Making future care plans for yourself or an aging loved one isn’t something to take lightly, particularly when considering a nursing home, given that, more often than not, it becomes a permanent residence.
“Choosing the right nursing home is crucial because older adults’ well-being and quality of life is highly dependent on the facility’s standards and services,” explains Stacey Eisenberg, owner of A Place at Home in Austin, Texas and a senior care expert. “Change and moving are difficult for anyone, let alone a senior who may have been dealing with previous grief, disability or even dementia.”
Here, Eisenberg and others explain the different types of nursing homes, what to look for during the decision process and more.
What is a nursing home?
Nursing homes are residential care facilities for individuals who cannot live independently due to aging or chronic illness, explains Jay Mikosch, a licensed nursing home and assisted living facility administrator and the campus director of Wellington Bay in Wellington, Florida. “They provide long-term care with assistance in daily activities and medical support,” he adds.
Nursing homes can vary in terms of the amenities and support they offer, but they all provide, at the very least, assistance with activities of daily living (ADLs), which may include dressing, bathing and overall mobility. Unlike assisted living facilities, older adults who reside in nursing homes aren’t permitted to come and go as they please. They’re, for all intents and purposes, patients of the facility.
Types of nursing homes
The first thing families should do when considering nursing homes is decide which type would suit their needs best, as they’re not one-size-fits-all.
Here, experts break down the different types of nursing homes.
Skilled Nursing Facilities
Skilled Nursing Facilities (SNFs) are healthcare centers that provide a high level of medical care and support to older adults who need short-term or long-term care due to illness, injury or chronic conditions, explains Eisenberg.
“These facilities offer services that go beyond what is typically provided in standard nursing homes or assisted living facilities,” she continues. “This makes them ideal for individuals recovering from surgeries, strokes, fractures or other medical conditions that require rehabilitation to regain function and independence.”
SNFs are staffed with licensed nurses and therapists for short-term or long-term care needs, adds Mikosch.
Here are some of the services SNFs may provide:
- Medical care.
- Rehabilitation services.
- Post-hospital care.
- Chronic care management. (For patients with chronic conditions like diabetes, heart disease or respiratory issues.)
- 24/7 nursing care.
- Palliative and hospice care.
Memory care units
Memory care units, which are not in every nursing home, are “specialized, often secured, areas specially designed and staffed to care for people with Alzheimer’s or other forms of dementia,” explains Mikosch.
Here are some of the features that may be present, per Eisenberg:
- Specialized staff, trained to work with cognitive impairments.
- Secure environment, equipped with locked doors, alarms and enclosed outdoor areas.
- Structured routine, including predictable schedules for meals, activities and personal care.
- Specialized activities, which are designed to promote cognitive stimulation, social interaction and emotional well-being.
- Personalized care plans, tailored to individuals.
- Specialized dementia programs. “Some memory care units offer programs specifically designed for different stages of dementia,” Eisenberg explains. “These programs may include therapies to slow cognitive decline, manage behavioral symptoms and improve communication skills.”
Memory care units, it should be noted, tend to be more expensive than traditional nursing home care. This, explains Eisenberg, is “due to the specialized training required for staff, staff to client ratio, enhanced security features and the tailored programming.”
“Choosing the right nursing home is crucial because older adults’ well-being and quality of life is highly dependent on the facility’s standards and services.”
— Stacey Eisenberg, owner of A Place at Home in Austin, Texas
Other types of nursing home units
Many nursing homes cast a wide net in terms of the care and support provided, but some have units within their facility that are geared towards specific conditions and situations.
These, per Eisenberg, may include:
- Rehabilitation units, with a focus on surgery/stroke/injury recovery.
- Subacute care units, which can include complex wound care, intravenous medication administration and ventilator care.
- Hospice or palliative care units, which focuses on end-of-life care.
- Behavioral health units, which can include support for behavioral needs often related to mental illness, substance abuse or severe cognitive disorders.
- Ventilator care units, which provide long-term mechanical ventilation for residents with chronic respiratory issues.
- Adult day care programs. “Some nursing homes offer adult day care programs,” explains Eisenberg. “Through these, seniors receive care and participate in activities during the day, but return to their homes or family caregivers at night.”
Nursing home services and care
No two nursing homes are exactly alike, but here’s an overview of the services most provide:
- Round-the-clock care.
- Medicine management.
- Wound care.
- Pain management.
- Physical therapists.
- Occupational therapists.
- Speech therapists.
- Support with ADLs.
- Incontinence care.
- Three meals per day, plus snacks, tailored to dietary needs.
- Games, movie nights, engaging activities.
- Light exercise.
- Religious services.
- Mental health professionals.
- Memory care.
- End-of-life care.
- Transportation to medical appointments.
- Group trips.
- Regular housekeeping.
- Handrails and assistive devices.
- Case managers.
To find out exactly what a specific nursing home provides, arrange a meeting and visit to the site.
“Some nursing homes offer adult day care programs. Through these, seniors receive care and participate in activities during the day, but return to their homes or family caregivers at night.”
— Stacey Eisenberg
What to consider when choosing a nursing home
Nursing home tours are imperative in the decision-making process, as this is where you can really get a gut feeling, he notes. He also recommends checking out the Centers for Medicare and Medicaid Services’s Nursing Home Compare tool, “which provides valuable information on each facility’s survey results, staffing levels and quality measures.”
“Folks should also review online reviews and social media posts in order to make the most informed decision,” Mikosch adds.
Here’s what else to take into consideration when choosing a nursing home:
- Facility size.
- Location.
- Ownership type (for-profit vs. not for-profit).
- Staffing levels.
- Private vs. semi-private rooms.
- Amenities.
- Cleanliness.
- Activities and engagement.
- Food.
- Visitation policies.
- Specialized services.
And last but not least, it’s “essential to discuss cost and which payment sources the facility accepts,” notes Mikosch.
What do nursing homes cost?
Costs can vary widely between facilities and locations, but according to Genworth, the 2024 median cost of a private room in a nursing home is $330 per day, $10,025 per month and $120,304 annually.
The median cost of a semi-private room is $294 per day, $8,929 per month and $104,025 annually.
“Medicaid may provide up to 100% coverage in a nursing home but individuals must meet state-specific requirements,” Mikosch notes. To find out exactly what’s covered and for how long, contact your local Medicaid office.
Medicare, on the other hand, covers short-term stays in a nursing home, usually following a hospital stay of at least three days, explains Eisenberg.
Additionally, there are different VA programs for veterans that can help cover the cost, so long as eligibility requirements are met. “This may also help with costs for the spouse of a veteran,” notes Eisenberg.
The bottom line on nursing homes
Finding the right nursing home fit takes dedicated research, but ultimately, it’s worth it, as it can be the difference between care that’s average and care that’s above average.
There are literally hundreds of questions and criteria you should take into consideration when trying to find the right nursing home for an older adult,” notes Eisenberg. “Unfortunately, most people don’t take the time, or don’t know, to ask all the right and important questions.”
