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Nursing Homes in Massachusetts
Located along the northern Atlantic coast just east of New York, Massachusetts is known for its deep historical roots, stunning coastal scenery and abundance of world-class medical facilities. The state is home to 97 hospitals, including the top-ranked Brigham and Women’s Hospital in Boston and the Bedford VA hospital.
Seventeen percent of the state’s 6,892,503 residents are aged 65 and older, and as of 2019, 34,363 people lived in nursing facilities in Massachusetts. Nursing homes provide 24/7 skilled medical care, accommodations and recreational programming for those who have complex medical needs due to advanced age, illness or disability.
According to Genworth Financial’s 2020 Cost of Care Survey, the average monthly cost of nursing home care in Massachusetts is $12,623 for a semiprivate room and $13,535 for a private room. This guide provides a comprehensive overview of nursing home care in Massachusetts, including a look at the costs, links to financial aid programs and services, and a summary of the state laws and regulations that apply to skilled nursing facilities.
The Cost of Nursing Home Care in Massachusetts
At a monthly average cost of $12,623 for a semiprivate room, nursing home rates in Massachusetts are similar to rates in Connecticut ($12,927) and New York ($12,319). Rates are notably lower in Rhode Island ($8,669), Vermont ($9,779) and New Hampshire ($10,646). Rates throughout the northeastern region are well above the national average of $7,756.
The cost of semiprivate nursing home care across Massachusetts varies from a low of $11,102 in Pittsfield to a high of $13,383 in the state capital of Boston. Costs are also above the state average of $12,623 in Barnstable Town on Cape Cod. Rates in Worcester ($12,486), Springfield ($11,586) and Pittsfield ($11,102) are all below the state average.
Pittsfield
$11102
Springfield
$11586
Worcester
$12486
Barnstable Town
$13326
Boston
$13383
Nursing home care, also known as skilled nursing care, is the costliest long-term option for those who need assistance because this level of care involves around-the-clock medical care in a specialized residential facility. Seniors and adults with disabilities who don’t need the level of care provided in a nursing home have a variety of options in Massachusetts.
The least-expensive care option is adult day health care for $1,598 per month, which includes nonmedical care and supervision in a communal setting. Seniors who want residential care may also be eligible for placement in an assisted living facility, which costs an average of $6,085 per month. Those who prefer to remain in their home can expect to pay about $5,529 per month for 44 hours of weekly homemaker service, while a home health aide costs an average of $5,649 per month.
Adult Day Health Care
$1598
Homemaker Services
$5529
Home Health Aide
$5649
Assisted Living Facility
$6085
Does Medicaid Cover Nursing Home Care in Massachusetts?
In Massachusetts, Medicaid is part of the MassHealth program. MassHealth has approximately 1.8 million enrollees, although some of those enrollees are members of the Children’s Health Insurance Program, which falls under the MassHealth umbrella. Residents who meet MassHealth’s financial guidelines and other qualifications may be eligible for coverage of nursing home stays. The state has around 370 nursing homes, and individuals who qualify for certain MassHealth programs may be able to access medical and personal care services in them.
Massachusetts runs Home and Community Based Services Waivers that can assist individuals who reside in nursing homes but can return home with proper support. One, the Moving Forward Plan Community Living Waiter, helps seniors who no longer need around-the-clock care transition back to their communities, where they continue receiving medical services like skilled nursing. The Frail Elder Waiver also helps residents receive levels of care similar to a nursing facility while remaining home. Other waiver types specifically focus on individuals with brain injuries.
Medicaid Eligibility in Massachusetts
To qualify for assistance, MassHealth applicants must meet requirements tied to financial need. MassHealth assesses applicants based on household size and income. Other requirements, like being 65 or older, blind or disabled and being in need of certain medical services, may also apply. Specific MassHealth programs can enact their own restrictions.
An individual applying for Medicaid as well as a couple with one spouse applying can maintain $1,215 per month in income with $2,000 in assets.
