Housing & Transportation

Nursing Homes

Nursing homes are licensed, regulated, and individually certified by the state for Medicare and Medicaid and provide 24-hour care. They offer a staff of licensed and/or registered nurses, nursing aides, and administrators as required by licensing standards. The health care is supervised and authorized by a physician. You can look at a facility's recent evaluation at the Medicare Web site. Click on "Compare Nursing Homes" and search for a nursing home by name or location. The Web site also offers a useful 64-page "Guide to Choosing a Nursing Home."

There are three types of facilities offering different levels of care, but they are all referred to as nursing homes. If a resident expects to access third-party payment, a determination of need for long-term care in a nursing home must be documented by the elder's primary care physician and your local Area Agency on Aging (AAA) Coordination of Care Unit.

  1. A Residential Care Facility or Rest Home provides 24-hour supervision and supportive services for individuals who do not routinely need nursing or medical care.
  2. A Nursing Facility is a residential facility that provides 24-hour nursing care, rehabilitation services, and support for activities of daily living for the chronically ill who require nursing care.
  3. A Skilled Nursing Facility provides 24-hour skilled nursing care and extensive rehabilitative care and services to the chronically ill; short-term care for individuals who have been hospitalized and need rehabilitation before returning home; and specialty care for individuals with physical and neurological disabilities. These facilities provide room and board, personal care, protection, supervision, and may offer other types of therapy.

Financial Considerations: Nursing homes charge a basic daily or monthly fee. In 2008 the average cost of a semiprivate room in a nursing home was $5,448 per month ($65,385 a year). Some families purchase long-term care insurance in anticipation of the cost, while most depend on other forms of financing. Nursing homes accept third-party payment from a variety of sources, including Medicare, Medicaid, and private insurance. Medicaid currently pays for 60 percent of nursing home care, typically covering costs after the resident has exhausted his or her private resources. Medicare also pays for short-term nursing care within 30 days of a hospitalization of three or more days and is medically certified. For more information, see also Long-Term Care Costs, Long-Term Care Insurance, and Medicare.

Protective Services for Nursing Home Residents

Adults residing in long-term care facilities can be victimized by abuse, neglect, and exploitation. There are ways to monitor the care elders receive, such as participating in the home's Resident Council, reviewing an elder's care plan with the staff on a regular basis, and asking family members to visit throughout the day and week. Nursing homes should offer a family reevaluation meeting with all the staff who care for the elder (nurses, aides, recreation directors, etc.) at least annually.

If you suspect that an elder is not receiving care and you are not able to work with the staff to resolve care issues, you can report it. The National Long Term Care Ombudsman Resource Center can help you resolve problems between residents and nursing homes or assisted living facilities. To locate the ombudsman for your region, visit the Web site or call 202-332-2275. The National Citizen's Coalition for Nursing Home Reform was formed because of public concern about substandard care in nursing homes. It offers fact sheets about nursing homes and other resources. (See also Protecting Elders' Rights.)

Veterans' Housing

Soldiers' Homes provide health care services to honorably discharged wartime veterans with non-service connected health problems. Soldiers' Homes are state-funded, accredited health care facilities that offer veterans hospital care, skilled nursing and long- term care, full-time residential accommodations, and a multi-service outpatient department. To find veteran housing options in your state, contact your AAA or your veteran's health care provider. (See also Other Government Plans.)

Financial Considerations: Veterans' housing is subsidized for eligible veterans who meet income requirements. In 2008, charges applied for those with a gross monthly income over $300.

Additional Information for Specific States

Below, you'll find additional state-specific information on the average daily cost for nursing home care. The states included have high percentages of elders and/or high elder populations.


The average daily cost for nursing home care in Alabama was $147 in 2006.


The average daily cost for nursing home care in California was $185 in 2006.


The average daily cost for nursing home care in Florida was $182 in 2006.


The average daily cost for nursing home care in Illinois was $156 in 2006.


The average daily cost for nursing home care in Michigan was $182 in 2006.


The average daily cost for nursing home care in Nevada was $184 in 2006.

New York

The average daily cost for nursing home care in New York was $230 in 2006.


The average daily cost for nursing home care in Ohio was $179 in 2006.


The average daily cost for nursing home care in Pennsylvania was $209 in 2006.


The average daily cost for nursing home care in Texas was $123 in 2006.

Continue to Elder Housing Resources...