Senior Living Guide
Skilled Nursing Facilities
A skilled nursing facility (SNF), or nursing home, provides round-the-clock care from licensed nurses under a physician's direction. It is the highest level of care outside a hospital, and serves two very different groups: people recovering from a hospital stay who need short-term rehabilitation, and people whose medical needs are too complex for assisted living and who live there long-term.
Because SNFs are medical settings, they are regulated and inspected by both the state and Medicare, and their inspection records are public.
Who it fits
- Someone leaving the hospital after surgery, a stroke, or a serious illness who needs physical, occupational, or speech therapy before going home.
- A person with complex medical needs — wound care, feeding tubes, ventilator support, or frequent nursing interventions.
- Someone with advanced dementia whose medical needs exceed what memory care can provide.
What's typically included
- 24-hour nursing care with a physician overseeing treatment.
- Physical, occupational, and speech therapy on site.
- All meals, personal care, and medication administration.
- Semi-private or private rooms (private rooms often cost extra).
- Social services and discharge planning.
What it costs
Long-term skilled nursing is the most expensive type of senior care — nationally around $9,000–$11,000 a month for a semi-private room and more for a private one. Short-term rehabilitation after a qualifying three-day hospital stay is covered by Medicare for up to 100 days per benefit period (fully for the first 20 days, with a daily copay afterward).
Long-term stays are paid privately, by long-term care insurance, or by Medicaid once a resident has spent down to the eligibility limit. Medicaid is the largest payer for long-term nursing home care in the country.
How to choose
- Check the Medicare Care Compare star ratings and read the actual inspection deficiencies, not just the summary.
- Ask about nurse and aide staffing hours per resident per day — it's the strongest predictor of quality.
- For rehab stays, ask how many minutes of therapy per day and how often the physician visits.
- Visit unannounced in the evening. Call-light response time and how residents are dressed and positioned tell you a lot.
Questions to ask on a tour
- 1.What are your registered-nurse hours per resident day, and is an RN on site 24 hours?
- 2.What was cited on your last state and federal inspection, and what changed as a result?
- 3.How much therapy will my parent receive each day, and who sets the goals?
- 4.What is the discharge plan and how will you involve the family?
- 5.Do you accept Medicaid if private funds run out, and would my parent have to change rooms?