The Ultimate Guide to Skilled Nursing

The Ultimate Guide To Skilled Nursing Care

If you or your senior loved one needs full-time nursing care, you have your work cut out for you. Of course you want them to get the best possible care, but serious medical needs that require care around the clock can be very difficult to manage. It is next to impossible to provide medical care yourself, so you’re left with few options. Thankfully, skilled nursing care is a great solution for many seniors. Skilled nursing communities provide advanced medical care for individuals with significant needs, while also offering a secure environment, meals, housekeeping, and social and recreational activities. Whether you’re just starting to explore your options or need to make a decision soon, this Ultimate Guide to Skilled Nursing Care will help every step of the way.

Most people will need assisted living or senior care at some point in their lives. However, for people with chronic and serious health conditions, or seniors recovering from illness, stroke, injury, or surgery, more advanced medical care is required.

Our comprehensive guide is designed to help you decide whether a skilled nursing community is the best choice for you or your loved one. We’ll also share the pros and cons of skilled nursing communities, the cost and payment options, and finally, the process of choosing the right skilled nursing community. So, if you’re considering skilled nursing care for yourself or a loved one, read on for all the information you’ll need to make an informed decision.

What is A Skilled Nursing Community?

Skilled nursing communities, also called skilled nursing facilities (SNFs) or nursing homes, provide specialized residential care for people with significant health needs that are provided by nurses or other medical professionals. Skilled nursing communities typically employ nurses, certified nursing assistants, physical and occupational therapists, doctors, dieticians, and more medical professionals. These staff members can provide medical care, like medication management, monitoring of blood pressure, blood sugar, and other vital signs, treatment of injuries, and physical and occupational therapy. They also coordinate care with doctors to ensure any new issues or symptoms are evaluated and treated.

Additionally, skilled nursing community residents will receive help with daily activities such as bathing, eating, mobility, toileting, and dressing. Typically, skilled nursing communities also offer dietician-approved chef-prepared meals, social and recreational activities, outings, and personalized care and therapies. If necessary, residents may receive 24/7 supervision as well.

Typically, you can live in a skilled nursing community either temporarily (as a short-term stay) or on a full-time basis. If your loved one is recovering from a recent illness, injury, or surgery, they may stay temporarily in a skilled nursing community after being released from the hospital. Once they have made a full recovery, they can return home (or to their independent or assisted living community). If you or your loved one needs skilled nursing care due to a chronic or progressive condition, they can stay in a skilled nursing care permanently, unless hospice care is later required.

How To Know When It’s Time for Skilled Nursing Care

It can be difficult to know when skilled nursing care is necessary. Some signs that it may be time to consider skilled nursing care include:

Frequent or severe falls or injuries
Intensive medical needs or specialized treatments, like a feeding tube, IV therapy, or wound care.
Recent or frequent hospitalization due to surgery, illness, or injury
Trouble managing medications (like remembering to take them, taking them on time, correct dosage, etc)
Living alone feels unsafe
Inability to manage daily tasks like eating, dressing, and bathing
Not able to move well, drive safely, or manage public transportation
Diagnosis of serious chronic and/or progressive medical conditions, like heart disease, respiratory issues, or diabetes
Recent stroke, cardiac event, or other significant medical issue
Need for constant, around-the-clock medical care or supervision
Medical care needed by trained professionals, beyond the ability of caregivers
Need for physical therapy or speech therapy.
Lack of mobility and need help walking, eating and/or transferring to the toilet.

15 Pros & Cons of Skilled Nursing Care Communities

Typically, people turn to skilled nursing care when it is medically necessary. The level of care skilled nursing communities provide is generally not needed unless you or your loved one has significant medical needs. However, there are still pros and cons, as well as a variety of care options. Here are some of the benefits and disadvantages of skilled nursing care communities:

Pros

Skilled nursing care communities often provide extra safety features, including secured exits, monitored entrances, and easy-to-navigate layouts.
These communities offer extensive, around-the-clock help with daily activities such as bathing, dressing, and grooming.
They also provide nutritious meals and housekeeping services.
Skilled nursing communities employ nurses, certified nursing assistants, physical and occupational therapists, dieticians, and other healthcare professionals to provide top-tier medical care.
Communities offer social and recreational activities, which can help to combat isolation and loneliness.
These communities can provide a higher quality of life for seniors with serious and/or progressive health conditions.
They can also offer a sense of community and belonging.
The type of care skilled nursing communities provide cannot be provided at home
These communities reduce stress and burden on caregivers, and provide peace of mind for families.
They also often include special support for family members.
Skilled nursing communities provide the most care you can receive outside of a hospital.
They can accommodate individuals with severe health issues or disabilities.

