A nursing home is a residential facility where people live and receive full-time medical and personal care. Unlike other senior living options, nursing homes provide round-the-clock supervision by licensed nurses and help with daily tasks like bathing, dressing, and eating. There are roughly 14,700 nursing homes operating across the United States, serving people who need more hands-on care than they can safely receive at home.
What Nursing Homes Actually Provide
Most nursing home care is what’s called custodial care: help with the basic activities of daily living that a person can no longer manage independently. That includes assistance with bathing, getting dressed, eating, using the bathroom, and moving around. For many residents, this kind of support is the primary reason they’re there.
Beyond daily personal care, nursing homes also offer skilled medical services. Residents have access to nursing care from registered nurses and licensed practical nurses, rehabilitation therapies (physical, occupational, and speech therapy), medication management, and wound care. Three meals a day, housekeeping, and social activities are standard. The combination of medical oversight and personal care under one roof is what sets nursing homes apart from other long-term care options.
How Nursing Homes Differ From Assisted Living
The distinction matters because the two serve different levels of need. Assisted living is designed for people who need some help with daily routines but can still live fairly independently. Residents typically have their own apartments, come and go with relative freedom, and pay more if they need additional services. The medical support is lighter.
Nursing homes, by contrast, focus heavily on medical care. They’re built for people who need daily skilled nursing, can’t manage multiple activities on their own, or have cognitive conditions like dementia that require constant supervision. Federal rules now require nursing homes to have a registered nurse on site 24 hours a day, seven days a week. The minimum staffing standard calls for about 3.5 hours of direct nursing time per resident per day, including dedicated time from both registered nurses and nurse aides. Assisted living facilities don’t face these same requirements.
Who Qualifies for Nursing Home Care
Admission to a nursing home typically involves a level-of-care assessment that evaluates how much help a person truly needs. The general threshold includes having difficulty with four or more activities of daily living, or having significant problems with memory, decision-making, or behavior that require regular intervention. People who need unpredictable, around-the-clock help with things like toileting, transferring from a bed to a chair, or repositioning often meet the criteria.
Not everyone in a nursing home is there permanently. Many people enter for short-term rehabilitation after a hospital stay, such as recovering from hip surgery or a stroke, and then return home once they’ve regained enough function.
What It Costs
Nursing home care is expensive. The national average for a semi-private room runs about $308 per day, which works out to roughly $112,400 per year. A private room costs more. These figures represent averages; prices vary significantly by state and region, with urban areas and northeastern states generally charging the most.
Most people pay for nursing home care through a combination of personal savings, Medicaid, and (for short stays) Medicare. Long-term care insurance covers some residents, but relatively few Americans carry these policies.
How Medicare Covers Short-Term Stays
Medicare does not pay for long-term nursing home care. It will, however, cover a skilled nursing stay of up to 100 days if you meet specific conditions: you must have had a qualifying hospital stay of at least three days, enter the nursing home within 30 days of leaving the hospital, and need daily skilled care like intravenous medications or physical therapy for a condition related to your hospitalization.
If you qualify, the first 20 days are fully covered after you pay a one-time deductible of $1,736 (in 2026). Days 21 through 100 come with a daily copay of $217. After day 100, Medicare stops paying entirely. This is the point where many families face a difficult financial transition.
How Medicaid Covers Long-Term Stays
Medicaid is the largest payer of long-term nursing home care in the country. Unlike Medicare, Medicaid will cover an indefinite stay, but eligibility is tied to both your medical needs and your finances. You generally must have limited income and assets to qualify. In California, for example, the asset limit is $130,000 for a single person, with additional allowances for married couples under spousal impoverishment protections.
If your assets exceed the limit, you’re expected to “spend down” by using your money on legitimate needs until you reach the threshold. One important rule to know: Medicaid looks back at financial transactions made before you entered a nursing home (30 months in some states, up to 60 months in others). Giving away assets for less than their value during that window can delay your coverage, sometimes by months.
Rights You’re Guaranteed as a Resident
Federal law gives nursing home residents a strong set of protections. These rights were established by the Nursing Home Reform Act of 1987 and are enforced through regular inspections. Every resident has the right to be treated with respect and dignity, to be fully informed about their medical condition in language they understand, and to participate in decisions about their own treatment. You have the right to choose your own doctor.
Residents are also protected from physical or chemical restraints used for staff convenience or discipline rather than genuine medical need. You can voice complaints to the facility or to outside agencies without fear of retaliation. These aren’t suggestions; they’re legally enforceable standards that every certified nursing home must follow.
How to Check a Nursing Home’s Quality
The federal government rates every Medicare- and Medicaid-certified nursing home on a one-to-five-star scale through the Care Compare tool on Medicare.gov. The overall rating combines three separate scores: health inspection results (based on the most recent on-site surveys), staffing levels (how many nursing hours residents actually receive), and quality measures (things like rates of falls, infections, and hospital readmissions).
A five-star facility scores well across all three categories. A one-star rating signals serious concerns. No rating system is perfect, but comparing these scores across several nearby facilities gives you a useful starting point. Visiting in person, talking to current residents’ families, and asking about staff turnover will fill in the gaps that numbers can’t capture.