What Is a Skilled Nursing Facility? Coverage, Cost & How to Find One

A skilled nursing facility (SNF) is a type of healthcare facility that is able to provide skilled nursing care, rehabilitation services, and 24-hour supervision to patients who have been hospitalized, are ill, injured, or post-surgery but are unable to return home safely. SNFs are different from regular nursing homes in their intensity and focus of medical care. While nursing homes offer long-term custodial care services (bathing, dressing and feeding, etc.), SNFs offer skilled medical services, which involve licensed nurses, doctors and therapists. The U.S. has some 16,000 Medicare and Medicaid certified nursing facilities, many providing both skilled and long-term custodial care within a single facility. This distinction is very important when it comes to Medicare coverage because Medicare will pay for skilled nursing facility care in certain circumstances and will not pay for long-term custodial nursing home care.

This guide defines a skilled nursing facility and describes the services that are provided, who requires SNF care and the distinctions between SNFs and related care settings. Medicare.gov, CMS and the American Health Care Association are the sources of information.

What "skilled care" actually means

One of the most important characteristics of a skilled nursing facility is the skilled care that it delivers. According to federal law, skilled care is nursing and therapy services that can only be safely and effectively provided by, or under the supervision of, a licensed medical provider. There's a difference because Medicare only pays for skilled care under certain conditions and not for non-skilled custodial care at all.

Specialized skilled nursing services include IV medications and infusions, wound care for serious wounds that need to be assessed and treated, tube feeding, management of complex urinary issues (catheters), administration of injections such as insulin for newly diagnosed diabetes, respiratory care such as ventilator management, monitoring of more complex medical conditions such as recovery from a recent stroke, and medication management that requires nursing oversight.

Skilled therapy can involve physical therapy following a hip replacement or stroke; occupational therapy for the restoration of daily living skills after a stroke or injury; speech-language pathology to address swallowing problems or communication difficulties after a stroke; rehabilitation therapy for traumatic injuries.

What is NOT skilled care: assistance with bathing, dressing, eating, transferring from bed to chair, toileting services, and activities of daily living (when no medical complexity is present). These are referred to as "custodial care" or "activities of daily living (ADLs)" services. Medicare will not pay for custodial care, even if it is offered in a skilled nursing facility, unless it is delivered related to the skilled care.

If you're looking for other home care options, check out our Medicare home health coverage guide.

Services provided at skilled nursing facilities

A skilled nursing facility offers a variety of medical and care services under one roof. Basic level of services offered are 24-hour nursing care, where registered nurses, licensed practical nurses and certified nursing assistants are available. Regular visits to residents by physicians, nurse practitioners, and physician assistants who have specific consultative relationships with the facility for medical care.

Rehabilitation services often are a significant part of SNF care. Physical therapy helps a patient regain mobility, balance and strength following illness or surgery. OT is about getting back to everyday life. Speech-language pathology focuses on speech and swallowing. Most SNFs provide their therapy services 5-7 days per week to comply with Medicare Therapy Coverage requirements for Therapy patients.

In addition to providing clinical services, the services that SNFs generally provide include three meals per day with a nutrition plan tailored to the resident's medical condition, the management of medications for complicated medication regimens, social services for discharge planning and family coordination, activities programming to support the mental and emotional needs of residents, and transportation by the ambulance service when other transportation services would be hazardous to the health of the resident.

The average price for skilled nursing facility care varies by location and level of care to around $314 for each day of care in 2026. For continuous care, it's approximately $9,400 per month or $114,000 annually, but Medicare will cover a significant portion of the out-of-pocket expenses for eligible short-term care.

Who needs skilled nursing facility care

Several patient populations typically benefit from skilled nursing facility care. The most common scenario is post-acute care following a hospital stay. Patients who had surgery (especially hip replacements, knee replacements, or major procedures), serious illnesses like stroke or pneumonia, or significant injuries often need a transitional level of care before returning home. They're medically stable but require continued skilled care, rehabilitation, or both.

Patients with chronic conditions requiring skilled care may need SNF placement when their needs exceed what family or home health services can provide. This includes complex medication management, frequent monitoring of vital signs, IV therapies, or wound care that family members can't safely manage.

End-of-life care patients sometimes use SNF placement when home hospice isn't feasible. While hospice care can be provided in various settings, some patients need the medical infrastructure of an SNF.

Patients recovering from severe injuries with rehabilitation needs benefit from concentrated rehabilitation services available in SNFs. The therapy intensity and 24-hour medical supervision often produce better outcomes than home rehabilitation for complex cases.

The decision to use an SNF typically happens during hospital discharge planning. Hospital social workers, case managers, and physicians evaluate whether a patient can safely go home (potentially with home health services) or needs the intermediate level of care that SNFs provide.

Skilled nursing facility vs nursing home vs assisted living

The terminology around care facilities can be confusing because terms are used inconsistently and many facilities offer multiple types of care.

A skilled nursing facility provides intensive medical and rehabilitative care for patients with significant medical needs, typically following hospitalization. Stays are often short-term (weeks to months) for rehabilitation, though some patients require long-term skilled care. Medicare pays for qualifying short-term SNF stays for up to 100 days per benefit period.

A nursing home (sometimes called a long-term care facility) provides primarily custodial care for residents who need help with daily activities but don't necessarily need intensive medical services. Many nursing homes also have skilled nursing units, blurring the distinction. Nursing home stays are typically long-term (months to years). Medicaid covers nursing home stays for qualifying low-income individuals; Medicare does not cover long-term nursing home care.

Assisted living facilities provide a residential setting with support services like medication reminders, meal preparation, housekeeping, and social activities. Assisted living residents are generally more independent than nursing home residents and don't require 24-hour medical care. Costs average $6,200 per month in 2026. Medicare doesn't cover assisted living; Medicaid covers it through specific waiver programs in some states.

Memory care facilities specifically serve patients with dementia, Alzheimer's, or other cognitive impairments. They may be standalone or part of larger facilities offering multiple care levels. Memory care typically costs $11,000+ per month in 2026.

For specific Medicare coverage details, see our skilled nursing facility coverage guide.

How SNFs differ from rehab hospitals

Some patients may also encounter inpatient rehabilitation hospitals (IRFs) during their care journey. IRFs differ from SNFs in important ways.

IRFs provide more intensive therapy, typically requiring 3+ hours of therapy daily, 5 days per week. They serve patients who can tolerate this intensity and have the rehabilitation potential to benefit. SNFs provide therapy when medically appropriate but at less intensive levels (typically 1-2 hours per day).

IRF patients must have specific qualifying conditions like stroke, traumatic brain injury, hip fracture, or major neurological diagnoses. SNFs serve a broader range of patients with various medical needs.

Medicare Part A pays for both IRF and SNF stays under different rules. IRF stays don't require the 3-day qualifying hospital stay that SNF stays require. IRF stays have different cost-sharing structures than SNF stays.

The choice between IRF and SNF depends on patient needs, rehabilitation potential, insurance coverage, and physician judgment about which setting best serves the patient.