2022 Medicaid Income Limits for Seniors in Massachusetts
| Household Size | Number of Applicants | Income Limits Per Year* | Asset Limits: Applicant(s) | Asset Limits: Non-Applicants |
|---|---|---|---|---|
| One Person | 1 | $14,580 | $2,000 | |
| Two People | 1 | $14,580** | $2,000 | 148,620 |
| Two People | 2 | $19,716 | $4,000*** |
*Except for a $72.80/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient's monthly income must be put toward the cost of nursing home care.
**Income limit is for applicant only.
***$2,000 per spouse
Additionally, applicants must be Massachusetts residents. They are also required to be a legal alien or citizen or permanent resident of the United States.
How to Apply for Medicaid in Massachusetts
There are multiple routes through which seniors can apply for MassHealth. One option is the online Massachusetts Health Connector. Seniors can also mail a filled-out application to the MassHealth Enrollment Center at P.O. Box 290794, Charlestown, MA 02129-0214. An office located at 529 Main Street, Suite 1M, Charlestown, MA 02129-0214 accepts hand-delivered applications. Additionally, applicants can send in their paperwork by fax at (617) 887-8799. To reach the MassHealth Enrollment Center, applicants can call (800) 841-2900.
A high-level outline of application documentation requirements is below, and the Massachusetts Senior Guide has more information on the necessary documentation and other facets of the MassHealth application process.
Information You Will Need:
- Social Security numbers for all applicants
- Proof of income, assets and current health coverage, including insurance premium bills
- Documentation on other health insurance your household can access
- Proof of citizenship/national status
- Proof of identity (such as a birth certificate, passport or naturalization papers)*
- Copies of both sides of immigration cards (for applicants who are not U.S. citizens or nationals)
*An exemption applies for older or disabled individuals eligible for Supplemental Security Income and individuals with disabilities who receive Supplemental Disability Income.
Additional Medicaid Support & Resources in Massachusetts
These resources can help seniors and their loved ones make sense of the intricate world of MassHealth applications. Their services include counseling and referrals.
| Resource | Contact | Services |
|---|---|---|
| MassHealth Representatives | (800) 841-2900 | MassHealth runs a main contact line, but seniors can instead schedule an appointment with a MassHealth representative. At such an appointment, seniors may gather information about renewal forms and new applications, verification requirements and changes to information such as assets and income. MassHealth representatives can also answer general questions. |
| Massachusetts Councils on Aging | (413) 527-6425 | The COAs of Massachusetts assist the state's older adults by conducting health insurance benefits counseling. They also help seniors and caregivers make use of elder services at the local and state levels. The parent organization maintains an online directory of local COAs. |
| Senior Legal Helpline | (800) 342-5297 | The Senior Legal Helpline is open to Massachusetts residents aged 60 years of age and up. Its representatives help callers determine eligibility and complete applications for many programs, including MassHealth. It can also refer callers to attorneys who offer legal services at reduced rates. |
Does Medicare Cover Nursing Home Care in Massachusetts?
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 and Resources in Massachusetts
While Medicare doesn’t cover nursing home stays over a set duration, it can provide an initial burst of financial assistance in some situations. The following organizations link seniors and family members with advisors able to provide input on individual circumstances.
| Program | Contact | Service |
|---|---|---|
| MassOptions | (800) 243-4636 | MassOptions is a public service that connects clients with useful resources. Notably for Medicare-related matters, MassOptions provides access to counselors from the Serving the Health Insurance Needs of Everyone program. SHINE's counselors can assist in areas like finding ways to pay for health care and learning about potentially available benefits. Current Medicare enrollees and soon-to-be-eligible individuals may use SHINE's services. |
| Massachusetts Division of Insurance | (617) 521-7794 | The Massachusetts DOI oversees an online repository of insurance-related information, covering matters such as health coverage and long-term care insurance, which may make extended care services more affordable. The DOI also responds to consumer inquiries. |
| Medicare.gov | (800) 633-4227 | Medicare.gov is a good starting point for seniors and family members who want to learn more about Medicare. Its hotline's agents can help callers find answers regarding Medicare claims and other information, and it operates a 24/7 online chat interface as well. Basic cost information is available on Medicare.gov, too. |
| Medicare Rights Center | (800) 333-4114 | Through its free helpline, the Medicare Rights Center assists clients with tasks like coordinating Medicare with other coverage and choosing between policies. They also aid with appeals and can help clients decide which Medicare cost-savings programs to pursue. The center may also be useful for seniors with complaints about medical care. |
| BenefitsCheckUp | (800) 794-6559 | Operated by the National Council on Aging, BenefitsCheckUp helps seniors learn about programs that can make medications and health care more affordable. Such programs may reduce the cost of copays and other expenditures. BenefitsCheckUp also focuses on guiding seniors toward additional sources of information and advice. |
Other Financial Assistance Options for Nursing Home Care in Massachusetts
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.
