The Average Nursing Home Cost per Month for Each State

Running a nursing home isn’t just about providing excellent care — it’s also about managing costs efficiently. With nursing home expenses rising each year, administrators need a clear understanding of what drives these costs, how they vary by state, and what payment options are available.

Whether you're looking to set competitive rates, optimize reimbursements, or help families navigate financial planning, staying informed about the latest average nursing home costs is essential.

In this article, we’ll cover:

• Factors influencing nursing home costs

• State-by-state cost of nursing home care

• Average nursing home cost per month

• Payment options and financial assistance

State-by-state nursing home cost variations

The cost of nursing home care depends on several factors, including location, facility type, and level of care provided. In 2024, the monthly median cost for a semi-private room in a nursing home was $9,277, while a private room averaged  $10,646.

However, these costs vary widely across states. Nursing homes in the South and Midwest tend to be more affordable, while Northeastern and West Coast states have some of the highest rates due to factors like labor costs, demand, and state regulations.

In some states, monthly costs exceed $14,000 for a private room, making affordability a growing concern for both nursing home operators and families.

Rising expenses — driven by staffing shortages, inflation, and regulatory requirements — continue to put financial pressure on nursing homes, making cost management and reimbursement strategies more important than ever.

Understanding these regional price differences can help nursing home administrators plan budgets, adjust rates competitively, and explore financial assistance options for residents.

Do nursing home costs cover medical care?

Yes, but the extent of coverage depends on the facility and the specific needs of the resident. Nursing home fees typically cover:

• Room and board: This includes accommodations, meals, housekeeping, and basic utilities.
  
  

• Nursing care: Routine monitoring, assistance with daily activities, and medication management are usually included.
  
  

• Basic medical services: Many facilities provide vital sign checks, medication administration, and care coordination as part of their standard services.

However, not all medical expenses are included in the base rate. Specialized services such as rehabilitation therapy, complex wound care, dialysis, and high-cost medications may be billed separately. Facilities must carefully track these additional costs to ensure proper reimbursement and financial stability.

Factors that influence cost of nursing home care

Several key factors determine how much a nursing home charges for care. While some of these are fixed, others can be adjusted to help facilities manage costs more effectively.

Geographic location

Where a facility is located has one of the biggest impacts on cost. States with a higher cost of living — such as California, New York, and Massachusetts — typically have higher nursing home rates. In contrast, states like Texas, Missouri, and Oklahoma tend to have lower costs.

Even within the same state, urban nursing homes often charge more than rural ones due to higher operating expenses.

Room type and accommodations

The choice between a private room and a semi-private room significantly affects cost. Private rooms, which offer more privacy and space, cost more. Some facilities also offer shared rooms, which provide an even lower-cost option. Additionally, high-end facilities with luxury accommodations, private dining areas, or premium amenities will charge more than standard nursing homes.

Level of care needed

Not all residents require the same level of medical attention. Facilities that provide specialized care, such as memory care for dementia patients, post-surgical rehabilitation, or intensive nursing support, have higher costs due to increased staffing needs and specialized medical equipment.

The more complex a resident’s care needs, the higher the overall cost of their stay.

Facility amenities and services

Basic nursing home fees cover essential services, but many facilities offer additional amenities that drive up costs. These may include:

• Private dining options

• On-site therapy and rehabilitation programs

• Personalized wellness and recreational activities

• High-end furnishings and accommodations

• Advanced security features for residents with cognitive impairments

While these services can improve a facility’s appeal and quality of care, they also increase overhead costs, which are often passed on to residents.

Length of stay

The length of a resident’s stay also plays a role in pricing. Short-term stays, typically covered by Medicare for up to 100 days, follow a different reimbursement structure than long-term stays, which are usually paid for through Medicaid, private insurance, or out-of-pocket funds. Facilities must carefully manage transitions from Medicare to other payment sources to avoid gaps in reimbursement.

Insurance coverage and benefits

Not all residents pay out of pocket for nursing home care. Medicaid, long-term care insurance, and veterans’ benefits can significantly reduce costs, but coverage varies widely based on eligibility. Some residents may also use private pay or a combination of funding sources.

Facilities need efficient billing systems to ensure they maximize reimbursements and minimize financial risk.

By understanding these cost factors, nursing home administrators can set competitive pricing, optimize operational efficiency, and ensure financial sustainability while maintaining high-quality care for residents.

