Skilled Nursing Facility vs Long Term Care

Care Setting

A skilled nursing facility is a medical environment that provides 24/7 care under the supervision of licensed professionals. These facilities often resemble hospitals in structure and equipment, but still provide a sense of community with patient-to-patient interactions and weekly activities. In many cases, skilled nursing facilities offer both short and long-term care options.

Long-term care typically takes place in assisted living communities, residential care homes, or even at home. The focus is on non-medical support with activities of daily living (ADLs), like bathing, dressing, and eating. The environment is often more residential and less clinical.

Level of Care

Skilled nursing facilities usually offer medically necessary services such as wound care, physical therapy, rehabilitation, and monitoring of chronic conditions. Licensed nurses and therapists are always on staff, and doctors are typically available on-call or by scheduled visits.

For long-term care at a nursing home or retirement community, the focus is on personal care and assistance with daily activities rather than medical treatment. Services include help with hygiene, mobility support, meal preparation, and housekeeping.

Cost

Skilled nursing facilities tend to be more expensive on a day-to-day basis due to the high level of medical care provided. However, insurance or Medicare often covers some or all of the cost, especially for short-term stays related to recovery.

Long-term care costs can add up over time, especially for extended stays. It’s often paid out of pocket or through long-term care insurance, as Medicare generally doesn’t cover custodial (non-medical) care.

Payment Options

At a skilled nursing facility, coverage is often provided through Medicare (for a limited time), Medicaid (if the individual qualifies), private insurance, or out-of-pocket payments. Medicare typically covers up to 100 days of skilled nursing care per benefit period, but it’s important to understand the eligibility criteria and the co-insurance payments the patient is required to make.

Medicare does not cover most long-term care services. Payment usually comes from private funds, long-term care insurance, Medicaid (if eligible), or veterans’ benefits. It’s important for families to plan ahead to manage long-term care costs, which can become quite significant over time. 

Length of Stay

Short-term care at a skilled nursing facility is often ideal for patients recovering from surgery or a serious health issue like a stroke or heart attack, where the goal is to support the patient in their recovery and restore as much independence as possible. Many skilled nursing facilities offer long-term care as well, which is a good option for patients requiring medical support with ongoing health issues. 

If an individual doesn’t require as much hands-on medical care, long-term care at a nursing home might be more suitable than a skilled nursing facility. The former is focused on providing a stable, supportive environment for residents over long periods (usually years).