What's the difference between a nursing home and assisted living?

Assisted living is meant for older adults who are largely independent but need help with everyday tasks like bathing, dressing, or managing medication, usually in a home-like, community-oriented setting. Nursing homes (also called skilled nursing facilities) provide a higher level of care: licensed nurses and physicians are on site to handle complex medical needs, wound care, rehabilitation, and 24/7 monitoring for residents who can no longer live independently. Assisted living is generally private-pay, while nursing home stays can sometimes be covered in part by Medicare or Medicaid.

Does Medicare pay for nursing home care?

Only in limited circumstances. Medicare Part A can cover short-term skilled nursing facility care after a qualifying hospital stay, generally up to 100 days per benefit period, but it does not pay for long-term custodial care or ongoing room and board. Coverage is typically full for the first 20 days, followed by a daily coinsurance from day 21 through 100, after which the resident pays the full cost. Medicaid, by contrast, can cover long-term nursing home stays for people who meet their state's income and asset limits.

How much does a nursing home cost?

Costs vary widely by location and room type, but nationwide estimates put a semiprivate room at roughly $7,900 to $8,700 a month, with private rooms running higher, often totaling $90,000 to $110,000 or more per year. Rural areas and shared rooms tend to be cheaper, while private rooms in high-cost states can run well above the national average. Most residents pay out of pocket at first, often drawing on savings, Social Security, or long-term care insurance, before potentially qualifying for Medicaid once their assets are spent down.

What does the CMS 5-star quality rating mean?

CMS rates every certified nursing home from 1 to 5 stars based on three components: results from onsite health inspections, self-reported staffing levels, and performance on clinical quality measures such as rates of falls, pressure ulcers, and hospital readmissions. Five stars means quality much above average and one star means much below average, with an overall rating plus separate scores for each component.

How do I file a complaint against a nursing home?

Complaints about care, safety, staffing, or conditions can be filed with your state's Survey Agency, which handles nursing home oversight, by phone, mail, fax, or online, and you can remain anonymous. It helps to document the incident first: dates, times, people involved, and what happened. You can also contact the facility's administrator directly or reach out to your state's long-term care ombudsman, who advocates specifically for residents' rights and quality-of-care issues.

How many nursing homes are there in the United States?

There are roughly 15,000 CMS-certified nursing homes operating across the U.S. today, though broader industry counts that include non-certified facilities put the total closer to 50,000. The number of certified facilities has gradually declined over the past decade even as demand from an aging population continues to grow, and counts vary significantly by state.

Nursing Homes in Pennsylvania

Frequently asked questions