Skilled Nursing Overview
Long-term care (LTC) and post-acute care (PAC) are typically provided in skilled nursing settings, where licensed nurses deliver a higher level of clinical care than what is available in non-medical residential facilities. Skilled nursing care includes services that must be performed or overseen by registered nurses or licensed practical/vocational nurses, such as complex assessments, medication administration, wound management, rehabilitation support, and care for chronic or unstable conditions. In the LTC and PAC continuum, skilled nursing facilities (SNFs) serve patients transitioning from hospital stays or those needing ongoing clinical supervision due to functional limitations, comorbidities, or recovery requirements. This sets LTC/PAC apart from custodial care, as the focus extends beyond assistance with activities of daily living to include continuous clinical monitoring, interdisciplinary care planning, and medically necessary interventions. Therefore, LTC and PAC nursing constitute a specialized branch of professional nursing rooted in skilled, regulated, and evidence-based care. LTC and PAC nursing concentrate on caring for individuals with chronic illnesses, disabilities, or recovery needs requiring long-term services in settings like skilled nursing facilities, rehabilitation centers, and home care. These nurses deliver holistic, interdisciplinary, and person-centered care that addresses medical, functional, and psychosocial needs over time.
Key Responsibilities
Responsibilities include comprehensive assessment, interdisciplinary care planning, medication administration, monitoring for complications, resident and family education, regulatory compliance, and quality improvement activities.
Work Settings
LTC/PAC nurses work in skilled nursing facilities, nursing homes, assisted living, rehabilitation centers, home health, and hospice settings.
Scope of Practice
Practice emphasizes chronic disease management, functional assessment, care coordination, and regulatory compliance, often with leadership responsibilities.
Education and Certification
Entry requires an ADN or BSN and RN licensure. Certifications include GERO-BC, RAC-CT®, and DNS-CT®. Advanced degrees support leadership roles.
Specialty Areas
Specialties include gerontology, dementia care, rehabilitation, hospice and palliative care, infection prevention, and quality improvement.
Career Traits
Successful nurses demonstrate strong clinical judgment, adaptability, collaboration, attention to detail, and compassion.
Salary and Job Outlook
Average salaries range from approximately $90,000 to $94,000 annually. Demand is expected to grow due to an aging population and increased chronic disease burden.
Demographics of the Workforce
Approximately 12% of RNs work in long-term care. The workforce is older on average, with a higher proportion of associate degree-prepared nurses.
Professional Organizations
Key organizations include the American Association of Post-Acute Care Nursing and the National Association of Long Term Care Administrator Boards.
References
American Association of Post-Acute Care Nursing. (n.d.). About AAPACN. https://www.aapacn.org/about/
Bureau of Labor Statistics. (2024). Registered nurses: Occupational outlook handbook. https://www.bls.gov/ooh/healthcare/registered-nurses.htm
NurseJournal. (2025). Long-term care nurse career overview. https://nursejournal.org/careers/long-term-care-nurse/
NursingEducation.org. (2024). Long-term care nurse salary. https://nursingeducation.org/careers/long-term-care-nurse/salary/
Vivian Health. (2026). Long-term care nurse salary data. https://www.vivian.com/nursing/long-term-care-nurse/salary/
Wagner, L. M. (2021). Race, ethnicity, and wages among nurses in long-term care. https://pmc.ncbi.nlm.nih.gov/articles/PMC8428870/