States with the lowest cost of nursing home care

Operating in a lower-cost state can provide financial flexibility, but it also means balancing competitive pricing with high-quality care. Facilities in these regions may need to optimize efficiency and explore alternative revenue streams to maintain profitability.

Here's a breakdown of states with lowest cost of nursing home rooms:

| State       | Semi-private room (monthly)                                           | Private room (monthly)                       |
|-------------|-----------------------------------------------------------------------|----------------------------------------------|
| Texas       | $5,323                                                                | $6,692                                       |
| Missouri    | $5,931                                                                | $6,540                                       |
| Oklahoma    | $5,931                                                                | $6,844                                       |
| Louisiana   | $6,905                                                                | $7,483                                       |
| Arkansas    | $6,996                                                                | $7,908                                       |
| Performance | Slower. It relies on screen interactions, which take time to execute. | Faster. It enables real-time data exchange.  |
| Best for    | Legacy systems without API access, UI-heavy tasks.                    | Real-time automation, secure data transfers

Nursing home costs by state

For nursing home administrators, pricing directly impacts occupancy rates, reimbursement strategies, and financial sustainability. Understanding how costs vary across states can help facilities adjust their approach to pricing, staffing, and financial planning.

Below is a breakdown of the median monthly costs for both semi-private and private rooms in each state:

|         State        | Semi-private room (monthly) | Private room (monthly) |
|:--------------------:|:---------------------------:|:----------------------:|
| USA National         | $8,669                      | $9,733                 |
| Alabama              | $7,604                      | $8,060                 |
| Alaska               | $18,706                     | $34,584                |
| Arizona              | $7,604                      | $9,429                 |
| Arkansas             | $6,996                      | $7,908                 |
| California           | $11,406                     | $13,231                |
| Colorado             | $9,475                      | $10,433                |
| Connecticut          | $15,056                     | $16,577                |
| Delaware             | $11,133                     | $11,893                |
| District of Columbia | $14,068                     | $14,448                |
| Florida              | $9,885                      | $11,406                |
| Georgia              | $7,939                      | $8,365                 |
| Hawaii               | $12,167                     | $12,197                |
| Idaho                | $10,494                     | $11,072                |
| Illinois             | $7,452                      | $8,669                 |
| Indiana              | $7,878                      | $9,703                 |
| Iowa                 | $8,365                      | $8,973                 |
| Kansas               | $7,483                      | $8,000                 |
| Kentucky             | $7,771                      | $8,912                 |
| Louisiana            | $6,905                      | $7,483                 |
| Maine                | $12,197                     | $13,155                |
| Maryland             | $11,513                     | $12,836                |
| Massachusetts        | $13,688                     | $14,600                |
| Michigan             | $10,570                     | $11,467                |
| Minnesota            | $10,281                     | $12,805                |
| Mississippi          | $8,517                      | $8,760                 |
| Missouri             | $5,931                      | $6,540                 |
| Montana              | $8,182                      | $8,456                 |
| Nebraska             | $7,604                      | $8,091                 |
| Nevada               | $10,205                     | $12,395                |
| New Hampshire        | $11,984                     | $12,927                |
| New Jersey           | $11,619                     | $12,699                |
| New Mexico           | $8,760                      | $10,007                |
| New York             | $13,976                     | $14,813                |
| North Carolina       | $8,365                      | $9,125                 |
| North Dakota         | $7,908                      | $8,593                 |
| Ohio                 | $8,365                      | $9,520                 |
| Oklahoma             | $5,931                      | $6,844                 |
| Oregon               | $14,585                     | $15,208                |
| Pennsylvania         | $10,768                     | $11,558                |
| Rhode Island         | $12,167                     | $13,535                |
| South Carolina       | $8,669                      | $9,368                 |
| South Dakota         | $8,578                      | $8,912                 |
| Tennessee            | $8,654                      | $9,277                 |
| Texas                | $5,323                      | $6,692                 |
| Utah                 | $7,604                      | $10,114                |
| Vermont              | $13,231                     | $14,144                |
| Virginia             | $9,247                      | $10,190                |
| Washington           | $12,167                     | $13,688                |
| West Virginia        | $11,619                     | $11,954                |
| Wisconsin            | $10,250                     | $10,190                |
| Wyoming              | $7,604                      | $9,429

Nursing home payment options and financial assistance

Paying for nursing care is one of the biggest financial challenges for residents and their families. Most people don’t have a plan in place for long-term care expenses, leaving nursing homes to navigate multiple payment sources, reimbursement timelines, and coverage gaps.