Cons

Skilled nursing care, as well as room and board at a skilled nursing community, is often expensive.
There is less privacy in a skilled nursing care community than you’d experience in a single family home.
A team of in-home care providers can sometimes provide more individualized care, which may be preferable for older adults that can afford that option.
Moving someone with severe health issues or disabilities to a new and unfamiliar environment can be stressful, and requires a period of adjustment.
Not all skilled nursing care communities can provide sufficient end-of-life care, which may require moving to hospice care.

Skilled Nursing Care Versus Other Types of Senior Care

There are a variety of care options available for people who are recovering from a hospital stay or who have significant health issues or disabilities. Skilled nursing communities are one option, but they may not be the right fit for everyone at every stage. In this section, we’ll explore how skilled nursing care compares to other types of senior care, including independent living, assisted living, memory care communities, home care, and respite care. By understanding the similarities and differences between skilled nursing and other types of senior care, you’ll be better equipped to make an informed decision about the best type of care for you or your loved one.

Skilled Nursing Communities vs Home Care

Instead of living in any type of senior living community, you can receive home care, where service providers come to your home to provide whatever assistance you need. This may include home healthcare providers, housekeepers, transportation services, lawn care, and more. Just like it sounds, home care is provided at home. For a disabled person, someone with extensive medical needs, or someone who is recovering from surgery, injury, or serious illness, home care often requires multiple caregivers to provide around-the-clock daily care and supervision.

Skilled nursing communities are a residential care option where individuals live in a specialized community setting and receive daily medical care and treatment, as well as 24/7 assistance with daily activities by staff at the community. For seniors looking for extensive medical care, around-the-clock help, safety, security, and community, skilled nursing communities are often the preferred choice.

Skilled Nursing Care vs Independent Living

Independent living is a type of senior housing where older adults live in apartments, condominiums, or single-family homes within a community of older adults, but typically do not receive assistance with activities of daily living. They also don’t receive medical care, or any care provided by healthcare providers. Independent living may be the right choice for people in the early stages of some progressive illnesses and people without serious health conditions.

Skilled nursing care, on the other hand, provides advanced medical care and treatment, assistance with daily tasks, and meals, housekeeping, medication management and social and recreational activities. It’s typically necessary for people with serious healthcare needs.

Skilled Nursing Care vs Assisted Living

Assisted living communities provide assistance with activities of daily living, but do not provide specialized medical care. Assisted living communities also aren’t typically as secure as skilled nursing communities. Many assisted living communities offer varying levels of care, including skilled nursing care. Not all skilled nursing facilities also offer assisted living.

Skilled nursing care is designed to give people with significant health needs advanced medical care. Skilled nursing communities provide a much higher level of care and security than traditional assisted living communities. They also provide daily access to healthcare professionals, who can provide diagnosis, treatment, and therapies as needed.

Skilled Nursing Care vs Memory Care Communities

Memory care communities have a more home-like feel and focus on treatment and management of memory loss disorders. They do not provide the same level of medical care as a skilled nursing community. They are typically staffed mainly by caregivers rather than licensed medical professionals, though they will often have nurses available and doctors on-call. People in the latest stages of dementia may require care at a skilled nursing community or hospital.

Skilled nursing communities, sometimes called “nursing homes” or “skilled nursing facilities,” provide a higher level of medical care than memory care communities, and they are typically staffed by licensed medical professionals and operate in a more clinical setting. They provide the most care you can receive outside of a hospital.

Skilled Nursing Care vs Respite Care

Respite care, sometimes called “adult daycare”, is a temporary form of care that is provided to give primary caregivers a break. Respite care can be provided in a variety of settings, including assisted living communities, skilled nursing communities, memory care communities, or in-home care. This is a great option for caregivers who want to provide in-home care for their loved ones by home healthcare and other service providers, but need someone qualified to take care of them during the workday or during trips and vacations. Respite care can also refer to a short-term stay at a senior living community, like a period of days or weeks. Not all skilled nursing communities offer respite care or short-term stays.

How Much Does Skilled Nursing Care Cost?

The million dollar question: how much does skilled nursing care actually cost?

Because of the higher level of care and security offered, and advanced medical care provided, skilled nursing care is not inexpensive. The median cost for a private room in a skilled nursing community in 2024 is $330 per day, which adds up to an average of $9,000- $10,000 per month (1, 2). Price varies widely depending on your location, length of stay, level of care needed, insurance, and the amenities provided at the community. At Stellar Living, we provide transparent line-item pricing for our communities. Just call our Family Advisors today to find out how much a Stellar Living Community will cost in your area.

In this section, we’ll take a closer look at what’s included in the cost of skilled nursing care and the factors that can affect it. We’ll also explore various payment options, such as long-term care insurance, Medicaid, veterans benefits, and more.

