Wondering what you can expect to spend on nursing home care? That's a complex question, as there are several factors that can impact the cost of a nursing home stay, including location, duration of stay, and care services required, among others. According to a 2021 Cost of Care Survey by Genworth, a private room in a nursing home costs $297 per day, or $9,034 per month. Semiprivate rooms are more affordable, with a median cost of $260 per day, or $7,908 per month.1 Regardless of the cost of nursing or in-home care, there are many ways families can make this necessary care more affordable. Let's get into what you can expect to spend and how most families go about paying for nursing, assisted living, or in-home care.
What Is a Nursing Home?
Before jumping into the costs of nursing homes, let’s first answer the question: What is a nursing home? Nursing homes provide nursing care for seniors around-the-clock, with 24-hour medical care available. This type of care is also referred to as skilled-nursing care and convalescent care. While seniors typically transition into a nursing home permanently, some homes also provide short stays for those in need of rehabilitation after an injury, illness, or surgery that may require skilled nurses and/or therapists.
Whether you need these services on a part-time or full-time basis, nursing home care comes at a premium price compared to other health care options. However, it also provides older adults with all of the valuable services they need concerning medical care, socialization, rehabilitation, and housekeeping services in environments designed to offer the comforts of home.
National Median Costs of Nursing Home Care
The long-term cost of nursing home care will depend on many factors, such as your location, the provider you choose, how long you plan to stay, and whether any type of special services are needed. In some cases, facilities' rates are all-inclusive, while others may charge additional fees for certain services, including physical therapy, speech therapy, and memory care.
Rates have climbed considerably in recent years, a trend that looks to accelerate over the next several years. In fact, if projections hold, the monthly cost of a semiprivate room in a nursing home will be over $10,000 by 2030, an increase of about one-third. For private rooms, expected annual costs already have passed the six-figure mark. Here's a look at past, present, and projected annual costs side by side:
The Cost of Nursing Home Care By State
In addition to costs that vary by the type of room, nursing home care is much more affordable in some states than others. Here's a look at the median monthly costs for nursing home care in semiprivate and private rooms around the country.
|District of Columbia||$10,494||$10,494|
In every state, the cost of both types of rooms in nursing homes rose between 2015 and 2021, and for some states, the increases have been dramatic. Minnesota, which already had a median cost on the higher side of the national average, also saw the largest increase both for semiprivate and private rooms. Genworth provides a look at each state's compound annual growth rate from 2015 to 2021 for the cost of semiprivate and private rooms in nursing homes. In other words, this is an estimate of how much each state's nursing home prices were rising each year for that period2:
|District of Columbia||1%||-2%|
Watch the video below with Jeff Hoyt, our editor-in-chief, for more information on the cost of nursing homes.
Cost of Nursing Homes vs. Assisted Living
Assisted living costs have continued to rise as well, though assisted living communities are much more affordable than nursing homes. The median cost of assisted living facilities is $148 per day, which equates to $4,500 per month, or $54,000 per year. While this represents an increase over the past few years, assisted living is far more affordable than semiprivate or private rooms in nursing homes. It's important to note that these figures don't take into account specialized care, such as memory care, or considerations for disabilities.
Cost of Nursing Homes vs. In-Home Care
Options for in-home care providers include homemaking service providers, which can help older people with activities of daily living and household tasks like cleaning, cooking, and running errands. Home health aides are another option; aides are trained to provide more extensive care, while also serving as companions. In some cases, individuals and families may choose skilled in-home nursing care, which is typically provided by a registered nurse or certified therapist who can administer medication and monitor their vitals regularly.
However, the more intense the medical care required, the more expensive it will be. For example, typical homemaker services cost about $163 per day, home health aides cost $169 per day, and for a 10-hour work day, a typical registered nurse would make $387. Though, in most cases, these types of services are not needed all day, or even every day.
Are Nursing Home Costs Tax Deductible?
In most cases, out-of-pocket nursing home costs are generally tax deductible under itemized medical expenses. If you, your parent, spouse or another legitimate dependent is in nursing care primarily for medical care, expenses related to medical care, lodging and meals are deductible. However, seniors in nursing homes for personal reasons, rather than medical, will only be allowed to deduct costs associated with actual medical care, not including meals and boarding costs.
Pro Tip: Visit our guide to health care tax deductions to learn more about ways to deduct medical expenses.
How to Pay for Nursing Home Costs
Nursing care expenses can be paid for privately, but they can also be offset in a number of ways, including through health insurance, life insurance, long-term insurance policies, savings, reverse mortgages, and local or regional agency assistance. We'll take a closer look at all of your various options below.
Did You Know: One way to cut down on nursing home costs is to age in place with a medical alert system. To find out more, see our best medical alert system picks page to help you make a better and more informed decision.
Medicare Coverage for Nursing Home Costs
Medicare will only cover skilled nursing care expenses in very specific situations and is not designed to pay for nursing home or custodial care costs long term. One such situation is when a senior has been hospitalized and released, but still requires a bit of specialized care. Medicare will help pay for short-terms stays in nursing homes if they:
- Were admitted to the hospital for a minimum of three days as an inpatient.
