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  3. Nursing Home Costs

Nursing home costs in 2021

Average costs by state and room type

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Nursing homes are senior living facilities that offer a high level of care and security. They provide 24/7 monitoring and support, including trained staff, emergency response systems and room and board. Common support services include personal care (like bathing and feeding) and specialized medical care. Nursing homes may also offer entertainment and social activities like live music, movie nights and field trips. Because of all these services and amenities, nursing home stays also come at a high cost.

  • Nursing home care costs about $7,500 to $9,000 per month on average.
  • That’s around double the cost of at-home care or assisted living.
  • There are many ways to pay, including government programs and different types of insurance.

How much does a nursing home cost?

Nursing home costs generally depend on the length of the resident’s stay, the services provided and the type of facility in question. The table below outlines the average costs of nursing home stays for older Americans, according to Genworth’s 2020 Cost of Care Survey.

Rate scheduleSemiprivate roomPrivate room
Per day$255$290
Per month$7,756$8,821
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Average nursing home costs by state

Not all states have the same costs for nursing home care. While the national median cost for nursing home care is between $7,500 and $9,000 per month, your cost will depend on whether or not you want a private room and where you’re looking.

  • Private rooms are about $1,000 per month more expensive than shared rooms.
  • Average monthly nursing home costs range from about $5,000 a month in Texas to more than $37,000 a month in Alaska.

This chart, put together using Genworth’s 2020 Cost of Care Survey, outlines the average costs by state for semiprivate rooms, sorted from highest to lowest.

StateAverage daily costAverage monthly costAverage yearly cost
New York$405$12,319$147,825
North Dakota$400$12,167$146,000
West Virginia$374$11,376$136,510
New Jersey$370$11,254$135,050
New Hampshire$350$10,646$127,363
Rhode Island$285$8,669$104,025
New Mexico$244$7,406$88,878
North Carolina$240$7,300$87,600
South Carolina$240$7,298$87,578
South Dakota$231$7,011$84,113
Average daily cost$1,230$425$415$406$405$400$395$374$370$363$350$335$333$330$322$317$315$305$304$295$286$285$285$285$280$272$252$252$244$241$240$240$237$235$235$233$232$231$225$221$220$216$215$210$205$195$182$175$167$165
Average monthly cost$37,413$12,927$12,623$12,349$12,319$12,167$12,015$11,376$11,254$11,026$10,646$10,190$10,114$10,038$9,779$9,642$9,581$9,262$9,247$8,973$8,684$8,669$8,669$8,669$8,517$8,258$7,665$7,665$7,406$7,330$7,300$7,298$7,194$7,148$7,133$7,072$7,057$7,011$6,844$6,722$6,692$6,570$6,540$6,388$6,235$5,931$5,536$5,323$5,080$5,019
Average yearly cost$448,950$155,125$151,475$148,190$147,825$146,000$144,175$136,510$135,050$132,313$127,363$122,275$121,363$120,450$117,348$115,705$114,975$111,143$110,960$107,675$104,208$104,025$104,025$104,025$102,200$99,098$91,980$91,980$88,878$87,965$87,600$87,578$86,323$85,775$85,593$84,863$84,680$84,113$82,125$80,665$80,300$78,840$78,475$76,650$74,825$71,175$66,430$63,875$60,955$60,225

Cost of home care vs. nursing homes

If you’re comparing senior living options for yourself or a loved one, you have a few to choose from. Think of it this way — “nursing home” is actually somewhat of an umbrella term that can refer to rest homes and similar facilities. Meanwhile, assisted living and in-home care are both alternatives to these traditional skilled nursing facilities (SNF).

Nationwide average costs for these services range from about $24 per hour to more than $8,000 per month, depending on your payment schedule. For instance, in-home care costs vary based on how often you or your loved one needs assistance, ranging from a few hours a week to live-in care.

You should also factor in any specialized needs, like care related to Alzheimer’s disease or dementia, which can cost an additional $1,000 to $4,000 each month.

Cost considerations are an important part of elder care planning. To learn more about your different options, compare the differences between assisted living, nursing homes and home care.

Facility typeNational median cost per month
Nursing home (private room)$8,821
Nursing home (semiprivate room)$7,756
Assisted living$4,300
In-home care$4,576

How to pay for a nursing home

Nursing home stays can be expensive, but there are many different payment options for residents and their families. Most people afford nursing home care by combining a few of the options below.

Medicaid is an option to pay for nursing home care in all 50 states. However, you must meet the government’s financial eligibility requirements to qualify.

Each state has different financial and care requirements. In many areas, Medicaid is an option to pay for skilled nursing care for individuals making less than about $2,500 per month. (Some states have different names for Medicaid programs, such as Medi-Cal in California and MassHealth in Massachusetts.)

