Nursing Homes in Oklahoma
As seniors age, many require a higher degree of care than what’s available in the home or an assisted living setting. Nursing homes meet the needs of older adults with advanced personal care and medical needs, helping them manage ongoing health conditions and maintain a high quality of life. These facilities are staffed with licensed health care professionals and provide services such as medication management, help with daily living activities, laundry and nutrition services.
In Oklahoma, about 16% of the state’s 4 million residents are aged 65 and over, the age group that accounts for the majority of nursing home residents. As of 2022, nearly 16,000 Oklahoma seniors, or a little over 2.5% of older adults in the state, live in nursing homes. The state is home to 297 licensed nursing homes, accommodating a variety of needs and preferences related to pricing, care services and location.
Through this guide, readers can find comprehensive information on nursing home care in Oklahoma, including whether residents can pay for services through Medicare and the state's Medicaid program and what other financial assistance options may be available. The guide also highlights some of the state-mandated rules nursing homes in Oklahoma follow.
Cost of Oklahoma Nursing Homes
The average cost of nursing homes in Oklahoma is $146 per day. This is higher than the national average which is $228 per day.
Can You Use Medicaid to Pay for Nursing Home Care in Oklahoma?
In Oklahoma, qualified seniors can pay for nursing home care through SoonerCare, the state’s Medicaid program. As of December 2022, 1.3 million Oklahomans were enrolled in Medicaid and CHIP, including about two-thirds of nursing home residents and one in six Medicare beneficiaries. Oklahoma has an expanded Medicaid program, meaning that it extends coverage to low-income individuals, rather than exclusively to seniors and those with qualifying disabilities. It provides comprehensive nursing home coverage, including diagnostic services, rehabilitative therapies, prescription medications, dietary services and around-the-clock skilled nursing. For seniors who qualify for nursing home level care but want to remain in the community, the Medicaid ADvantage Waiver Program covers skilled nursing services at home or in an assisted living facility.
Eligibility for Medicaid in Oklahoma
To be eligible for Medicaid, applicants must meet financial guidelines. Single applicants can have an annual income of up to $32,904, and if both spouses are applying for Medicaid, the annual income limit is $65,808. If only one spouse is applying, only their income counts, and they can transfer a Monthly Maintenance Needs Allowance to the non-applying spouse to prevent impoverishment. Applicants may have up to $2,000 in countable assets, or $4,000 if both spouses are applying for coverage. Certain assets are excluded from this limit, including the applicant’s primary residence, primary vehicle and personal belongings.
In addition to financial criteria, Medicaid applicants must meet other eligibility criteria, including:
- Legal U.S. residency or citizenship
- Permanent residents of Oklahoma
- Require nursing home level care
Applying for Medicaid in Oklahoma
Seniors obtain SoonerCare through the state’s Department of Human Services and have several avenues for applying for coverage. The department has an online portal, OKDHSLive!, where individuals can apply for coverage. Alternatively, seniors can visit their nearest DHS office to apply for coverage, or they can call the Director’s Helpline at (877) 751-2972 for application assistance.
What Information You Will Need
- Social Security card
- Birth certificate
- Proof of assets
- Income verification letters
- Tax forms
- Funeral trust documents
- Bank account statements
- Driver’s license or state-issued ID card
- Proof of life insurance assignment
- Policy numbers for other health insurance policies, including Medicare or TRICARE
Additional Medicaid Support & Resources in Oklahoma
Seniors have access to several agencies that help them determine eligibility and apply for Medicaid coverage. The following resources provide in-person and over-the-phone application assistance, as well as comprehensive information on what services Medicaid covers. This table also includes resources that provide advocacy for seniors in instances of denied charges or canceled policies.
|The SoonerCare Helpline is staffed with live agents who provide free information and assistance for those seeking Medicaid coverage. The helpline can also help seniors resolve problems with their coverage, including denied claims for covered services.
|Oklahoma Health Care Authority
|The Oklahoma Health Care Authority administers the state’s Medicaid program. It publishes information on SoonerCare programs and benefits and features the Member Toolkit, which has details on finding health care providers, after-hours clinics and dental services. It also lists community resources for Medicaid beneficiaries.
|American Council on Aging
|To arrange to speak with a Medicaid Planning Professional, seniors can submit an online contact form.
|The American Council on Aging publishes information on SoonerCare’s eligibility guidelines and waivers that pay for skilled nursing services in the community. The council also lists programs that can help seniors qualify for Medicaid coverage if their income or assets exceed the program’s limits.
|Social Security Administration
|For assistance, seniors can visit their nearest field office or call the toll-free number at (800) 772-1213.
|The Social Security Administration issues documents that may be necessary to apply for Medicaid coverage. Through their local office, seniors can obtain replacement Social Security cards, benefits verification letters and proof of income. The SSA also publishes information on Medicaid and the coverage it provides for Medicare beneficiaries.
Can You Use Medicare to Pay for Nursing Home Care in Oklahoma?
Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet a number of specific requirements. This benefit is available to beneficiaries who have been hospitalized for at least three days, excluding the date of discharge, so it's most valuable for those who are recovering from an injury, illness, or surgery.
Once seniors meet the hospitalization requirement, Medicare will pay for up to 100 days of skilled nursing per benefit period. The first 20 days are covered in full. Starting on day 21, beneficiaries must pay a daily coinsurance rate. After day 100, seniors are responsible for the entire cost.
What Does Medicare Cover?
