Skilled nursing facilities — commonly called nursing homes — are the most expensive and most medically intensive form of senior residential care. Understanding what they cost, and critically, what Medicare and Medicaid will actually pay, is essential to planning.
What Does Skilled Nursing Care Cost in 2026?
The national median costs for skilled nursing facility care in 2026: - Semi-private room: $9,000 per month ($108,000/year) - Private room: $12,000 per month ($144,000/year)
These are the most expensive senior care costs in any category. The premium over assisted living ($5,200/month) reflects 24-hour licensed nursing care, intensive medication management, and the medical infrastructure required to serve residents with significant health needs.
Skilled Nursing Costs by State (2026 Estimates)
| State | Semi-Private (Monthly) | Private (Monthly) |
|---|---|---|
| Alaska | $29,000 | $30,000 |
| Connecticut | $14,000 | $16,500 |
| Massachusetts | $13,500 | $15,000 |
| New York | $12,800 | $14,500 |
| California | $12,000 | $14,000 |
| Pennsylvania | $10,500 | $12,000 |
| Florida | $9,000 | $11,000 |
| Illinois | $8,500 | $10,500 |
| Michigan | $9,000 | $10,500 |
| North Carolina | $8,800 | $10,200 |
| Ohio | $8,400 | $9,800 |
| Texas | $7,600 | $9,000 |
| Georgia | $7,200 | $8,400 |
| Mississippi | $6,600 | $7,600 |
What Medicare Covers for Skilled Nursing
What Medicare Part A covers: - Days 1–20: Medicare pays 100% after a qualifying hospital stay - Days 21–100: Medicare pays covered costs minus a daily copay of approximately $204/day (2026 estimate) - Day 101+: Medicare pays nothing — the resident pays the full private-pay rate
The qualifying hospital stay requirement: The person must have had a minimum 3-consecutive-night inpatient hospital stay (not observation status) immediately before entering the skilled nursing facility.
What Medicare does NOT cover: - Long-term custodial nursing home care - Nursing home care without a preceding qualifying hospital stay - Any skilled nursing care beyond 100 days per benefit period
Medicare's skilled nursing benefit is designed for short-term rehabilitation — not long-term care.
What Medicaid Covers for Skilled Nursing
Medicaid is the primary payer for long-term nursing home care in the United States. Nearly two-thirds of nursing home residents are covered by Medicaid.
Eligibility: Medicaid nursing home eligibility typically requires: - Income: Below $2,742/month (2026 limit for most states; varies) - Assets: Below $2,000 in countable assets for an individual
Most nursing homes accept Medicaid. However, some nursing homes limit Medicaid beds, so placement can take longer.
See your state page for Medicaid nursing home coverage details specific to your state.
When Is a Skilled Nursing Facility the Right Choice?
Skilled nursing is appropriate when: - The person requires continuous nursing oversight — wound care, IV therapy, complex medication management, ventilator support, or frequent medical monitoring - The person is recovering from a major health event — hip replacement, stroke, serious infection — needing intensive rehabilitation - Assisted living or memory care can no longer safely manage the person's medical needs - Advanced dementia with complex medical complications that require nursing-level management
If the primary need is supervision and personal care rather than active medical management, assisted living or memory care will typically provide better quality of life at lower cost.
Alternatives to Full-Time Skilled Nursing
Assisted living with nursing services: Many communities now offer on-site licensed nursing consultation and expanded medical services, potentially deferring the need for skilled nursing.
Continuing Care Retirement Communities (CCRCs): Offer a full continuum — independent living, assisted living, memory care, and skilled nursing — on one campus. Residents transition between levels without relocating.
Home-based skilled nursing: For individuals who can remain at home with intensive support, some skilled services can be delivered at home with Medicare coverage.
The Bottom Line
Skilled nursing care in 2026 costs $9,000 to $12,000 per month nationally — the most expensive senior care option. Medicare covers short-term skilled nursing rehabilitation, not long-term custodial care. Medicaid is the primary payer for long-term nursing home stays.
Use our cost calculator to see skilled nursing costs in your specific city, and see your state page for Medicaid eligibility details.
Sources: Genworth Cost of Care Survey 2024; Centers for Medicare and Medicaid Services; Kaiser Family Foundation Long-Term Care Data.