| Name | How To Apply | How It Works |
|---|---|---|
| Aid and Attendance | Learn more and apply online at va.gov. | Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for skilled nursing care. |
| Reverse Mortgages | Learn more about your options and how to apply at ftc.gov | If you own a home, you may be able to use a reverse mortgage to help pay for nursing care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan. |
| Long-Term Care (LTC) Insurance | Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov. | Seniors who already have long-term care insurance may be able to use it to pay for skilled nursing care. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not typically be eligible to sign up for a LTC insurance policy. |
Free and Low-Cost Resources for Seniors in Massachusetts
There are many resources in Massachusetts that assist seniors in their retirement. Caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.
Area Agency on Aging
Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| Massachusetts Area Agencies on Aging | Massachusetts is home to many Area Agencies on Aging that provide supportive services to older adults. These agencies can help seniors get connected with local programs that assist them with daily needs, including caregiver support, transportation services, meal programs and health and wellness resources. AAAs also work to combat elder abuse and fraud and empower seniors to ensure a life of safety and dignity. |
Cash Assistance Programs
Cash assistance programs in Massachusetts provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.
| Program Name | Phone Number | Description |
|---|---|---|
| Massachusetts Worcester State University Categorical Tuition Waiver | 508-929-8051 | Under Massachusetts law, adults 60 years of age and up may take classes at public universities without paying tuition. You may still need to pay campus and class fees, and not all classes are available under the waiver program. Contact a specific's college bursar's office for availability. |
Food Assistance Programs
Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help Massachusetts seniors afford the nutritious food they need.
| Program Name | Phone Number | Description |
|---|---|---|
| Massachusetts Meals on Wheels | Massachusetts Meals on Wheels supplies an estimated 30,000 meals per day to seniors across the state, either as a home-delivery service or as congregate meals served in the community. There are more than 20 agencies across the state that help to manage local and regional Meals on Wheels programs. Any senior struggling to prepare meals on their own may be eligible for these services. Costs are based on a sliding scale. | |
| Massachusetts Supplemental Nutrition Assistance Program (SNAP) | 877-382-2363 | The Department of Transitional Assistance operates Massachusetts' Supplemental Nutrition Assistance Program to provide monthly funds on an electronic benefits card, contributing to seniors' healthy food budget. To be eligible, seniors must provide proof of residency, Social Security number or similar documentation and proof of income, including any veteran's benefits and Social Security payments. Seniors who participate in SNAP can receive money back on their EBT cards by purchasing local produce through the Healthy Incentives Program. |
| Massachusetts The Charity Guild Food Pantry | 508-583-5280 | Located in Brockton, the Charity Guild Food Pantry distributes perishable and nonperishable foods to seniors, families and individuals in need. It's part of The Greater Boston Food Bank and its doors are open to anyone, not just those living in Brockton. Seniors needing assistance may visit the pantry Tuesday through Thursday and every other Saturday. Those who are homebound can arrange to have food parcels delivered to their door. |
Free Used Medical Equipment
Due to the high cost of purchasing new medical equipment, several organizations in Massachusetts collect lightly used medical devices such as wheelchairs, ramps and walkers and distribute them to local seniors and residents in need.