Understanding the different funding options can help facilities guide residents through payment options while maintaining financial stability.

Personal savings

For residents who don’t qualify for Medicaid or have long-term care insurance, out-of-pocket payments are the primary method of covering nursing home costs.

Many residents use a combination of savings, retirement income, home equity, or family support to pay for care. Consider the following:

• Who this applies to: Individuals who do not have Medicaid coverage or a long-term care insurance policy, and those in higher-income brackets.
  
  

• Disadvantages: Since nursing home care costs thousands of dollars per month, residents who pay privately often deplete their savings quickly, eventually transitioning to Medicaid once their assets are spent down.

For nursing homes, private pay residents are ideal because payments are typically received directly and on time. However, administrators must be proactive in tracking financial depletion and preparing residents for Medicaid eligibility to avoid unpaid balances.

Long-term care insurance

Long-term care (LTC) insurance is designed to cover nursing home care, assisted living, in-home care, and other long-term services that standard health insurance does not pay for. Consider this option if:

• Who this applies to: Residents who purchased a long-term care insurance policy before needing skilled nursing care.
  
  

• What’s covered: Coverage varies by policy but may include room and board, medical care, therapy, and personal assistance. Some policies cover only a portion of the daily or monthly costs, leaving the resident responsible for the difference.

Limitations:

• Many long-term care insurance policies have elimination periods (e.g., 30 to 90 days), but some offer immediate benefits depending on the policy terms.
  
  

• Some policies require a specific level of disability before coverage kicks in.
  
  

• Coverage may be capped at a daily limit or a maximum lifetime benefit.

Verifying a resident’s LTC insurance policy details upfront is crucial to prevent billing disputes and coverage denials. Facilities should also be aware of claim processing delays and ensure families understand potential out-of-pocket costs.

Medicaid

Medicaid is the largest payer of nursing home care in the United States, covering more than 60% of long-term care residents. Unlike Medicare, Medicaid covers long-term stays in skilled nursing facilities for eligible individuals. Consider Medicaid when:

Who this applies to: Low-income individuals who meet their state’s Medicaid eligibility requirements.

What’s covered:

• Room and board

• Skilled nursing care

• Medically necessary therapies

• Medications (in some cases)

Medicaid eligibility is state-specific, and each state has different income and asset limits. 

What nursing homes need to know about Medicaid

• Reimbursement rates are lower than private pay: Medicaid typically reimburses facilities at a lower rate than private pay or Medicare.
  
  

• State-by-state variation: Each state has its own Medicaid reimbursement structure, which affects facility revenue.
  
  

• Eligibility tracking is critical: Nursing homes must closely monitor Medicaid pending cases and ensure residents maintain eligibility to avoid lapses in payment.

Veterans benefits

The U.S. Department of Veterans Affairs (VA) provides financial assistance for eligible veterans who need long-term care. While VA benefits do not cover all nursing homes, veterans may receive financial assistance for care in VA-approved nursing homes, state veterans’ homes, or contract facilities.

Who this applies to: Veterans and surviving spouses who meet eligibility criteria.

What’s covered:

• Full or partial coverage of nursing home costs is available only for eligible veterans in VA Community Living Centers, State Veterans Homes, or VA-contracted nursing homes. Coverage depends on factors like service-connected disability status, income, and availability of services.
  
  

• The VA Aid & Attendance benefit provides additional monthly financial assistance for qualifying veterans and surviving spouses, which can help cover long-term care expenses, including nursing home costs, but it does not directly pay for nursing home care.

For nursing homes, working with VA-approved providers or helping residents apply for VA benefits can open up an additional reimbursement stream. However, eligibility requirements and bureaucratic delays can slow down payment, making it essential to confirm benefits before admission.

Does Medicare cover nursing home costs?

Medicare does not cover long-term nursing home stays but does pay for short-term skilled nursing care under specific conditions.

Who this applies to: Medicare beneficiaries who need short-term rehabilitation or skilled nursing care following a hospital stay.

