Nursing Homes

A skilled nursing home gives medical care, social support, and personal care to people who need help with long-term health conditions, disabilities, or memory problems.

The federal government sets quality standards for nursing homes that accept Medicare or Medicaid. These rules say nursing homes must provide skilled nursing, therapy, and other services that people may need. States also require nursing homes to meet similar rules.

Who Lives in Nursing Homes?

About 1 in 3 older adults will live in a nursing home at some point. Most residents are 65 years old or older. About 15% of residents are under 65, and less than 1% are 30 or younger. 

A typical nursing home resident is a White, unmarried (usually widowed) woman over 85. She often lives alone and needs more help with daily tasks than nursing home residents did in the past.

Care Settings - Nursing Homes

Factors Associated with Nursing Home Admission

Several things can raise a person’s chance of needing a nursing home:

  • Age. The older a person is, the more likely they are to need a nursing home.
  • Low income
  • Few social supports or social connections
  • Physical or mental health problems
  • Race/ethnicity. White people are more likely than other groups to go into a nursing home.
  • Presence of Geriatric syndromes. These include frailty, frequent falls, pressure sores, dementia, and others.

Reasons for Being Admitted to a Nursing Home

The main reasons people go to nursing homes include:

  1. Short-term Skilled Care. About 20% of people in nursing homes have been there for 3 months or less. These residents need skilled nursing or therapy for a short time. The goal is to help them get stronger so they can go back home. Common reasons for short-term care include:
    • Being in the hospital for an infection or other illness
    • Needing therapy or rehab after surgery, like a hip replacement
  2. Long-term Needs. These residents have lasting disabilities and need skilled nursing care that cannot be provided at home.
  3. Memory Care and around-the-clock supervision. Dementia and some mental health conditions can cause people to need reminders or help with daily tasks. Some people may also show difficult behaviors, such as aggression, wandering, or trouble communicating. These people may need constant supervision and other forms of care.
  4. End-of-life care. Almost 1 in 3 older adults receive care in a nursing home during the last 6 months of their life. About 1 in 11 die there.

Many residents have more than one type of problem. For example, most residents have memory problems and also need help with daily activities. 

Characteristics of Nursing Homes

Nursing homes do not provide the same intense medical care as hospitals. Nursing home staff have different skills than hospital staff. However, many nursing homes can handle complex medical needs and offer many services, including:

  • Skilled nursing care

  • Care for muscle, joint, and bone problems

  • Breathing treatments for COPD flare-ups

  • Managing congestive heart failure

  • Support after surgery

  • Physical, occupational, and speech therapy

  • IV fluids and antibiotics

  • Wound care

Nursing homes also provide:

  • Nutrition counseling

  • Social work services

  • Activities and recreation

  • Respite care to give family caregivers a short break

  • End-of-life care, including hospice

Choosing a Nursing Home

Your healthcare professional, such as a home health nurse or social worker, can recommend nursing homes for you to look into.

 The U.S. Centers for Medicare and Medicaid Services Care Compare website lets you compare the quality of different nursing homes. It gives scores on things like:

  • Flu and COVID vaccines
  • Physical restraints
  • Falls
  • Pressure sores
  • Weight loss

Older adults and their families can visit several nursing homes to get a feel for the care and environment. A visit usually takes one to two hours. You can talk with admissions staff, administrators, nursing directors, and social workers.

Questions to Ask When Visiting a Nursing Home

Using a checklist can help you compare nursing homes. Here are some helpful questions to ask:

Condition of the Facility

  • Is the nursing home clean and well kept?

  • Do residents look well cared for?

  • Are rooms large enough? If rooms are shared, is there privacy?

  • What common and private spaces are available?

  • Are there safety features like railings and grab bars?

Licensing and Staffing

  • Is the home licensed by the state and approved by Medicare or Medicaid?

  • How many nurses and nursing assistants are there for each resident? Ask how this compares to state and national averages.

  • Do staff and administrators have special training in care for older adults?

  • Does the medical director have special training? Do they have Certified Medical Director (CMD) status?

  • Are key staff (administration, rehab, nursing, activities) full-time or part-time?

  • How long have managers and nurses worked at the home?

  • Is the flu and COVID vaccine required for all staff? If not, what percent of staff get these vaccines?

  • Who will be the doctor or nurse practitioner caring for the resident? How easy is it to reach them?

Other Concerns

  • How does the nursing home handle transfers to and from the hospital? Passing along medical records is a key quality issue.

  • Does the nursing home have special units, like a memory care unit for people with dementia?

  • How does the nursing home handle end-of-life care?

  • How close is the nursing home to family?

  • How close is it to the nearest hospital?

  • What is the food like? Ask to see a sample menu and a planned weekly menu.

Financial Concerns

  • What do basic services cost? What is covered?

  • What extra services are available and what do they cost?

  • What happens if a person runs out of money and needs Medicaid?

  • Does the nursing home accept Medicaid?

No nursing home is perfect, and most will feel very different from home. Moving into a nursing home can be scary and emotional. It may bring feelings of guilt or loss for both the resident and their family.

Family involvement is very important during this transition. Families can visit, help with daily activities, and act as a link between the resident and nursing home staff. They can help share information about the resident’s care preferences and habits.

 

Paying for Nursing Home Care

In 2026, the average daily cost of a private nursing home room was $376, or about $ 135,528 per year. A semi-private room averaged $328 per day, or about $ 118,104 per year. There are four main ways to pay for nursing home care:

  1. Medicare. Covers the full cost for the first 20 days and part of the cost for days 21–100, after a 3-day hospital stay. This only applies if the person needs skilled nursing or therapy.
  2. The Department of Veterans Affairs. May cover nursing home care for eligible Veterans.
  3. Self-pay. People pay out of pocket if they don’t qualify for Medicare or Veterans Affairs benefits.
  4. Medicaid. Once a person has used most of their own money on nursing home care and has few assets left, Medicaid may cover the cost.

 

Last Updated May 2026

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