| Program Name | Phone Number | Description |
|---|---|---|
| Easterseals Massachusetts Long-Term Device Loan Program | 800-244-2756 | Easterseals Massachusetts long-term device loan program is for those on low incomes who may be unable to purchase medical equipment for home use. The service provides assistive technology, such as phones with large tactile buttons, wrist-cuff blood pressure monitors and screen reading devices. |
| Massachusetts Compassionate Care ALS | 508-444-6775 | Compassionate Care ALS is a nonprofit that helps people who have been diagnosed with ALS. In addition to support services, the organization provides new and gently used equipment to people diagnosed with ALS. These can include voice amplifiers, speech communication devices and wheelchairs. |
| Massachusetts Hospital Equipment Loan Program | 781-322-1052 | The Hospital Equipment Loan Program loans medical equipment free of charge and for home use only. Subject to donations and availability, seniors can request various devices, such as electric lift chairs, exercise bikes, rollators and under mattress supports. |
| Massachusetts REquipment Inc. | 800-261-9841 | REquipment connects residents with reconditioned mobility items, accessibility aids and assistive technology. Clients can reserve equipment online or over the phone. All items are free, and delivery or pickup is available for a nominal fee. |
Health Insurance & Prescription Drug Coverage for Seniors
Massachusetts seniors who meet certain income criteria can apply to local resources to help them pay for prescription drugs. Eligible residents can also receive assistance through health insurance and other programs to access free or discounted medical services.
| Program Name | Phone Number | Description |
|---|---|---|
| Massachusetts ConnectorCare | ConnectorCare plans help residents with incomes not exceeding 300% of the federal poverty level. Because several insurers participate in ConnectorCare plans, you should check that a plan satisfies your medical care and prescription drug needs | |
| Massachusetts MassOptions | 800-243-4636 | MassOptions is a statewide service that helps older adults connect with programs and supports in the community. It has an up-to-date online database with service providers, which seniors can browse through on their own or call the toll-free hotline for one-on-one assistance. The program also administers the statewide health insurance options counseling program, which provides free, unbiased advice and information to Medicare beneficiaries. |
Home Repair and Modifications
Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in Massachusetts have different eligibility criteria and often assist retirees by providing grants or loans.
| Program Name | Phone Number | Description |
|---|---|---|
| Massachusetts Home Modification Loan Program (HMLP) | 866-500-5599 | The Home Modification Loan Program provides older residents with interest-free loans, which they can use to adapt their homes to their needs. Loans are repaid when the owner sells the property or transfers the title deed. |
| Massachusetts Weatherization Assistance Program | The purpose of the Weatherization Assistance Program is to improve the energy efficiency of seniors' homes, which can reduce utility costs, while also making living spaces safer. |
Senior Centers
Senior centers in Massachusetts bring together residents through recreational activities and events. Many also offer advice and support on senior issues, run wellness and nutrition programs, and connect older adults with other resources in the local area.
| Program Name | Phone Number | Description |
|---|---|---|
| Massachusetts Councils on Aging | 413-527-6425 | Throughout the state of Massachusetts, 350 Councils on Aging and Senior Centers provide local help to seniors on the community level. This may include transportation and meals, as well as outreach and companionship services. Many of these services are provided free of charge to qualified seniors living at home. |
Senior Engagement
Senior engagement resources and programs in Massachusetts help older adults remain active and ensure they contribute to the community. Resources include wellness programs, volunteer opportunities, support groups and organizations that help residents connect with the community to live fulfilling lives.
| Program Name | Phone Number | Description |
|---|---|---|
| Massachusetts North Shore Community College Tuition Waivers | 978-762-4000 | Massachusetts residents aged 60 and older are eligible for a categorical tuition waiver at the state's educational institutions. Seniors can use this discount to sign up for in-person or online courses offered by North Shore Community College. Course fees still apply. |
Social Security Offices
Social Security offices in Massachusetts help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.
| Program Name | Phone Number | Description |
|---|---|---|
| Massachusetts Social Security | Social Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working. |
Tax Assistance
Seniors can apply for tax assistance from several Massachusetts resources. Elderly residents and those with disabilities could be eligible for tax exemptions on medical expenses, reductions on property tax and other tax assistance programs.
| Program Name | Phone Number | Description |
|---|---|---|
| Massachusetts Age 65 or Over Exemption | 800-392-6089 | The exemption is $700 for a single adult, and a married couple may be eligible for $700 each if they're both aged 65+ before the final day of the tax year. |
Utility & Energy Bill Assistance
Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. Massachusetts retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices.
