain some sort of professional training.
However, nursing homes can have staff with the skillset and certifications that qualify under skilled nursing in order to offer general, ongoing care and medical monitoring. In other words, a nursing home has the choice of employing skilled specialists while skilled nursing facilities unconditionally require skilled specialists.
Minus the advanced training demanded by a skilled nursing facility, nursing homes are often less equipped to handle recovery from an acute illness or restoring a function that was lost subsequent to a hospital stay. Specialized services available at a skilled nursing facility such as physical rehabilitation, cardiac care, pulmonary rehab, post-stroke recovery, sound care and speech therapy will most likely not be available in a nursing home. Some of the services performed at skilled nursing homes can also be carried out at nursing homes including assistance with activities of daily living (bathing, feeding, etc.), dialysis, medication management, blood sugar testing and insulin injections.
The bottom line: The fundamental difference is that nursing homes perform these activities where the senior lives full-time, either in the nursing home or at the patient’s residence, while skilled nursing facilities perform these services in a more medically intensive, short-term setting.
Medwave provides credentialing and medical billing for skilled nursing facilities.
Co-Founder and COO of Medwave, bringing more than 30 years of hands-on experience in healthcare revenue cycle management, payer contracting, and medical credentialing.