Nursing homes: what it is and who it's for
Round-the-clock skilled nursing care under licensed medical staff.
When it's the right level
Nursing homes is generally the right place to look when the issue is daily medical needs — wound care, injections, constant monitoring. Care needs change, though, and many communities are licensed for more than one level — what happens when needs increase is the single best question to ask on any tour.
How it's licensed
This category is licensed by the state, which means inspection reports and substantiated violations are usually public records you can read before you tour. On every register here it is nursing facility.
Where you can browse them
Live coverage, each from that state's own licensing register: Nevada, 58; Oregon, 128. Everywhere else is on the coverage map.
What Medicare pays, and what it does not
This is the one families most often have backwards, and getting it wrong is expensive. Medicare does not pay for a long stay in a nursing home. Its own words are “Medicare doesn’t pay for long-term care” — the help-with-daily-life kind, which it calls custodial care — and you pay all of it.
What it can cover is a short recovery stay after a hospital admission. Medicare is strict about this, and says you must meet all of the following — not just the first, which is the one everybody has heard of:
- A hospital stay of at least three nights as an admitted inpatient. Time under observation or in the emergency room before you are admitted does not count, “even if you’re there overnight”, and the day you leave does not count either. Being in a hospital bed is not the same as being admitted, and the difference is worth asking about out loud, on the day.
- You still have days left in the benefit period.
- You move in within a short time of leaving the hospital — generally 30 days.
- A doctor has decided you need daily skilled care, such as IV medication or physical therapy. When the daily skilled need ends, the coverage ends with it, whatever day of the 100 you are on.
- The skilled care is for a condition that was treated during the qualifying hospital stay, or for a new one that started while you were getting SNF care for that condition.
- The care is in a Medicare-certified skilled nursing facility. This is a federal certification and it is not the same thing as the state license the communities this page links to are listed under — a different agency, a different list, in every state. A community can hold the state license and not be certified — so if this matters to your family, ask the community directly whether it is Medicare-certified, before anything else.
If all of that is met, Part A covers up to 100 days in a benefit period — a ceiling, not an entitlement:
- Days 1–20 — nothing per day. There is a $1,736 Part A deductible, but you do not pay it again here if you already paid it for the hospital stay in the same benefit period, which is the usual case given that a hospital stay is required.
- Days 21–100 — $217 a day.
- Day 101 onward — you pay everything.
All of the above is Original Medicare. If your parent is in a Medicare Advantage plan — about half of people with Medicare are — the plan sets its own terms: it may waive the three-night hospital rule, and it may charge a copayment during the first 20 days. Ask the plan. There is also one way round the three-night rule under Original Medicare: some hospitals belong to an accountable care organization approved for a “Skilled Nursing Facility 3-Day Rule Waiver”. It is worth asking the hospital whether yours is one.
2026 figures. Source: Medicare on long-term care, Medicare on skilled nursing facility care, both read 2026-08-12.
What Medicaid pays for this license
This is what a state pays a provider, not a private-pay price, and the two are far apart — what care actually costs, and the hours where staying home costs the same. Rates are set state by state, so they are listed that way — one heading per state, each citing that state's own schedule, and nothing below a heading applies outside the state it names.
Nevada
If she qualifies financially, Nevada pays between $146 and $212 a day, depending on which facility it is. Effective July 1, 2026 (Nevada Health Authority, Division of Nevada Medicaid — Nursing Facility Rates).
Nevada does not set one nursing-facility rate. Each facility is paid its own per diem, calculated from that facility's case mix and republished every quarter, so the figures above are the lowest and highest in the current table rather than a rate anyone is guaranteed. The same table pays each facility a separate quarterly supplemental payment on top of the per diem, which these figures do not include — so this is a floor on what a Nevada facility receives, not the whole of it.
Oregon
If she qualifies financially, Oregon pays $16,511 a month ($568 a day). A nursing facility works differently from the other licenses here: there is no room-and-board deduction. She pays her income to the facility less the allowances the rule sets — a personal needs allowance of $81.28 a month ($90 where a VA benefit has been reduced to that), and, if her husband or wife is still living at home, a further allowance for them of up to $4,066.50 a month. Which of those apply is what decides the number, so read the rule if a spouse is involved (OAR 461-160-0620, read 2026-08-29). Effective July 1, 2026 (Oregon ODHS, Aging and People with Disabilities — Medicaid rate schedule).
Of Oregon's 128 communities licensed for this level, 122 accept Medicaid — so for most families reading this these are the operative numbers.
Reading the capacity figure
The register publishes licensed capacity — how many residents the license permits — and nothing about how many places are free this week. Ask about openings on the first call: a community with nothing available for four months is not an option however good it looks.
Still deciding?
Here is where nursing homes sits against the other five. The other levels are here: independent living, assisted living, residential care, memory care, adult foster care.
No daily care
Hands-on help most days
Daily medical care
Memory care is a state certification added on top of a community's existing license, not a seventh box — how the six relate.