Nursing Homes in California

With around 39.5 million residents, California has the largest population in the United States. Almost 15% of that population is aged 65 and above, and seniors in California have access to resources and programs that can help them age in comfort. There are a large number of world-class hospitals in the state, including some that are ranked among the top in the nation for geriatric care, and healthcare costs are lower than the national average.

Seniors can also access excellent nursing care, with more than 1,200 nursing home facilities in the state caring for more than 400,000 Californians annually. These facilities provide extensive long-term care that includes personal care, skilled nursing care, medical monitoring and treatments. In California, nursing home care costs an average of $9,247 per month for a semi-private room and $11,437 for a private room.

This guide includes detailed information about the cost of nursing home care in California, the financial assistance and other resources available to seniors in the state and the rules and regulations that cover nursing homes in California.

The Cost of Nursing Home Care in California

The average monthly cost of nursing home care in California is $9,247, according to the Genworth Cost of Care Survey 2020. This is $1,491 higher than the national average of $7,756. Despite this, California’s costs are more affordable than most of its neighbors. Nevada’s costs are slightly higher at $9,262 per month. In Washington state the cost is $9,581 per month and seniors in Oregon pay $10,114 monthly, $867 more than those in California. Arizona is the only nearby state with more affordable nursing home care. The average cost there is $6,844 per month, $2,403 lower than California. 

California’s diverse range of cities means that the cost of nursing home care can vary widely depending on a senior’s location. Large coastal cities tend to have higher prices, with San Jose offering the least affordable care at $12,547 per month. San Francisco is slightly lower at $12,471 and San Diego’s seniors pay $10,722. Sacramento’s costs are also higher than average, at $9,946 per month. Los Angeles is the exception, with costs in the state’s biggest city averaging $8,060, $1,187 lower than the state average. Seniors in Bakersfield have the same costs. Those looking for lower costs can look to inland cities such as Fresno and Riverside, where the seniors pay $7,787 and $7,756 respectively. 

Due to the extensive skilled care available, skilled nursing is the most expensive type of care offered in California, at $9,247 per month. However, seniors do have other options for long-term care. Adult day care, which provides services in a group setting to seniors who live at home, is the most affordable option at $1,733 per month. Assisted living in the state averages $5,000 monthly and provides room, board and personal care, though doesn’t provide skilled nursing. Home care can provide either non-medical or skilled nursing care and may be an option for seniors that require a nursing home level of care. Both types in California cost an average of $5,529 per month.

Does Medicaid Cover Nursing Home Care in California?

Medi-Cal, California’s Medicaid system, covers nursing home care for seniors who have limited financial means. There are 13 million people in California who rely on Medi-Cal, including 2 million seniors. Medi-Cal pays for around 55% of all patient days in long-term care facilities. There are approximately 1,230 licensed nursing homes in the state.

Nursing homes provide 24-hour skilled nursing care for seniors who require more supervision and medical attention than an assisted living facility would be able to provide. They help seniors maintain a high quality of life whether they’re recovering from an operation or living with the effects of a long-term condition.

Seniors who would prefer to receive care in their own homes rather than moving into a nursing home may be eligible for a Home and Community Based Services Waiver that allows them to receive skilled nursing care in the community. Institutional nursing home care is covered under the means-tested Medi-Cal program.

Medicaid Eligibility in California

To qualify for Medi-Cal, seniors must either reside in a skilled nursing facility or meet income limits. This means a person must be a resident of California with an income that’s at or below 138% of the Federal Poverty Level. At the time of writing, this is $18,768 for a single person or $25,968 for a two-person household with one person applying and $25,272 if both apply.

California plans to remove assets from its calculations from the first day of 2024. Currently, a single person can have countable assets not exceeding $130,000, while the two-person household threshold is $195,000.

2022 Basic Medi-Cal Income Limits for Seniors in California

*Combination of the applicant’s $18,768 income limit and the non-applicant spouse’s $7,200 annual maintenance needs allowance

Some individuals may qualify for Medicaid based on other criteria, for example, if they are:

• Aged 65 or over
• Blind
• Have a qualifying disability
• Hold refugee status
• Reside in a skilled nursing home
• Are enrolled in CalFresh, SSI/SSP or Refugee Assistance

There are some other qualifying criteria. Seniors can contact their local county office to determine if they’re eligible for Medicaid and other government programs.

How to Apply for Medicaid in California

Seniors can apply for Medi-Cal online via Covered California or visit their local county office to submit an application.

A printable application form is available from the DHCS website. For more information about applying for Medi-Cal, call the California Department of Health Services at (916) 558-1784.

What Information You Will Need

When applying for Medicaid, seniors may be asked to provide:

• Proof of date of birth (e.g. a birth certificate)
• Proof of U.S. Citizenship or eligibility for residence (e.g. a passport, driver’s license or green card)
• Proof of income, including pay stubs, SSI income and retirement benefits
• Proof of other resources, such as bank statements, evidence of stock holdings and life insurance information
• Proof of residence based on rent payment receipts, landlord information or property deeds
• Medicare card or evidence of other insurance

Seniors who are unable to provide the specific documents listed above should contact their county office for advice and a list of acceptable alternatives.

Additional Medicaid Support and Resources in California

There are several organizations that offer support to help seniors navigate the Medi-Cal system in California. Seniors can contact one of these organizations for help with the application or to discuss concerns about eligibility for Medi-Cal.

Does Medicare Cover Nursing Home Care in California?

Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet a number of specific requirements. This benefit is available to beneficiaries who have been hospitalized for at least three days, excluding the date of discharge, so it’s most valuable for those who are recovering from an injury, illness, or surgery.

Once seniors meet the hospitalization requirement, Medicare will pay for up to 100 days of skilled nursing per benefit period. The first 20 days are covered in full. Starting on day 21, beneficiaries must pay a daily coinsurance rate. After day 100, seniors are responsible for the entire cost.

What Does Medicare Cover?

Medicare covers a number of specific services, including:

• Meals
• A semiprivate room
• Medications
• Skilled nursing
• Physical therapy
• Occupational therapy
• Speech therapy
• Audiologist care
• Medical supplies
• Medical social services
• Nutritional counseling
• Ambulance transportation

What Isn’t Covered by Medicare?

Medicare does not cover long-term custodial care that addresses seniors’ day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.

For more information about Medicare and when it covers Nursing Home Care, read our Guide to Nursing Homes.

Medicare Support & Resources in California

Seniors can request advice and information about Medicare and their insurance options by contacting one of the following organizations. These providers offer options counseling, advice and support to those who need help navigating the Medicare system in California.

Other Financial Assistance Options for Nursing Home Care in California

While Medicaid and Medicare are two of the most common programs used to pay for Nursing Home Care, there are other financial assistance options available, depending on your unique situation.

Free and Low-Cost Resources for Seniors in California

Seniors living in California can take advantage of a variety of programs and services to help them find suitable long-term care. There are also some organizations that offer financial support to help seniors offset the cost of necessary services whether they’re provided at home or in a skilled nursing facility.

COVID-19 Rules for Nursing Homes in California

The following information is based on research done on several government websites, including cdph.ca.gov and publichealth.lacounty.gov. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 2/22/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visitation Policies

Outings & Social Activities

*Note: This information was not available for this state, contact your local area agency on aging or senior living facility for more information.

COVID-19 Safety Measures for Staff and Residents

Nursing Home Laws and Regulations in California