What’s included in this cost?

The cost of skilled nursing care varies depending on the location, type of community, and level of care needed. For Stellar Living Communities, this cost includes specialized medical care, access to a wide range of healthcare professionals, room and board, as well as assistance with daily activities such as bathing, dressing, grooming, and medication management. The “room and board” cost of Stellar Living Communities also includes chef-prepared meals, housekeeping, transportation, use of gyms, libraries, computer rooms and other on-site amenities, and social and recreational activities both on- and off-site.

Does Health Insurance Cover Skilled Nursing Care?

The coverage for skilled nursing care varies depending on the type of insurance and the individual’s policy. Health insurance does not usually include the assisted living or room-and-board costs of a skilled nursing community. However, health insurance typically does cover medical costs related to injuries or serious illnesses or health conditions. This might include medications, physical or occupational therapies, and doctor’s appointments. If custodial full-time skilled nursing care is considered medically necessary, health insurance may cover some of the cost. However, even if private health insurance does cover it, they typically only cover short-term stays. Long-term care insurance, Medicaid, and veterans benefits may also cover some or all of the cost of skilled nursing care communities.

What about Medicare or Medicaid?

Medicare does not cover the room and board cost of any senior living communities or long-term care. However, they will cover the cost of skilled nursing care in some situations. For example, they’ll provide coverage if:

You have recently had a medically necessary hospital stay, typically of at least 3 days.
Your doctor or other health care provider has decided that you need daily skilled care (like intravenous fluids/medications or physical therapy) that must be administered by a healthcare professional.
You need skilled services due to a new or ongoing health condition.

Typically, all of these conditions must be met for Medicare Part A participants to be covered.

Unfortunately, even when Medicare covers skilled nursing care, it will only cover a short-term stay. Medicare will cover 100% of the cost of days 1-20 in a skilled nursing community. After that, you will pay $204 each day until you hit 100 days. Medicare does not provide any coverage beyond 100 days.

Medicaid does cover long-term care in an approved Medicaid Nursing Facility for those who qualify (source). It should be noted that not all skilled nursing communities are approved by Medicaid or accept Medicaid as payment. Consult the community about Medicaid payment options.

Are there Veterans Benefits for Skilled Nursing Care?

VA benefits are available for veterans who have VA healthcare and require skilled nursing care. VA Healthcare usually covers skilled nursing care. Find out more here.

Who qualifies for VA benefits for skilled nursing care?

You can get VA benefits for skilled nursing care if:

You’re signed up for VA health care, and
They conclude that you need skilled nursing care to help with your ongoing treatment and personal care, and
There is an approved community near you.

They may also consider other factors, like your service-connected disability status or insurance coverage.

How do I apply for veteran benefits for skilled nursing care?

To apply for veteran benefits for memory care, veterans should contact the Department of Veterans Affairs or a veterans’ service organization for more information.

Is skilled nursing care tax deductible?

Yes, skilled nursing care is tax-deductible. If you or your loved one is staying at a skilled nursing community primarily for medical care, the entire expense is deductible as a medical expense. Find out more here.

More Ways To Pay for Skilled Nursing Care

Life Insurance

Life insurance is another option for seniors who wish to pay for skilled nursing care expenses. You may be able to use your life insurance benefits to cover the costs of skilled nursing care and other long-term care needs. When you do this, you get a percentage of the value of your life insurance policy to pay for skilled nursing care costs. Typically, you’ll get about 20%-50% of the face value of your policy. However, using this feature will close out your life insurance policy, so any beneficiaries won’t receive any money. It’s a good option to consider if you don’t have a spouse and/or children, or your children are grown and your spouse is already financially stable.

Additionally, many life insurance policies also offer hybrid policies or riders that allow you to access some of your death benefit early in order to pay for medical expenses or other emergency costs. Contact your life insurance provider to learn more about these options.

Long-Term Care Insurance

Long-term care insurance is a great way to prepare to pay for skilled nursing care. You can purchase a long-term care insurance policy in addition to your health insurance plan to prepare for skilled nursing care care in the future. Most policies will cover skilled nursing care, as well as assisted living, memory care, physical and occupational therapy, and respite care. Be sure to check the details and exclusions of your policy to be sure a skilled nursing community will be covered. Some policies will cover you for the rest of your life, while others might only cover as little as two years. It may also be more difficult to get this type of insurance if you are over the age of 70. Get this coverage sooner rather than later, because it is likely to be less expensive in the long term.

