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What is a skilled nursing facility?

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By Nursing Homes In Each State · Published · Last updated

Short answer

A skilled nursing facility (SNF, often said "sniff") is a nursing home that Medicare has certified to provide skilled nursing and therapy care. In practice, most US nursing homes are certified both as a skilled nursing facility for Medicare and as a nursing facility for Medicaid, so the same building often serves short-term rehab patients and long-term residents.

What "skilled nursing facility" means

"Skilled nursing facility" is a Medicare term. It describes a facility that meets federal requirements to give skilled nursing care and rehabilitation services, and that has been inspected and certified to bill Medicare. Medicaid uses a parallel term, "nursing facility," for homes certified to care for Medicaid residents. The federal requirements for both are in the same set of regulations, 42 CFR Part 483.

Skilled care means care that has to be given by, or under the supervision of, licensed nurses or therapists. Examples include wound care, IV medicines or injections, monitoring after surgery, and physical, occupational or speech therapy. The other kind of help, with bathing, dressing, eating and moving around, is called custodial care. Nursing homes provide both.

Certification matters for payment. Medicare Part A only pays for a skilled nursing stay in a facility that Medicare has certified, and Medicaid only pays for nursing home care in a home certified for Medicaid.

How many homes are certified for each program

CMS's data lists 14,686 active certified nursing homes. 13,904 (95%) are certified for both Medicare and Medicaid, 537 for Medicare only, and 245 for Medicaid only.

Source: CMS Provider Data Catalog, October 2026. Only homes certified by Medicare or Medicaid appear in CMS's data, so this doesn't count assisted living or private-pay-only homes.

Skilled nursing facility vs nursing home vs rehab

People use these words loosely, and the same building can be all three.

TermWhat it usually means
Skilled nursing facility (SNF)A facility certified by Medicare to give skilled nursing and therapy. Often used for short stays after a hospital admission.
Nursing homeThe everyday name for a licensed facility that gives 24-hour nursing care and help with daily activities. Most are also certified SNFs.
Short-term rehabA stay, usually days or weeks, for therapy and nursing after surgery, a stroke or an illness. Many nursing homes have a rehab unit or rehab wing.
Long-term careLiving in a nursing home for months or years, mainly for custodial care. Medicare doesn't pay for this; Medicaid or private payment usually does.
Inpatient rehabilitation facilityA separate kind of facility, often part of a hospital, for intensive therapy. It isn't a nursing home and has different Medicare rules.

So when a hospital discharge planner says "we're sending your dad to a SNF for rehab," that is very often a nursing home with a rehab unit. Medicare's rules for those stays, including the 3-day hospital requirement and the 100-day limit, are in our guide Does Medicare pay for nursing home care?

Who works in a skilled nursing facility

Nursing care in a SNF comes from three main groups:

  • Registered nurses (RNs) assess residents, plan care, give complex treatments and supervise other staff. Federal rules require an RN on site at least 8 consecutive hours a day, 7 days a week, and a full-time RN as director of nursing, unless a waiver is granted.
  • Licensed practical or vocational nurses (LPNs/LVNs) give medicines and treatments under RN supervision.
  • Certified nursing assistants (CNAs), also called nurse aides, give most of the hands-on daily help: bathing, dressing, eating, moving and toileting.

Physical, occupational and speech therapists provide rehab. A physician (or a nurse practitioner or physician assistant working with one) oversees each resident's medical care, and homes also have social services staff, dietitians and activities staff.

A 2024 federal rule would have set minimum total nurse staffing hours and required an RN on site 24 hours a day. CMS repealed those requirements in December 2025, so the older federal standards above apply. States can and do set their own, stricter minimums.

How much nursing time residents get

The median certified nursing home reports 3.72 of total nursing staff time per resident per day, of which 0.59 is registered nurse time. That total combines RN, LPN and nurse aide hours, divided by the number of residents.

Source: CMS Provider Data Catalog, reported staffing hours per resident per day, October 2026. Each home's page on this site shows its own hours next to its state's median.

How skilled nursing facilities are inspected and rated

Every certified SNF gets an unannounced standard inspection from its state survey agency, on CMS's behalf, roughly once a year, with additional inspections when someone files a complaint. Inspectors check the home against the federal requirements and record any problems they find as deficiencies, also called citations.

CMS turns those inspection results, the home's staffing data and its quality measures into 1-to-5 star ratings, published on Medicare's Care Compare site and on each home's page here. The ratings include separate quality ratings for short-stay residents, who are mostly rehab patients, and long-stay residents. If you are choosing a place for rehab, the short-stay quality rating is the more relevant of the two. Our guide to nursing home star ratings explains how CMS builds them and what they leave out.

Questions to ask a skilled nursing facility

  1. Are you certified for Medicare, and for Medicaid in case the stay becomes long-term?
  2. How many days a week, and how many hours a day, will therapy be provided?
  3. How many residents does each nurse and each nursing assistant look after on day, evening and night shifts, and on weekends?
  4. How often will we meet with the care team, and how is the discharge plan decided?
  5. If you're in a Medicare Advantage plan: is this facility in the plan's network?

Then check the facility's record before you decide. Look at its star ratings, its most recent inspection findings and its staffing compared with the state median, all on its page here, and visit if you can.

Find nursing homes in your state

Each state page lists every Medicare- and Medicaid-certified nursing home there, with CMS star ratings, staffing and inspection records.

Ranked lists for the largest states

Already have a shortlist? Compare nursing homes side by side, or find nursing homes near you.

More guides

Sources

  1. Medicare.gov: Skilled nursing facility (SNF) care
  2. Medicare.gov: Nursing home care
  3. Medicaid.gov: Nursing facilities
  4. eCFR: 42 CFR Part 483, requirements for long-term care facilities
  5. CMS: Nursing Home Five-Star Quality Rating System, Technical Users' Guide (September 2026)
  6. CMS Provider Data Catalog: Nursing homes, including rehab services

Last updated October 31, 2026. Figures about nursing homes on this page come from the CMS Provider Data Catalog, October 2026, and update when CMS releases new data. Rules and dollar amounts are from the government sources listed above and can change; check them before you rely on them. Not medical, legal or financial advice. Nursing Homes In Each State is independent and not affiliated with CMS or Medicare. About the data · Report an error.

https://www.nursinghomesineachstate.com/guides/what-is-a-skilled-nursing-facility/ · Data: CMS, October 2026 · Nursing Homes In Each State, not affiliated with CMS or Medicare.