Home health brings skilled, intermittent care to you while you live at home. Skilled nursing provides 24-hour care inside a certified facility. CMS lists 12,392 certified home health agencies and 14,699 certified nursing homes — same skilled care, different setting and intensity.
The core difference
Both deliver licensed, skilled care under a physician’s direction. The difference is where and how much: home health is a schedule of visits to your residence, while a skilled nursing facility is a place you stay for continuous care during recovery.
- Skilled visits at your residence
- Intermittent — not 24-hour
- Requires homebound status
- No copay for covered Medicare services
- 12,392 certified agencies
- 24-hour skilled care in a facility
- Continuous nursing and rehab
- Covered after a qualifying hospital stay
- Cost-sharing after day 20
- 14,699 certified facilities
Where care happens
Home health keeps a person in their own home, which many prefer and which lowers exposure to facility-based risks — but it depends on a safe home environment and a caregiver for the hours between visits. A skilled nursing facility concentrates care and equipment in one place for people who need more supervision than visits can provide, particularly right after a hospital discharge.
Who qualifies
Medicare home health requires a physician’s plan of care, an intermittent skilled need, and homebound status. A covered skilled nursing-facility stay requires a qualifying prior inpatient hospital admission and a continued need for daily skilled care or rehabilitation. People often move from a facility stay to home health as they recover and the need shifts from continuous to intermittent.
What Medicare covers
Medicare home health covers skilled nursing, therapy, social services, and aide visits tied to the skilled need, with no copay for covered services and no fixed day limit while criteria are met. A skilled nursing-facility stay is covered for up to 100 days after a qualifying hospital admission, with no cost-sharing for the first 20 days and a daily coinsurance after that. Neither benefit pays for indefinite custodial care.
Comparing quality
Both settings publish CMS quality data, but nursing homes add a staffing dimension you can read directly. Using the Payroll-Based Journal, 4,153 facilities meet the 4.1 nurse-hours-per-resident-day benchmark while 1,063 fall below 3.0 — a gap that materially affects care. Home health agencies are compared on quality-of-patient-care measures instead.
By the numbers
Compare specific providers
Browse loaded certified home health agencies and nursing homes by state, with available CMS source and snapshot metadata on supported fields.
Browse facility data →Frequently asked questions
- What is the difference between home health and skilled nursing?
- Home health brings skilled, intermittent care — nursing and therapy visits — to a person who lives at home and is homebound. A skilled nursing facility provides round-the-clock skilled care in a certified facility. CMS lists 12,392 certified home health agencies and 14,699 certified nursing homes, each with its own quality data.
- Can you get skilled nursing care at home?
- Yes — that is essentially what Medicare home health is. A registered nurse can deliver skilled services such as wound care, injections, and monitoring at home, on an intermittent visit schedule, under a physician's plan of care. The difference from a skilled nursing facility is intensity and continuity: home health is visit-based, not 24-hour.
- Is a skilled nursing facility the same as a nursing home?
- Yes — skilled nursing facility is the medical term for a Medicare-certified nursing home. It provides 24-hour licensed nursing, rehabilitation, and medical oversight, and CMS surveys it and publishes its quality, staffing, and inspection data. Home care delivered to a residence is a separate, agency-based service.
- Does Medicare cover home health and skilled nursing the same way?
- No. Medicare home health covers skilled, intermittent care for a homebound patient with no copay for covered services. A skilled nursing-facility stay is covered only after a qualifying hospital admission, for up to 100 days while skilled care is needed, with cost-sharing after the first 20 days. Long-term custodial nursing-home stays are not covered by Medicare.
- Which is cheaper, home health or a skilled nursing facility?
- Home health is generally less costly because it does not include room and board, and Medicare covers qualifying home health with no copay. A skilled nursing-facility stay carries facility costs and Medicare cost-sharing after day 20. Cost is only one factor — the right choice depends on whether someone needs 24-hour care or can stay safely at home.
- How do I compare specific agencies and facilities?
- Both have records on CMS Care Compare and are mirrored on Fonteum, with available source and snapshot metadata displayed on supported fields. Nursing homes also carry staffing data from the Payroll-Based Journal — 4,153 facilities meet the 4.1 hours-per-resident-day benchmark while 1,063 fall below 3.0 — letting you weigh staffing alongside quality stars.
Related
- What is a skilled nursing facility (SNF)? — the facility setting in full, and how CMS measures it.
- Medicare home health care: what’s covered — the homebound rule and what skilled home health includes.
- Nursing home vs. assisted living — skilled care versus residential support.
- Nursing home staffing levels — the Payroll-Based Journal data behind the staffing numbers.
- Home health agency quality data — per-agency CMS quality measures with provenance.
- Home health vs. hospice — recovery-focused care versus comfort care.