Most nursing homes in the United States accept Medicare, but only for short-term skilled nursing care, not for long-term stays. To participate in Medicare, a facility must be certified by the federal government after passing health, safety, and emergency preparedness inspections. You can search for certified facilities near you using Medicare’s online Care Compare tool at medicare.gov. The more important question for most people isn’t which facilities accept Medicare, but what Medicare actually covers once you’re there.
How Facilities Get Medicare Certified
A nursing home can’t simply decide to accept Medicare. It must meet federal requirements laid out by the Centers for Medicare and Medicaid Services (CMS) and pass a series of state-conducted surveys: a standard health survey, a life safety code inspection, and an emergency preparedness review. Facilities that pass are certified as skilled nursing facilities (SNFs) and can bill Medicare for eligible patients. The vast majority of nursing homes hold this certification, though some smaller or privately operated homes may only accept private pay or Medicaid.
To check whether a specific facility is Medicare-certified, visit Medicare’s Care Compare website (medicare.gov/care-compare). You can search by city, state, or ZIP code and filter results to show only Medicare-certified nursing homes. The tool also displays quality ratings, staffing levels, and recent inspection results, which can help you compare options.
What Medicare Covers in a Nursing Home
Medicare Part A covers skilled nursing facility care, meaning care that requires trained professionals like registered nurses, physical therapists, or occupational therapists. This includes things like IV medications, wound care, physical and occupational therapy, speech therapy, medical social services, medications, dietary counseling, and medical supplies used in the facility. A semi-private room and meals are also included.
The key word is “skilled.” Medicare pays for nursing home stays only when you need daily care from licensed professionals to treat, manage, or monitor a medical condition. A stay for rehabilitation after hip surgery, for example, qualifies. A stay because you need help getting dressed, bathing, or eating does not.
What Medicare Does Not Cover
Most nursing home care in the U.S. is actually custodial care: help with everyday activities like bathing, dressing, using the bathroom, eating, and moving around. This type of non-skilled personal care, even when provided in a Medicare-certified facility, is not covered by Medicare. It also doesn’t cover long-term room and board for people who simply need a safe place to live with daily assistance. This is the single biggest gap that surprises families. If your loved one needs custodial care indefinitely, you’ll need to pay out of pocket, through long-term care insurance, or eventually through Medicaid once assets are spent down.
The 3-Day Hospital Stay Rule
Even if a facility is Medicare-certified and you need skilled care, there’s another requirement: you must first have a qualifying inpatient hospital stay of at least 3 consecutive days. The count starts the day you’re formally admitted as an inpatient and does not include the day you’re discharged.
This is where many people run into trouble. Time spent in the emergency room or under “observation status” at a hospital does not count toward the 3-day requirement, even if you’re physically in a hospital bed overnight for multiple nights. Observation is technically an outpatient classification, and it can disqualify you from Medicare-covered nursing home care entirely. If you or a family member is hospitalized, ask explicitly whether the admission is inpatient or observation. The distinction has real financial consequences.
How Long Medicare Pays
Medicare Part A covers up to 100 days of skilled nursing facility care per benefit period. Your costs change as the stay progresses:
- Days 1 through 20: $0 per day after you meet the Part A deductible ($1,632 in 2024, $1,676 in 2025).
- Days 21 through 100: You pay a daily coinsurance of $204.00 in 2024 or $209.50 in 2025. That adds up quickly: a full 80 days at the 2025 rate costs roughly $16,760 out of pocket.
- Day 101 and beyond: Medicare pays nothing. You’re responsible for the full cost.
Many people don’t use the full 100 days. Medicare will stop coverage when you no longer need daily skilled care, even if you haven’t hit the limit. If the facility determines your condition has stabilized or you’ve reached your rehabilitation goals, coverage can end well before day 100.
How Benefit Periods Work
A benefit period starts the day you’re admitted as an inpatient to a hospital or skilled nursing facility. It ends after you’ve gone 60 consecutive days without receiving inpatient hospital care or skilled nursing care. Once that 60-day clock runs out, a new benefit period begins the next time you’re admitted, and the 100-day SNF benefit resets.
This means you could have multiple benefit periods in a single year if your health situation changes. You could also remain in a single benefit period for months if you’re transferred between a hospital and a nursing facility without a long enough gap. The stays don’t even need to be for the same condition. Any readmission before 60 consecutive days have passed keeps you in the same benefit period, using the same 100-day allotment.
Medicare Advantage Plans and Nursing Homes
If you have a Medicare Advantage plan (Part C) instead of Original Medicare, your plan must cover at least the same skilled nursing facility benefits. However, there are practical differences. Medicare Advantage plans typically use provider networks, which means you may be limited to certain nursing homes that contract with your specific plan. Going to an out-of-network facility could mean higher costs or no coverage at all.
Some Medicare Advantage plans also require prior authorization before approving a nursing home stay, which can create delays. On the other hand, certain plans have waived or reduced the 3-day hospital stay requirement, making it easier to qualify. Check your plan’s specific rules before assuming Original Medicare guidelines apply. Your plan’s member services line or benefits summary will spell out which facilities are in-network and what approvals you need.
How to Find a Medicare-Certified Facility
Start with Medicare’s Care Compare tool at medicare.gov/care-compare. Enter your location and you’ll see a list of nearby nursing homes along with their Medicare certification status, overall quality star rating (1 to 5 stars), health inspection results, staffing data, and quality measures like how often residents develop pressure sores or experience falls. You can compare up to three facilities side by side.
Beyond the online search, your hospital’s discharge planner or social worker is one of the most useful resources available to you. When a patient is being discharged from a qualifying hospital stay, the discharge team typically provides a list of Medicare-certified skilled nursing facilities in the area and can help coordinate the transfer. They’ll know which facilities have available beds, which ones specialize in the type of rehab you need, and which ones have strong track records for specific conditions. Don’t hesitate to ask questions about quality and to visit a facility before agreeing to a placement if time allows.