In short
Skilled nursing is a nursing home: licensed nurses on duty 24 hours a day, medical oversight, and therapy, for people whose needs are medical and constant. The national median cost in 2025 was $9,581 a month for a semi-private room. It's used two ways—short-term rehab after a hospital stay, which Medicare covers for up to 100 days, and long-term care, which Medicare does not cover and Medicaid usually pays for.
Two very different uses
When people say "nursing home," they usually mean one of two situations, and they could not be more different.
Short-term rehab
After a hip replacement, a stroke, or a serious illness, your parent goes from the hospital to a nursing facility for rehabilitation. The goal is to get them strong enough to go home. Physical and occupational therapy happen most days, a nurse manages medications and wound care, and a discharge planner works on the plan home. Medicare can cover up to 100 days of this, and many people are home well before that.
Long-term care
When a parent's needs are medical and permanent—advanced dementia with nursing needs, a condition that keeps them in bed, care that no home arrangement can safely provide—a nursing home becomes a long-term home. Medicare generally does not pay for this. It's usually funded by Medicaid for people who qualify, or by private funds until they do.
Who needs it
Skilled nursing fits someone who needs a nurse or therapist, awake and on duty, around the clock. That's a higher bar than most families realize, and it's why assisted living or home care is often the better answer when the need is help rather than medicine.
- It may be the right level of care for: recovery from surgery or a stroke; ongoing wound care or IV therapy; someone who cannot get out of bed safely; advanced illness needing 24-hour nursing; medical needs that supervision at home can't cover.
- It's usually not the right level for: someone who mostly needs help with bathing and meals (that's assisted living); someone with mild memory loss who's still mobile (memory care may fit better); someone who simply needs company and lighter help (independent living or home care).
What Medicare pays, and for how long
This is where families most often get caught, so here it is precisely. Medicare Part A can cover short-term skilled nursing or rehab—but only if all of these are true:
- Your parent has Part A.
- They had a qualifying inpatient hospital stay of at least three consecutive days, not counting the discharge day.
- They're admitted to a Medicare-certified facility within 30 days of leaving the hospital.
- Skilled nursing or therapy is medically necessary.
Coverage runs up to 100 days per benefit period. In 2026, the patient pays a $1,736 Part A deductible, then $0 a day for days 1 through 20, and $217 a day of coinsurance for days 21 through 100. From day 101 onward, the patient pays all costs. Some Medigap policies cover all or part of that day 21-to-100 share.
A hospital discharge is coming fast. Let's plan now.
Tell us what happened and what the doctors are saying. We'll help you understand the rehab-to-home path and what happens if home isn't ready.
What it costs and who pays
The 2025 national median for a nursing home was $9,581 a month for a semi-private room and $10,798 for a private room. Some cities run far higher. Who pays depends entirely on which of the two situations you're in:
| Situation | Who usually pays |
|---|---|
| Short-term rehab after a hospital stay | Medicare Part A for up to 100 days, with the deductibles and coinsurance above; then private pay, or Medicaid if eligible |
| Long-term nursing care | Medicaid for people who meet their state's income and asset limits; otherwise private funds, long-term care insurance, or veterans benefits |
Medicaid is, nationally, the primary payer for long-term care, and it pays for nursing home care for people who qualify. Because eligibility involves spending down assets and rules about past transfers, families planning for a long-term placement should talk to a licensed elder law attorney—not a benefits "consultant" who charges a fee. Our guide to paying for care covers the whole picture.
How to choose a facility
Not all nursing homes are equal, and the differences show up on paper if you know where to look.
- Check Medicare Care Compare. Medicare publishes star ratings, health-inspection results, staffing levels, and quality measures for every certified nursing home at medicare.gov/care-compare. It's the same data the facility reports.
- Look at the state inspection record. Your state's licensing agency publishes inspection findings and complaints. Read the most recent survey, not just the rating.
- Ask about staffing, and look at it at night and on weekends. Federal data on nursing hours per resident is public on Care Compare; compare it across the facilities on your list.
- Visit. Ask how rehab patients spend their day, whether therapy happens most days, and what the discharge plan looks like. Smell and noise tell you a lot.
- Ask who you'd talk to, and how. If you live far away, you want a named social worker or director of nursing you can actually reach.
Questions families ask
Does Medicare pay for a nursing home?
Only short-term: skilled nursing or rehab after a qualifying inpatient hospital stay of at least three days, in a certified facility, for up to 100 days per benefit period—with the 2026 deductible and coinsurance described above. Medicare does not cover long-term nursing home stays.
What's the difference between a nursing home and assisted living?
Medical care. A nursing home has licensed nurses and round-the-clock medical oversight; assisted living offers personal help and 24-hour non-medical staff. If your parent needs a nurse rather than a helper, it's skilled nursing.
How do we pay for a long-term stay?
Usually Medicaid for those who qualify, after spending down assets to the state's limits, or private funds and long-term care insurance until they qualify. A licensed elder law attorney should guide the planning; the rules around transferring assets are unforgiving.
Can they come home after rehab, or will they have to stay?
For short-term rehab, going home is the goal and most people do. Whether your parent can return safely depends on how much help they'll need at home—which is a question to ask the therapy team and the discharge planner early, not the day before discharge. If home isn't safe, the options are more home care, assisted living, or a longer nursing stay.
How long can someone stay in a nursing home?
As long as it's the medically appropriate setting and the stay is paid for. There's no fixed limit on a long-term placement; the constraint is usually payment and whether the level of care still fits.
Sources: CareScout (Genworth) Cost of Care Survey 2025, carescout.com/cost-of-care; Medicare.gov, Nursing home care and Skilled nursing facility care (publication 10153); CMS, 2026 Medicare deductible and coinsurance rates (cms.gov); Medicaid.gov, Long-Term Services and Supports. Retrieved October 8, 2026.