Skilled nursing vs. nursing home: what is the difference?
Short answer: Often the same building. “Skilled nursing” describes short-term, daily skilled care (usually Medicare-covered); “nursing home” usually means long-term custodial care (usually Medicaid or private pay).
Figures change periodically. Double-check current amounts before relying on them.
Most nursing facilities provide both kinds of care.
Skilled nursing care is daily care that must be provided by, or under the supervision of, licensed nurses or therapists: wound care, IV medications, physical therapy after a hip replacement. Medicare Part A pays for skilled nursing facility care for up to 100 days per benefit period after a qualifying three-day inpatient hospital stay, with a daily coinsurance after day 20 ($217 a day in 2026), and only while daily skilled care is needed.
Long-term custodial care is help with daily activities (bathing, dressing, eating, toileting) and supervision, provided over months or years. Medicare does not pay for custodial care. It is paid privately, by long-term care insurance, or by Medicaid for people who qualify.
Many residents start in a skilled bed under Medicare, then stay in the same facility for long-term care under Medicaid or private pay. Plan the Medicaid application during the Medicare period.
Getting help
Every situation is different, and small facts can change the answer. If this question affects a real decision, especially with a spouse at home, a home, gifts or a trust, a Certified Medicaid Planner can apply your state’s rules to your situation. As a rough guide, published fees for help with an application range from about $500 to $6,000, and hourly help from about $150 to $600.
Related
- Medicaid vs. Medicare for Long-Term Care
- How Nursing Home Care Is Paid For
- More questions: Nursing homes and care
- All FAQs
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.