- Have been admitted to a Medicare-certified facility within 30 days of the hospital stay.
- Need skilled care like physical therapy, speech therapy, and other types of rehabilitation.
Those who meet all of these conditions under original Medicare will qualify for assistance as follows.
- Up to 20 days of nursing care is 100 percent by Medicare.
- After day 21 and up to day 100, patients will pay a copay that is $194.50 per day.
- After 100 days, all Medicare coverage ends, and all payments are the patient's responsibility.
Medicaid Coverage for Nursing Home Care
Medicaid is an excellent option for low-income older adults. This coverage assists individuals with many types of medical care, including doctor's visits, hospital stays, and long-term care services such as those received in a skilled nursing facility. Often, this program covers 100 percent of these costs, but there may be copayments for certain beneficiaries. For those who qualify for Medicaid, this is the best choice for nursing care coverage.
Veterans Benefits for Skilled Nursing Care
Veterans with service-related injuries and disabilities can receive full coverage from the Department of Veterans Affairs for long-term care services at specified locations or through certain providers approved by the department. Those without service-related disabilities may also qualify for VA benefits if they meet certain qualifications. However, depending on the veteran's household income, there may be copayments required.
It's common to pay for nursing home care privately at first, then move to Medicare or another funding source later. The main benefit of paying privately is flexibility. With Medicare and other taxpayer-subsidized programs, seniors have fewer choices because nursing homes can limit the number of publicly-funded enrollees. So, it's important to know the accepted payment setups before deciding to move into a given facility. Sources of private funds could be savings or money from cashing out IRAs and other investments. People also borrow from life insurance policies, sell their homes, and get reverse mortgages, as explained below.
When planning ahead for long-term care, a person with savings can buy an annuity. The underwriter receives a lump sum of cash and then issues regular monthly payments to the individual after retirement. The individual can use these payments for a nursing home, a car payment, or anything else. The main advantage of having an annuity is financial discipline. The annuity forces savings to be stretched out over time and regular payments are guaranteed. Additional advantages of annuities are listed below.
- Savings put into an annuity are shielded from consideration on applications for government aid.
- A person who lives a long life could draw more from the account than they put into it.
The main disadvantage of annuities is that value is lost in commission and annual charges. Also, penalties are charged if funds are withdrawn early.
A whole life insurance policy (but not a term life insurance policy) can be tapped for long-term care payments. However, this, of course, reduces the financial benefit for heirs. Three approaches are:
- Surrendering a policy
- Selling a policy
- Converting life insurance to “life assurance”
First, a whole life insurance policy can be surrendered to the provider. This means that the agency buys the policy back from the policyholder. However, usually, they’ll pay just 50 to 75 percent of the face value. Similar terms are offered for the second approach: selling the policy to a “life settlements” company. Again, the typical offer is about 50 to 75 percent of the policy’s value. The life settlements company continues to pay the policy’s premiums until the policyholder passes away. The company then receives the financial payout. Life insurance conversion to “life assurance” is a third option designed specifically to pay for long-term senior care. Like life insurance, life assurance includes a savings guarantee plus an investment portfolio. Life insurance conversion accounts might give less for senior care but preserve a death benefit (inheritance). The advantages and disadvantages vary from person to person. Meeting with a financial advisor could be worthwhile.
Long-Term Care Insurance
When a person is planning well in advance to pay for senior care, buying long-term care insurance can be a smart move. It offers more freedom of choice compared to using Medicare and other public programs for nursing home payment. People buy policies that pay anywhere from $2,000 to $10,000 per month. To guard against dramatic market changes, inflation protection can be included with monthly premium payments. It's important to know that long-term care insurance policies vary in terms of when they'll pay benefits. Generally, to receive payments for nursing home care or assisted living, a person must need help in at least two activities of daily living. A doctor's statement documenting this need is required as part of the claim.
Renting Out a Property
When a senior leaves their old living space empty, renting it out with careful management could be a valuable income source. Turning a home into a rental might become a permanent source of income for the family or just a temporary source of income until the home is sold. Ideally, any rental arrangement will be made when the homeowner is still a competent decision-maker. For a loved one to take over, that person will need legal guardianship or power of attorney over the homeowner.
Bridge loans can cover people’s living expenses as they await a property sale, pension payout, or another virtually guaranteed source of income. A bridge loan is a short-term loan, but often the first payment isn’t due until 90 days after signing. Typical loan lengths vary from three months to two years.
Reverse Mortgage Loan
While a bridge loan can help during a pending home sale, a reverse mortgage loan helps keep the home until the second spouse moves out or passes away. The loaned money can help pay for nursing home care. The advantage of using a reverse mortgage loan for nursing home payment is that it covers two housing costs at once. However, when the second person no longer lives in the home, loan payments become due. Heirs often opt to sell the property rather than maintain payments.
How Can I Find Nursing Homes Near Me?
You can explore an array of nursing homes and skilled care providers with ease by using our comprehensive nursing home directory. Our database allows you to search by ZIP code or state and then lets you narrow down your search by specific needs or preferences.