Coverage limitations:

• Medicare only covers up to 100 days of skilled nursing care per benefit period.
  
  

• The first 20 days are fully covered, but after that, the patient must pay a daily copay (which increases annually).
  
  

• Coverage is only for skilled care, meaning custodial care (assistance with daily activities like bathing and dressing) is not covered.

Medicare can be a strong revenue source, but strict compliance with documentation, care plans, and medical necessity requirements is essential to receive full reimbursement. Facilities should also have a transition plan for Medicare patients who reach the end of their 100-day coverage to prevent gaps in care and payment.

Helping residents and families navigate payment options

Nursing homes must balance financial sustainability with helping families understand their payment options. Proactive communication, eligibility tracking, and billing efficiency are key to ensuring facilities receive timely payments while easing the financial burden on residents.

By optimizing private pay, Medicaid, insurance claims, and VA benefits, facilities can maintain strong financial health while providing high-quality care.

The benefits of a nursing home vs. other care options

Choosing the right care setting for an aging loved one is a major decision. Nursing homes offer distinct advantages over other care options such as assisted living, home care, and skilled nursing facilities. For individuals who need round-the-clock supervision, structured care, and access to medical support, a nursing home is often the best choice.

Key benefits of a nursing home:

• Nursing homes provide 24/7 supervision and support. Unlike home care, which relies on scheduled visits, nursing homes have staff available at all times to ensure residents’ safety.
  
  

• Residents receive comprehensive daily care. Nursing homes assist with bathing, dressing, mobility, meals, and other daily activities to help residents maintain their quality of life.
  
  

• Medical oversight is available when needed. While nursing homes do not provide intensive medical care like a skilled nursing facility, they still offer medication management, wound care, and routine health monitoring.
  
  

• Social engagement and activities improve residents’ well-being. Many nursing homes offer group activities, entertainment, and community events to prevent isolation and encourage interaction.
  
  

• Nursing homes can be more cost-effective than round-the-clock home care. Full-time in-home care can exceed $15,000 per month, while nursing homes provide structured, predictable costs that include room and board.

For families navigating long-term care decisions, nursing homes provide a safe, supportive environment with continuous care and supervision.

What nursing home services typically charge extra?

Understanding what is included in the base nursing home rate versus what incurs additional fees is important for both administrators and families. While room, board, and basic care services are typically part of the monthly cost, many facilities charge extra for specialized services.

Common services that may have additional costs:

• Physical, occupational, and speech therapy are often billed separately. Therapy services for mobility, rehabilitation, or speech impairments may require specialized staff that work extra hours on extended Baylor shifts, plus extra equipment, which all increases costs.
  
  

• Specialized medical services are typically not included in base rates. Treatments such as dialysis, wound care, IV therapy, or injections often involve additional charges.
  
  

• Medication management beyond standard prescriptions may require extra fees. While basic medication administration is covered, specialty drugs, injections, or customized treatment plans may cost more.
  
  

• Personalized or private dining options may be available at an additional cost. Some facilities offer upgraded meal plans, in-room dining, or specific dietary accommodations for an extra charge.
  
  

• Personal care and grooming services are often not included. Haircuts, manicures, pedicures, and other non-medical personal care services may be available for a fee.
  
  

• Transportation services for non-emergency medical visits may come with additional charges. Nursing homes that offer transportation for outings or personal appointments often charge separately for these services.
  
  

• Memory care services for residents with dementia may require extra payment. Specialized dementia care, secured wings, and cognitive therapy programs may come with additional costs due to the higher level of supervision required.

Why this matters for nursing home administrators:

For nursing home administrators, clear and accurate pricing structures are essential to maintaining financial stability and avoiding disputes with families.

Without well-defined costs, misunderstandings can arise, leading to frustration over unexpected fees and potential payment delays. Ensuring proper billing practices helps facilities receive full reimbursement for the services they provide, preventing revenue loss and supporting long-term financial sustainability.

At the same time, transparency in pricing builds trust with residents and their families, allowing them to make informed decisions about care without worrying about hidden costs.

With rising operational expenses and evolving reimbursement challenges, nursing homes must stay proactive in tracking which services are covered under standard rates and which require additional charges.

By maintaining clear communication and accurate billing, administrators can protect both their bottom line and their relationships with residents.