Medicare covers a number of specific services, including:
- A semiprivate room
- Skilled nursing
- Physical therapy
- Occupational therapy
- Speech therapy
- Audiologist care
- Medical supplies
- Medical social services
- Nutritional counseling
- Ambulance transportation
What Isn't Covered by Medicare?
Medicare does not cover long-term custodial care that addresses seniors' day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.
For more information about Medicare and when it covers Nursing Home Care, read our Guide to Nursing Homes.
Medicare Support & Resources in Oklahoma
Medicare is complex, and understanding its benefits and coverage is critical for making informed decisions regarding paying for nursing home care. The following resources help older adults sign up for coverage, learn how to avoid late enrollment fees and determine whether a Medicare Advantage or Medigap plan is right for their needs. They can also provide advocacy and representation for seniors in cases regarding denied coverage.
|Legal Aid Services of Oklahoma, Inc.
|Legal Aid Services of Oklahoma, Inc., specializes in helping older adults apply for Medicare and other public benefits that may help them pay for nursing home care. Its legal experts can also assist seniors with navigating coverage-related issues, such as denied claims.
|Oklahoma Senior Health Insurance Counseling Program
|SHIP is a free program that provides in-person and over-the-phone assistance to Medicare-eligible individuals. It has advisors who can answer questions about Medicare’s coverage for nursing home care, as well as available Medigap and Medicare Advantage plans.
|Oklahoma Insurance Department
|(800) 522-0071, or to file a complaint, seniors can fill out and submit an online or paper complaint form.
|The Oklahoma Insurance Department regulates all insurance policies sold in the state, including Medicare plans. Seniors can contact OID to learn more about private Medicare plans available in their area and to file a complaint regarding denied coverage or canceled policies.
|Area Agencies on Aging
|To obtain services through their local AAA, seniors can call (800) 211-2116 or the OKDHS Aging Services Division at (405) 521-2281.
|Oklahoma is home to 11 Area Agencies on Aging, each of which has designated service areas. Through these agencies, those aged 60 and over can speak with health insurance options counselors who answer questions about Medicare’s benefits, cost-sharing responsibilities and enrollment windows.
Other Financial Assistance Options for Nursing Home Care in Oklahoma
While Medicaid and Medicare are two of the most common programs used to pay for Nursing Home Care, there are other financial assistance options available, depending on your unique situation.
|How to Apply
|How It Works
|Aid and Attendance
|Learn more and apply online at va.gov.
|Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for skilled nursing care.
|Learn more about your options and how to apply at ftc.gov.
|If you own a home, you may be able to use a reverse mortgage to help pay for nursing care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. This type of funding can be especially useful for married couples when only one partner needs nursing care, as the other residents of the home may continue living there. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.
|Long-Term Care (LTC) Insurance
|Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.
|Seniors who already have long-term care insurance may be covered for skilled nursing care. Most policies cover at least a portion of the cost of nursing home care, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not be eligible to sign up for a LTC insurance policy.
Nursing Home Laws and Regulations in Oklahoma
|Nursing homes in Oklahoma are required to apply for licensing through the Department of Health at least 30 days before they begin operations, and then every 12 months they're in operation. Prior to applying, facilities must ensure full compliance with state and federal guidelines.
|Nursing homes must have qualified staff members awake and on-site 24 hours per day. All facilities are required to have an administrator, a licensed medical director, licensed nurses, consulting registered nurses, certified medication aides and certified nurse aides. Facilities must also designate an activities director.
|Staff Training Requirements
|All staff members must complete orientation and training specific to their role before working without supervision. Regardless of their role, all staff members must complete training on residents' rights and what to do in the event of a fire.
|Before admitting a new resident, nursing homes must evaluate their social, medical and nursing needs. Facilities are only permitted to admit residents if they can fully meet the residents' needs.
|Care Planning Requirements
|Nursing homes are required to provide every resident with a personalized care plan that outlines their current health status and care needs. These assessments must be completed within 14 days of admitting a new resident and updated on a quarterly basis.
|Dietary and Nutritional Services Requirements
|Nursing homes are required to serve at least three meals daily, with at least four hours between each meal. They must accommodate physician-ordered diets and provide alternative meals when a resident refuses served menu items, and they must promptly address nutritional risks.
|Specialized Rehabilitative Services
|In Oklahoma, nursing homes may either provide rehabilitative services directly or contract with outside agencies to provide this type of care. Depending on their needs, residents should have access to physical, speech and occupational therapy; audiology; mental health care and nutritional counseling.
|Medication and Pharmaceutical Services
|Nursing facilities must have written policies for acquiring, storing, distributing and controlling prescription medications. There must be a system in place for accounting for controlled medications prescribed to residents, and facilities must keep records of each resident's medication regimen.
|Facilities must have activities directors responsible for planning activities to meet residents' cognitive, physical and social needs. There must be at least two activities planned on weekdays and at least one activity per weekend day. Facilities must make accommodations for those with physical or mental impairments.
|Infection Control Requirements
|Nursing homes must test prospective residents and employees for tuberculosis within 30 days prior to exposure to residents, and they must conduct annual tuberculosis risk assessments. Facilities must also develop procedures for food handling, controlling air-borne viruses, hand-washing and isolating those with communicable illnesses.
|Qualified seniors may pay for nursing home services through the state's Medicaid program. To qualify for services, seniors must meet criteria related to their age, financial status and functional needs.
Senior Homes has an extensive directory of senior living options, with care and living providers across the United States.
Nursing Homes Articles and Resources
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