Long-Term Care vs. Skilled Nursing

Support for medical needs can look different for each person. It may be needed for a short time, or it may continue for months or years.

As you explore care options for a loved one, you may hear terms that sound similar but mean different things. Two common examples are long-term care and skilled nursing care. While they are sometimes used interchangeably, they are not the same.

Understanding the difference can help you make a more informed decision about the type of support your loved one needs.

Long-Term Care vs. Skilled Nursing: Key Differences

Skilled nursing can exist independently or as a component of long-term care. To understand the difference, take a moment to learn about each form of care.

Skilled Nursing Care

Skilled nursing care consists of medical oversight and hands-on care from qualified medical professionals. For example, this care may include:

• Administration of intravenous medications or injections
• Treatment of wounds or surgical sites
• Monitoring of vital signs
• Administration of physical, occupational, or speech therapy

When skilled nursing is referred to outside of the context of long-term care, it typically refers to care provided temporarily for those who are recovering from an acute medical condition, such as an injury or illness, or from surgery.

Long-Term Care

For those with chronic health conditions, long-term care can provide skilled nursing care on a permanent basis, along with more generalized support to assist with activities of daily living (ADLs), such as bathing and dressing. This more general support is known as custodial care. Long-term care provides both custodial care and skilled nursing care in a residential setting for older adults with extensive daily needs.

For example, depending on the individual care plan, long-term care may provide:

• Medication administration
• Specialized therapies
• Management of chronic medical conditions
• Hands-on help with ADLs
• 24/7 on-call assistance
• Prepared meals
• Transportation
• Planned classes, events, and social experiences

Long-Term Care vs. Skilled Nursing: A Quick Comparison

Refer to the table below for an easy comparison of long-term care and more temporary skilled nursing care.

Cost Differences and Insurance Coverage

Another key difference in the skilled nursing vs. long-term care comparison is the cost for these services and the way these costs are covered.

Pricing Structures

Skilled nursing usually is billed as a medical service with daily all-inclusive rates or as an itemized bill, while long-term care is billed as a residential service with monthly or yearly rates. (These monthly or annual costs may be offset by an initial move-in fee.)

Cost Totals

In terms of daily costs, skilled nursing is generally more expensive than long-term care because it involves more extensive clinical support. However, skilled nursing may cost less out of pocket than long-term care because Medicare offers coverage for short-term care after a qualifying hospital stay.

Insurance Coverage

For those who qualify, Medicare can cover up to 100 days of skilled nursing care. The first 20 days are usually fully covered. After that, the person may share part of the daily cost.

Medicare doesn’t pay for long-term care because of its focus on nonmedical custodial care, such as help with bathing, dressing, and meals. However, for people who qualify, Medicaid or private long-term care insurance (LTCI) may help pay for long-term care.

LTCI policyholders pay premiums so that, if they need long-term care in the future, their premiums will eventually cover those costs. LTCI can be a helpful solution for future care planning, but it comes with certain limitations and drawbacks. Some individuals and families prefer to set aside assets to help cover future care costs if, and when, they arise, while others may opt for a continuing care at home program to secure future care and keep costs predictable.

How to Choose the Right Option for Your Situation

Not sure whether your loved one needs skilled nursing or long-term care? It’s best to consult with their medical team to see whether a temporary stint of rehabilitative medical care or a permanent arrangement of daily assistance and medical care is more fitting.

Skilled nursing delivered temporarily is the right choice for someone who was living independently (or with minor help) but was hospitalized for an injury, illness, or surgery requiring recovery in a medical setting. Under the supervision and care of a skilled medical team, the person can receive the necessary treatments and therapies to fit their needs.

Long-term care is the right choice for a person whose well-being would benefit from ongoing supervision, assistance with ADLs, and less intensive medical care. If a person has been struggling to live independently, or if family caregivers or home health aides are no longer sufficient for meeting their needs, long-term care offers a comprehensive and lasting solution.

The Value of a Full Continuum of Care

In some scenarios, a seamless transition from one form of care to another is the ideal means of meeting a person’s evolving needs. For example, after addressing a condition in the hospital, a person may be referred to a short-term rehabilitation center to receive skilled nursing care. If the patient has ongoing needs for assistance after their stay concludes, it may be time to transition to assisted living or long-term care, depending on their level of health and independence.

Long-Term Care vs. Skilled Nursing: Final Thoughts

In short, you can think of skilled nursing as a bridge back to health or to a different form of care, while long-term care is more of a destination for ongoing support. Skilled nursing care can be a key component of long-term care, along with continuous oversight and hands-on assistance with daily needs.

A full continuum of care can fully support your loved one, whatever their needs, and can continue to do so as those needs change. Some communities offer short-term rehabilitation, long-term care, and other levels of living all on the same campus, allowing people to find the support they need at every stage within the same familiar setting.

Would long-term care be a good fit for your loved one’s needs? Start by exploring long-term care options near you. Or, if you need help planning your loved one’s next steps after a recent hospitalization, reach out to our team.