If you are eligible for Medicaid support, it should cover 100% of the cost of care in a nursing home. However, Medicaid usually won’t cover medical services outside of the facility itself. Each state also sets its own “Nursing Home Level of Care” that dictates how much care someone needs and how it affects their Medicaid eligibility. In most cases, the more help they need, the more likely they’ll be eligible for Medicaid coverage.

Payments can be complicated with Medicaid because there are deductions and income limits to keep in mind, so many people choose to work with a Medicaid planner to figure out their options.

Medicare Part A can cover a portion of short-term inpatient stays, like intensive rehabilitation, but its coverage is otherwise fairly limited. For example, nursing home coverage is not included if you only need custodial care.

That said, Medicare can still help cover other costs while you or a loved one is in a nursing home, such as medical services, prescription medications and hospital stays. If you have a Medicare Advantage Plan (Part C) or other government health plan (like an HMO or PPO), check with your provider to find out if there’s any available coverage. Medicare Advantage nursing home coverage is not included in Original Medicare.

VA benefits
If you’re a veteran, benefits from the Department of Veterans Affairs may help cover the cost of a stay at different senior living options, including:
  • Nursing homes
  • Assisted living communities
  • In-home care
  • Adult day centers
  • Private home care

Using your VA benefits is a good idea because they’re very comprehensive — coverage for long-term care (LTC) services include nursing and medical care, physical therapy and help with daily tasks. The VA also offers quite a few services dedicated to helping veterans figure out their options and coverage levels.

Prospective nursing home residents need to be signed up for VA health care to be eligible for coverage. VA benefits can be used to stay in non-VA nursing homes, VA nursing homes and state veterans homes.

Long-term care insurance
Long-term care insurance is designed to cover expenses related to custodial care, including nursing homes. It provides an additional level of medical coverage that can help pay for an extended stay in a nursing home.

However, you have to buy this type of coverage before you actually need it. If you wait until you require a nursing home, you will either not qualify for coverage or be charged an excessive amount. Many people choose to buy this type of coverage in their 50s. Because of its expense, long-term care insurance is usually better for people who make a good amount of money. For more information, compare long-term care insurance providers.

Life insurance
Some life insurance policies allow you to access your funds while you’re still alive in order to pay for nursing home coverage through “accelerated death benefits.” This may be a good option if you don’t qualify for any other form of assistance.

However, this is a pretty limited solution for most people because it’s hard to qualify for and it may not offer much of a return. Plus, it limits how much your family receives when you pass away.

Reverse mortgage
A reverse mortgage is a type of loan that's available to homeowners aged 62 or older. Reverse mortgages let you take out loans against the value of your home, but you need to have a good amount of equity to use this option. Borrowers can generally use the funds provided to pay for anything they want, including a nursing home stay.

Be aware that a reverse mortgage has to be paid back once the homeowner dies, moves away for at least one year or sells the home. While the loan should be covered by the sale of the home, it takes away from any planned inheritance. For more information, compare reverse mortgage lenders.

Savings and private pay
You can also pay for a nursing home stay out of pocket without any type of assistance, but the expense is significant. If you have enough money, you can even pay in advance without having to worry about monthly costs.

Cashing out savings or retirement accounts helps cover nursing home costs. Just make sure you understand all of your options and what it means for your bottom line.

Before cashing out a retirement plan, check the tax implications to make sure it’s a viable option. For example, if you cash out your 401(k) before it’s matured, you will have to pay both a penalty and taxes on the account.

Bottom line: Is a nursing home the best choice?

Paying for nursing home care can be expensive and complicated. If you or your loved one qualifies for less intensive care, like an assisted living facility, that’s generally a better option. However, a nursing home is the only safe, logical option for many people. This is why it’s important to plan ahead and figure out a sustainable payment solution that benefits not only the resident requiring care but also their family.

For more info, read about the signs it’s time for senior assisted living. For fun games and memory care projects, check out our guide on activities for people with dementia.

Article sources
ConsumerAffairs writers primarily rely on government data, industry experts and original research from other reputable publications to inform their work. To learn more about the content on our site, visit our FAQ page.
  1. Genworth, “Cost of Care Survey: Ranked State Data Tables.” Accessed May 26, 2021.
  2. Centers for Medicare & Medicaid Services, “Medicare Part A coverage—nursing home care.” Accessed May 26, 2021.
  3. Centers for Medicare & Medicaid Services, “Nursing home care.” Accessed May 26, 2021.
  4. Centers for Medicare & Medicaid Services, “Nursing Facilities.” Accessed May 26, 2021.
  5. U.S. Department of Veterans Affairs, “VA nursing homes, assisted living, and home health care.” Accessed May 26, 2021.
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