| Program Name | Phone Number | Description |
|---|---|---|
| Massachusetts Fuel Assistance Programs | 617-573-1100 | Massachusetts Fuel Assistance Programs are aimed at assisting seniors with home heating costs during the state's severe winters. Residents who receive SNAP or other low-income benefits can qualify for the Low Income Home Energy Assistance Program (LIHEAP) as well as discounted utility rates. Applications for LIHEAP open on October 1. Seniors may be eligible for one-time emergency financing from the Salvation Army Good Neighbor Fund or Joe-4-Oil. |
| Massachusetts Low Income Home Energy Assistance Program (LIHEAP) | 617-573-1100 | The Massachusetts Low Income Home Energy Assistance Program (LIHEAP) assists eligible seniors with their home heating bills. Residents who qualify must have income equal to or lower than 60% of the estimated state median income for Massachusetts. Applications are open online on October 1 and available in person at one of several local LIHEAP agencies. Residents must provide a photo ID, a list of household members, income proof and a heating bill copy. |
Veteran's Services
Massachusetts retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.
| Program Name | Phone Number | Description |
|---|---|---|
| Massachusetts VA Benefits and Health Care | Massachusetts VA Benefits and Health Care offers medical care and practical assistance for senior veterans. It also oversees three national cemeteries. Older veterans with medical needs can obtain treatment at four medical centers located in Brockton, Leeds, Jamaica Plain and West Roxbury. Edith Nourse Rogers Memorial Veterans Hospital and several community-based outpatient clinics offer varying levels of medical care. Seniors can check if they are receiving all the financial assistance they qualify for and can also access community supports through seven vet centers. |
Nursing Home Laws and Regulations in Massachusetts
Nursing homes in Massachusetts are licensed and regulated by the Department of Public Health in accordance with Regulation 105 CMR 150.00.
| Topic | Rule |
|---|---|
| Licensing Requirements | Facilities that accept Medicare or Medicaid funding must comply with federal nursing home regulations. Under state law, nursing homes are licensed as either Level 1 or Level 2, with Level 1 homes providing the highest level of care and support. |
| Staffing Requirements | Licensed nursing homes must have a full-time administrator who is on-site at least five days a week, as well as a substitute administrator. The administrator must be licensed as a Nursing Home Administrator by the Board of Registration of Nursing Home Administrators, which requires that license holders complete at least 40 hours of continuing education annually. |
| Staff Training Requirements | Staff must complete an approved Resident Care Assistant course or higher before being hired to work in a licensed nursing home. |
| Admission Restrictions | Nursing homes may only admit those who cannot be safely supported in a less-restrictive setting, such as an assisted living facility. Individuals who pose a threat to the health and safety of other residents due to behavior or communicable disease cannot be admitted to a nursing facility. |
| Care Planning Requirements | New residents should have a comprehensive care plan that includes a health assessment within 14 days of admission. This care plan is to be reviewed every 90 days or more often for residents who experience frequent changes to their health conditions. |
| Dietary and Nutritional Services Requirements | Nursing homes must provide three dietician-approved meals daily plus snacks, and meals need to be prepared in a way that is safe for residents who have difficulty swallowing. Dietary preferences and special requirements should be accommodated. |
| Specialized Rehabilitative Services | Nursing home residents can receive specialized rehabilitative services, such as speech and language, occupational and physical therapy, either on-site or at a nearby clinic. |
| Medication and Pharmaceutical Services | Medications may only be administered with the consent of the resident or their legal guardian except in emergency situations where the medication is approved by a licensed medical expert. |
| Activities Requirements | Long-term care facilities must provide age-appropriate recreational programming for residents. |
| Infection Control Requirements | Nursing homes are required to comply with public health guidelines related to the prevention and control of infectious diseases. |
| Medicaid Coverage | MassHealth, the state Medicaid program, covers the care costs for eligible MassHealth members residing in a skilled nursing facility certified by state regulations and complying with federal Medicaid participation requirements. Residents are responsible for their own room-and-board costs. |
Facilities in Massachusetts
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