How to improve occupancy rates in a nursing home

Maintaining high occupancy rates is critical for a nursing home’s financial health, yet many facilities struggle with inconsistent referrals, long admission processing times, and competition from other care options.

A well-planned strategy can help attract more residents, optimize revenue, and improve overall facility stability.

Key tips to increase occupancy rates:

Tip #1

Strengthen relationships with case managers and referral sources. Hospital discharge planners, social workers, and home health agencies are key sources of referrals. Maintaining regular communication and demonstrating fast, reliable admissions decisions can increase your facility’s preferred referral status.

Tip #2

Improve your online presence and marketing efforts. Families often research nursing homes online before reaching out. An up-to-date website, positive online reviews, and a clear explanation of services can improve visibility and credibility.

Tip #3

Offer flexible payment options to appeal to more residents. Many families struggle to navigate the cost of long-term care. Being upfront about costs and assisting with Medicaid applications, insurance coordination, and private pay options can remove financial barriers to admission.

Tip #4
Focus on resident satisfaction and word-of-mouth referrals. Happy residents and their families are some of the best advocates for your facility. Providing excellent care, engaging activities, and responsive communication can lead to positive reviews and direct referrals from current residents’ families.

Now that we’ve covered all the cost details, let’s look at how to optimize them for your facility: 

3 ways that ExaCare improves nursing home cost management and efficiency

Managing costs in a nursing home isn’t just about cutting expenses — it’s about ensuring every part of the admissions, reimbursement, and operational process runs efficiently.

Delayed approvals, billing errors, and mismanaged resources can eat into revenue, making it harder to maintain high-quality care. ExaCare helps nursing homes streamline admission operations, optimize reimbursement, and reduce administrative burdens through AI-powered automation.

Here’s how it makes a difference.

1. Optimizing reimbursement tracking

Nursing homes lose revenue when reimbursements are delayed, denied, or miscalculated. ExaCare helps facilities estimate payments.

• AI-powered screening identifies high-cost medications and reimbursement risks upfront so facilities can make informed decisions before admission.
  
  

• The platform helps reduce claim rejections and missed charges.
  
  

• Administrators can track remaining coverage days and the financial responsibility for each resident.

2. Reducing delays in admissions and hospital referrals

Delayed admissions cost nursing homes money. Hospitals expect quick responses, and slow decision-making means losing referrals. ExaCare accelerates the admissions process by centralizing all referrals into one platform and automating key decisions.

• The system scans and summarizes referral packets instantly, eliminating hours of manual review.
  
  

• AI-driven decision support helps nursing homes quickly determine clinical and financial fit, ensuring they accept the right patients.
  
  

• Direct integration with PointClickCare, and other referral platforms means nursing homes can respond faster, securing more high-value referrals.

3. Automating cost analysis and financial forecasting

Understanding where money is being spent is essential for nursing homes to stay financially stable. To help with financial planning, ExaCare provides:

• Estimated medication costs per patient
  
  

• A reimbursement estimator per patient to see average weekly costs 
  
  

• The necessary info to file your claims to Medicare 

Simplify nursing home cost efficiency with ExaCare

Rising costs, slow admissions processes, and reimbursement challenges make it difficult for nursing homes to maintain financial stability. When families and case managers inquire about placement, responding quickly and accurately is essential to keeping occupancy rates high.

For many nursing homes, manual admissions processing, scattered referral sources, and incomplete financial assessments create bottlenecks that slow decision-making. Sorting through lengthy referral packets, verifying insurance details, and determining whether a facility can meet a resident’s needs takes time — time that staff could be spending on resident care.

ExaCare streamlines this process, using AI to automate document review, centralize referrals, and provide clear financial insights.

Without the right tools, facilities risk revenue leakage, compliance issues, and missed referral opportunities. That’s where ExaCare comes in.

Here’s what we offer:

• AI-powered referral screener that reviews hospital packets in minutes, enabling quick and accurate admissions decisions
  
  

• Centralized referral management that brings all your sources into one platform
  
  

• Built-in analytics to help you track performance and optimize your referral relationships
  
  

• Automated insurance verification, expensive med alerts, and reimbursement analyses to guard your bottom line.
  
  

•  A unified communication hub to streamline decision-making with colleagues.

Now that we’re clear about the average nursing home cost per month, find out how ExaCare can help your facility win more referrals? Talk with our team to learn more.

Schedule a demo.