What Is the Difference Between a Skilled Nursing Facility and a Nursing Home?

Discover the nuances between skilled nursing facilities and nursing homes with US News as we unravel the distinctions to help you make informed care decisions.

By Payton Sy, RN | May 18, 2023

Source: U.S. News & World Report

It’s overwhelming enough when the doctor tells you that your elderly mom can’t be discharged home after a fall. Then, when searching for where she should go, you’re inundated with unfamiliar senior living terminology: What is a skilled nursing facility? What is a nursing home? Are they the same?

The answer isn’t so straightforward. In some situations, the terms “nursing homes” and “skilled nursing facilities” are interchangeable. In others, they can mean two distinct levels of care. Read on to learn about the subtle differences between the two names.

Nursing Home vs. Skilled Nursing Facility

The main distinction between nursing homes and skilled nursing facilities lies with the length of care in question, says Sue Johansen, a San Francisco-based executive vice president with A Place for Mom, a senior referral service. Care can be either short-term (temporary) or long-term (sometimes permanent). Let’s start with the latter.

Long-term nursing home care

Let’s say your mom fell because of worsening Alzheimer’s disease and has experienced continued difficulty keeping her balance. The fall caused minor scrapes and bruises, but her doctor thinks she needs to be discharged to a location where she has around-the-clock medical supervision.

In this situation, your mom would mainly receive what’s known as “custodial care.”

Custodial care includes:

  • Aid with activities of daily living, like toileting or grooming.
  • Basic health care that unlicensed professionals can provide. This care, for example, can involve giving an over-the-counter oral medication or administering eye drops.

Short-term skilled nursing care

Going back to our situation, let’s say your mom’s fall caused her to need a hip replacement. After surgery at a hospital, she would require short-term nursing care, such as physical therapy and IV pain medication.

At a skilled nursing facility, she would likely receive custodial care as well as a higher level of care, or “skilled nursing.”

Skilled nursing care includes:

  • Care that is done by a licensed professional. This kind of help can include catheter care or tracheostomy care.
  • Specialized therapy, such as physical, occupational or speech therapy.

The main distinction with short-term skilled nursing care is that Medicare coverage may be an option (more on that later on).

“For most people, a Medicare rehab short-term stay in a skilled nursing center is often their point of entry to this type of care,” explains John Dattilo, the president and CEO of BHI Senior Living in Indianapolis.

After that, where they go is determined by insurance coverage and bed availability.

“It’s also likely that families will need to make decisions quickly based on when their loved one is discharged from hospital care,” Datillo says.

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