Nursing Homes (Skilled Nursing) in the United States

Nursing homes—also called skilled nursing facilities—provide 24/7 clinical oversight, licensed nursing, and rehabilitation services for residents who need a higher level of medical support than assisted living can offer. These communities serve people with complex conditions, long-term care needs, or short-term rehab after a hospital stay. This guide outlines what nursing homes provide, how coverage and costs work, and what to evaluate when comparing facilities.

Clinical Care and Services

• Round-the-clock nursing and access to on-call physicians
• Post-acute rehabilitation (physical, occupational, speech therapy)
• Medication administration, wound care, IV therapy, and monitoring
• Care planning with interdisciplinary teams and family conferences
• Assistance with ADLs, meals, and housekeeping
• Safety systems, infection-control protocols, and specialized equipment

Coverage and Costs

Short-term skilled nursing or rehab may be covered by Medicare after a qualifying hospital stay, subject to program rules and limits. Long-term custodial care is typically private-pay or supported by Medicaid based on state eligibility. Out-of-pocket costs depend on room type, therapy frequency, and clinical complexity. Ask for a clear explanation of what is covered, what is billed separately, and how rates change if care needs increase.

How to Evaluate a Nursing Home

• Inspect licensure status, survey results, and quality measures
• Review staffing levels, training, and continuity (weekends and nights)
• Assess rehab intensity, care plan goals, and discharge planning
• Observe resident dignity, call-light response times, and cleanliness
• Confirm policies for infections, falls, and hospital transfers

When Nursing Homes Make Sense

Choose a nursing home when clinical stability, skilled therapies, or complex medication management are the top priorities. If your loved one needs continuous nursing assessment or specialized treatment, a skilled setting provides the structure and safety required. Use SeniorHomesDirectory to locate licensed facilities near you and request information or a tour.