What a Nursing Home Costs

Nursing home prices turn on room type, care level, and location. Learn the real cost components and how to obtain a written rate before committing.

Updated 2026

This guide is informational and is not medical advice.

Category: costs-and-payment · Updated 2026

Nursing home pricing is nearly impossible to compare from advertising alone. Two facilities on the same street may quote sharply different monthly figures because they bundle different services, serve different payer mixes, and set rates around the local labor market. The only dependable number is the one a facility hands you in writing for the specific room type and care level your family member requires.

This guide explains what drives the price, what is normally included, and how to obtain an accurate figure. It does not quote a national average, because averages conceal the differences that matter most to one family. For current medians by state and care setting, see the CareScout Cost of Care Survey.

What the bill actually covers

A nursing home bill usually combines several cost categories:

Room and board, priced by private or semi-private room and by location
Nursing and personal care, the 24-hour staffing model required for care
Therapies, physical, occupational, and speech therapy billed separately in some cases
Medications and supplies, sometimes included, sometimes not
Ancillary services, such as podiatry, dental, salon, phone, cable, and laundry
Specialty care, such as a secured memory care unit or ventilator care

Request an itemized list. The base rate is merely the starting point.

The largest cost drivers

Driver	Why it moves the price
Geography	Wages, real estate, and competition vary widely by state and metro area
Room type	Private rooms generally cost more than shared rooms
Care level	More nursing and therapy time raises labor cost
Memory care	Secure units with higher staffing cost more
Payer mix	Facilities with more Medicaid residents may shift some costs to private-pay rates

Private pay compared with Medicaid and Medicare rates

Private-pay residents normally pay the facility's posted rate. Medicaid typically pays a state-set rate that is often lower, while Medicare pays a prospective per-day rate for a covered skilled stay. Because Medicare and Medicaid pay on different formulas, a facility's private-pay price can exceed what it receives from public payers. Federal and state governments publish their rate methodologies, and states set Medicaid nursing facility rates every year. Ask the facility whether the quoted rate is private pay and whether it will change should the payer change.

How to obtain a real quote

Do not rely on a website or a phone estimate. To get a usable figure:

Request a written rate sheet covering room, care level, therapy, and ancillaries
Ask what current residents in this room type actually pay
Ask about annual increases and how far ahead they are announced
Ask what happens to the rate if the person's care level rises
Ask whether a Medicaid-eligible resident may stay once private funds run out
Request the deposit and refund policy in writing

Then compare the all-in monthly cost with the other care options in Nursing Home vs Assisted Living.

Planning the financial runway

Estimate how many months the family can pay privately, and what happens afterward. Options include Medicaid if the person qualifies, long-term care insurance, VA benefits, and financial products. Work through the payment guides: Does Medicare Pay for Nursing Homes?, Medicaid and Nursing Home Coverage, and Long-Term Care Insurance and Alternatives. A financial planner versed in elder law can help, and many states offer free counseling through their Senior Health Insurance Assistance Program or Area Agency on Aging.

Sources: CareScout Cost of Care Survey; Medicare.gov; Medicaid.gov; CMS Care Compare.

Related guides

Frequently asked questions

Why don't facilities publish prices online?

Rates depend on room type, care level, and payer and shift over time, so a single published number is frequently misleading. Ask for a written rate sheet instead. You can also compare facilities using the CMS data on our care-type pages.

Might the price rise after we move in?

Yes. Facilities generally increase rates once a year and may charge more when the care level rises. Ask for the increase history and the notice policy in writing before signing.

Will every nursing home accept Medicaid?

No. Some facilities cap the number of Medicaid-pay residents or decline Medicaid entirely, even when certified. If Medicaid is part of the plan, request the facility's Medicaid policy in writing and confirm bed availability.

Is a shared room always less expensive?

Usually, though availability matters and some facilities offer only private rooms. A semi-private room can also affect sleep and privacy. View both and compare the total monthly cost, not just the room rate.

Where are average costs by state published?

The CareScout Cost of Care Survey publishes medians for nursing homes, assisted living, and home care by state and care setting. State Medicaid agencies also publish their nursing facility payment rates.

Data sources

CMS Provider Data Catalog · CMS Care Compare. This guide is provided for information and is not medical advice. Processing date: 2026-10-06.

Required disclosures

For general information only, not medical advice. This website shares public data and general information. It does not offer medical advice, diagnosis, or treatment guidance, and it cannot replace a consultation with a qualified health care professional or with Medicare.

Independent and unaffiliated. NursingFacilities.org is a private, independently run directory. It is not affiliated with, nor endorsed or operated by, the Centers for Medicare & Medicaid Services (CMS), Medicare, or any government agency. CMS has not reviewed or endorsed this site.

Confirm details before acting. Facility records come from public federal datasets and may lag or contain errors. Always verify current ratings, services, availability, and coverage directly with the provider and on Medicare.gov.

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