People use 'nursing home' and 'skilled nursing facility' interchangeably, but they mean different things — especially for payment. Here's the difference.
What is the difference between a nursing home and a skilled nursing facility?
The core difference is purpose and duration. A skilled nursing facility (SNF) delivers short-term, medically intensive care — physical and occupational therapy, wound care, IV antibiotics — typically to help someone recover after a hospital stay and return home. A nursing home provides long-term custodial care: help with daily activities like bathing, dressing, and eating for residents who live there indefinitely. Confusingly, many facilities are dual-certified and offer both levels under one roof, which is why the terms blur. The distinction matters most for payment: Medicare covers skilled care, but not long-term custodial care. Knowing which level applies determines who pays. Call 1-800-MEDIGAP (1-800-633-4427) for free help sorting it out.
Who pays for each type of care?
Payment differs sharply. For skilled nursing facility care, Medicare covers up to 100 days per benefit period after a qualifying hospital stay — days 1-20 fully, days 21-100 with a coinsurance that Medigap can cover. For long-term nursing home (custodial) care, Medicare pays nothing; you rely on Medicaid (for those who qualify), long-term care insurance, or private funds. This is the single most important thing families get wrong: assuming Medicare will pay for an indefinite nursing home stay. It won't. Understanding which level of care your loved one needs — and how it's funded — can save tens of thousands of dollars and prevent painful surprises. Call 1-800-MEDIGAP for free guidance.