What is the Difference Between Skilled Nursing, Assisted Living and Nursing Homes

Confusion often arises surrounding the use of the term “skilled nursing.” Because there are so many options, understanding the terminology used is an important first step in determining the best care options for you or your loved one.

Here, we explain the key differences between skilled nursing, assisted living and nursing homes and provide situations where in-home skilled nursing can be a good fit, even for seniors with medical needs.

Skilled Nursing

Skilled nursing care is a high level of medical care that must be provided by trained individuals, such as registered nurses (RNs) and physical, speech, and occupational therapists. These services can be necessary over the short term for rehabilitation from an illness or injury, or they may be required over the long term for patients who need care on a frequent or around-the-clock basis due to a chronic medical condition. Examples of skilled nursing services include wound care, intravenous (IV) therapy, injections, physical therapy, and monitoring of vital signs and medical equipment.

Skilled Nursing Care in the Home

As more seniors choose to age in place, home health agencies have responded by offering skilled services provided by licensed nurses or therapists in clients’ homes. When prescribed by a doctor, these short-term skilled care services can be covered by Medicare, some private health insurance policies, veteran’s benefits, and long-term care insurance policies. Utilizing a home health care provider enables an individual to receive highly effective medical treatment while remaining as independent as possible in the comfort of their own home.

Skilled Nursing Care in Assisted Living Facilities

Seniors who require more assistance than what can be provided in the home may need to consider a move to an assisted living facility. Assisted living facilities provide a wide range of services to individuals who want to maintain some level of independence but require support with activities of daily living.

Assisted living facilities vary widely in the levels of care available, and state licensing often determines the tiers of medical care that can be provided. Residents’ care plans are created, overseen and regularly reviewed by RNs and licensed practical nurses (LPNs). Some level of security, personal care, and nursing staff is available around the clock, but the purpose of assisted living is to provide supervision and support with ADLs, not 24/7 skilled care. If a resident’s care needs exceed what the ALF can provide, they must either hire a home health agency to come in and provide these additional services in their apartment.

Nursing Homes

Nursing homes provide around-the-clock skilled nursing care for the frail elderly who require a high level of medical care and assistance. Twenty-four-hour skilled nursing services are available from licensed nurses. Many nursing homes now provide short-term rehabilitative stays for those recovering from an injury, illness or surgery. Long-term care residents generally have high care needs and complex medical conditions that require routine skilled nursing services. Residents typically share a room and are served meals in a central dining area unless they are too ill to participate.

If you have any questions or need help deciding which option is right for you or your loved one please click here or call 913-242-3925.


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