Nursing Home Cost

The cost of a stay in a nursing home is dependent upon the circumstances of an admission, particularly whether care is needed on a short-term or long-term basis. While short-term care is almost always covered by Medicare for those who are eligible to receive benefits, long-term care requires alternative payment methods and the costs can be very expensive.

Other factors influencing nursing home costs include the geographic location of the facility and whether a patient has a private or semiprivate room.

Short-Term Care & Medicare

Skilled care, provided by nursing homes (also known as skilled nursing facilities), is often needed on a short-term basis by seniors who have been hospitalized due to illness or injury. Medicare provides coverage for skilled care on a short-term basis when the following criteria are met:

  • A senior is currently receiving Medicare Part A (Hospital insurance) benefits and is therefore 65 years or older or has been formally diagnosed with renal failure.
  • A hospital stay of three or more consecutive days (three midnights) within the past 30 days.
  • A physician has determined that skilled care and/or rehabilitation is medically necessary due to a current health condition.
  • The skilled services required are provided in a facility that has been certified by Medicare.

If all of these conditions are met, Medicare will contribute to the nursing home cost required on a short-term basis (for up to 100 days). Specifically, Medicare will provide 100% coverage for skilled nursing costs for the first 20 days of a nursing home stay. From day 21 through day 100 of the benefit period, the patient is responsible for paying approximately $130 per day.

Long-Term Care & Alternative Payment Methods

A benefit period ends when skilled care or rehabilitation has not been provided by the nursing home for 60 days. In such cases, Medicare no longer covers nursing home costs unless a patient experiences another qualifying hospital stay. Nursing home care provided from this point on is typically considered long-term care and patients must rely on other types of insurance coverage or pay privately.

Other payment types include long-term care insurance (which does not cover pre-existing conditions), Medigap policies and/or veteran’s benefits. Those who pay privately will commonly spend down their assets to qualify for Medicaid, a state-administered program for low-income individuals or families.

Nursing Home Costs By State

Nursing home costs vary depending on geographic location and whether a patient receives care in a private or semiprivate room. According to a 2015 Cost of Care Survey, the nationwide average daily rate for care provided in a private room is $250 and in a semiprivate room is $220, which equals $91,250 and $80,300 per year respectively. For those living in a nursing home long term, they can expect to see nearly a 4% annual increase in the base rate.

The table below shows the range of costs by state in 2015* of the daily rate for a private room.

StateMinimumMedianMaximum
Alabama$140$209$396
Alaska$461$771$1,255
Arizona$164$233$650
Arkansas$130$180$865
California$144$285$913
Colorado$179$256$650
Connecticut$215$435$505
Delaware$232$323$350
District of Columbia$270$270$270
Florida$180$265$505
Georgia$120$195$679
Hawaii$263$370$616
Idaho$176$243$369
Illinois$130$204$1,035
Indiana$150$250$450
Iowa$148$187$298
Kansas$145$180$288
Kentucky$175$239$805
Louisiana$112$170$500
Maine$215$295$443
Maryland$200$302$464
Massachusetts$225$382$489
Michigan$197$272$464
Minnesota$167$263$424
Mississippi$177$220$300
Missouri$130$167$380
Montana$175$220$287
Nebraska$133$218$600
Nevada$135$270$508
New Hampshire$275$335$514
New Jersey$249$350$449
New Mexico$175$234$473
New York$226$374$1,080
North Carolina$108$225$630
North Dakota$169$288$407
Ohio$118$235$465
Oklahoma$135$165$340
Oregon$185$280$345
Pennsylvania$155$310$1,015
Rhode Island$190$283$356
South Carolina$122$206$349
South Dakota$176$212$257
Tennessee$152$207$412
Texas$101$188$391
Utah$147$210$500
Vermont$260$288$500
Virginia$175$254$765
Washington$191$289$525
West Virginia$210$295$365
Wisconsin$185$273$836
Wyoming$190$245$300
*From the Genworth Financial 2015 Cost of Care Survey.

The states with the most expensive median daily rate for a private room in a nursing home are:

  1. Alaska - $711
  2. Connecticut - $435
  3. Massachusetts - $382
  4. New York - $374
  5. Hawaii - $370

The states with the least expensive median daily rate for a private room in a nursing home are:

  1. Oklahoma - $165
  2. Missouri - $167
  3. Louisiana - $170
  4. Kansas - $180
  5. Arkansas - $180

Additional costs incurred during a nursing home stay may include supplies such as incontinence products, transportation to medical appointments and nutritional supplements if requested by the patient or family members.

Though you cannot predict whether your parents or yourself may require a stay in a nursing home, you should plan in advance for how to pay for nursing home care so you aren’t facing the stressful situation of hefty bills that insurance or Medicare won’t cover.

Written by gerontologist Sara Shelton and Andrea Watts.