How To Choose a Skilled Nursing Community

Choosing the right skilled nursing community for you or your loved one can be a daunting task. There are many factors to consider, from the specific therapies and treatments offered, to the staff-to-resident ratio, to the cost. In this section, we’ll provide you with a comprehensive guide on how to choose a skilled nursing community. We’ll cover the top 10 questions to ask when visiting a skilled nursing community, as well as other important factors to consider when making your decision. By following the guidelines outlined in this section, you’ll be able to confidently choose a skilled nursing community that meets your needs and preferences.

Skilled Nursing FAQ (Quick Answers To Your Top Questions)

What is skilled nursing care?

Skilled nursing care is a type of senior living that provides medical care, specialized housing, and assistance with daily activities, such as bathing, dressing, and medication management. Typically, skilled nursing communities have the highest level of care you can receive outside of a hospital. They have nurses and certified nursing assistants on staff, as well as doctors, physical and occupational therapists, speech therapists, dieticians, and other healthcare professionals. Skilled nursing care is intended for people who have significant daily healthcare needs due to chronic illness, injury, disability, or recent serious illness and/or hospitalization.

Who is eligible for skilled nursing care?

Eligibility for skilled nursing care varies depending on the community and state regulations, but generally, it is intended for seniors who need help with activities of daily living (ADLs) and require routine services by healthcare professionals. This may include wound care, IV therapies, tube feeding, or other specialized or intensive medical care.

How much does skilled nursing care cost?

The cost of memory care can vary widely depending on location, length of stay, and the level of care required. On average, room and board at a skilled nursing community costs $330 per day, or $9,000-10,000 per month.

Is skilled nursing care covered by Medicare or Medicaid?

Medicare will cover medical costs and qualifying short-term stays at skilled nursing communities, but does not cover room and board for long-term care. Medicaid will pay for some or all of the costs of an approved skilled nursing community for qualifying seniors who require it.

What services are provided in skilled nursing care?

Services offered in skilled nursing care can include daily medical treatment and assessment, assistance with ADLs, meals, transportation, housekeeping, and medication management. Most communities also offer recreational and social activities, as well as various therapies and treatments for specific health conditions.

Can I bring my own furniture to a skilled nursing community?

It depends on the community. Some communities allow residents to bring their own furniture, while others provide furnishings. It’s best to check with the community directly.

Can I bring my pet to a skilled nursing community?

Some skilled nursing communities allow residents to bring their pets, while others do not. It’s important to check with the community before moving in to ensure they are pet-friendly.

Can I have visitors in skilled nursing care?

Yes, residents in skilled nursing care are generally allowed to have visitors, but there may still be restrictions in place due to COVID-19.

Can I keep my own doctor when in skilled nursing care?

Yes, residents in skilled nursing communities are generally able to keep their own doctor, as long as the doctor is located near the community. Transportation to doctor’s appointments is typically provided. However, there may be exceptions.

How do I find the right skilled nursing community for me or my loved one?

Research different communities and visit them in person to get a sense of the environment and the level of care provided. It’s also a good idea to talk to current residents and staff.

How is skilled nursing different from assisted living or a memory care community?

Skilled nursing communities provide the highest level of medical care you can receive outside a hospital. Assisted living communities provide caregiver assistance with daily activities. Memory care provides assisted living within a specialized environment specifically for people with dementia or memory loss. Memory care or assisted living communities typically do not offer medical care or care by medical professionals beyond basic assistance with ADLs.

What happens if a resident’s health needs change and they need more medical care?

They may need to move to a higher level of care, such as hospice care.

How can I pay for skilled nursing care?

There are a variety of ways to pay for skilled nursing care, including health insurance, private pay, long-term care insurance, veterans’ benefits, Medicare, and Medicaid. Research different options and work with a financial advisor to find what will work for you.

Can I bring my car or keep my driver’s license when living in skilled nursing care?

It depends on the community, but most memory care communities provide transportation for residents and do not allow them to keep their car. It’s best to check with the community directly.

Can I leave skilled nursing care and return home?

Yes. Many people use skilled nursing communities for short-term stays when recovering from a serious illness, injury, or hospital stay. In these situations, you can return home when and if you have fully recovered. However, people with disabilities or chronic or progressive illnesses may need long-term care in a skilled nursing community.

Final Thoughts

In conclusion, skilled nursing communities can provide a great quality of life for older adults with significant medical needs who also need assistance with daily activities. It’s important to consider the pros and cons, costs, and the different types of senior care available before making a decision. When choosing a skilled nursing community, it’s also important to visit several communities and ask questions to ensure the best fit for you or your loved one.

If you’re looking for a top-rated skilled nursing community, Stellar Senior Living can help. We have communities throughout the United States and have received numerous awards for our high-quality care and services. To learn more about Stellar Senior Living’s skilled nursing communities and to find a community near you, click here.