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Nursing Homes in Missouri
Missouri has a lot to offer seniors, including big-city amenities, small town living and beautiful rural scenery. The state has a comfortable climate and a low cost of living that can help stretch budgets. It’s home to around 6.1 million people, and more than 17% are aged 65 and over. Older adults in the state can access a variety of resources and services to help them age comfortably, including world-class hospitals and around 504 nursing homes that provide long-term care. Nursing homes in the state have an average monthly cost of $5,080 for a semiprivate room and $5,749 for a private room. These facilities provide skilled nursing and medical monitoring in addition to rooms, meals and activity programs.
Seniors and their families can use this guide to help plan for their future care. It includes detailed information about the cost of nursing home care, financial assistance and other programs that support seniors as well as details about the rules and regulations governing nursing homes in the state.
The Cost of Nursing Home Care in Missouri
Genworth Financial’s Cost of Care Survey 2020 shows that the average cost of nursing home care in Missouri is $5,080 per month. This is $2,676 lower than the national average of $7,756 monthly. Missouri also has the lowest price among its neighbors. Arkansas has the next highest cost at $5,931, and seniors in Illinois pay $6,235 per month. In Iowa, the average cost is $6,570, while Kansas has the least affordable nursing home care at a cost of $6,692.
Seniors in Missouri may find a wide range of nursing home prices depending on their location. St. Joseph and Columbia have the lowest rates with averages of $4,867 and $4,940 respectively. In Jefferson City, seniors pay $5,019 per month, while the cost in both Cape Girardeau and Springfield is $5,171. In St. Louis, the average is $5,355, and in Joplin, seniors pay $5,566. At $6,844 per month, Kansas City has the least affordable nursing home care in the state.
St. Joseph
$4867
Kansas City
$6844
Columbia
$4940
Jefferson City
$5019
St. Louis
$5355
Cape Girardeau
$5171
Springfield
$5171
Joplin
$5566
Due to the skilled nursing and medical services provided, nursing home care is the most expensive senior care option. The most affordable is adult day care, which provides care in a group setting, such as a community center, to people who live at home. This type of care has an average cost of $1,788 per month. The cost of assisted living facilities that provide room, board and personal care is $3,000 per month. In Missouri, care in the home is more expensive than assisted living. Nonmedical in-home care costs $4,372. Home health care, which provides skilled nursing care in the home, has a slightly higher cost at $4,385. This may be an option for seniors who wish to age in place.
In-Home Care
$4372
Home Health Care
$4385
Adult Day Care
$1788
Assisted Living Facility
$3000
Nursing Home Care
$5080
Does Medicaid Cover Nursing Home Care in Missouri?
MO HealthNet, Missouri’s Medicaid program, can cover some or all of the costs of nursing home care for eligible seniors aged 65 and older. Also known as vendor coverage, the program fulfills the remaining costs after the senior has paid what they can from their existing income.
Approximately 17.5% of Missouri’s population gets assistance from Medicaid. This equates to around 1,081,802 people, although this figure includes younger residents with disabilities and other care needs, not just seniors in residential care facilities. The benefits of long-term care and nursing home services include 24/7 support from qualified medical professionals and affordable access to medications and health care treatments. Missouri has over 81,100 beds in its 1,165 long-term care communities, with 504 of these communities specializing in skilled nursing. For seniors in need of nursing home levels of care who prefer to remain at home, the Department of Social Services provides the Aged and Disabled Waiver. It’s available to adults aged 63 and older, providing in-home services such as home-delivered meals, adult day care and homemaker support.
Medicaid Eligibility in Missouri
In Missouri, a nursing home resident must pay for as much of their care as possible before claiming MO HealthNet nursing home coverage, as the program is designed to only cover shortfalls. The assessor will also factor in the applicant’s sales of real or personal property up to five years prior to the application date. If the applicant has a spouse, their income and assets will be considered too, although the Prevention of Spousal Impoverishment federal law provides a degree of protection.
| Household Size | Number of Applicants | Income Limits Per Year* | Asset Limits: Applicant(s) | Asset Limits: Non-Applicants |
|---|---|---|---|---|
| One Person | 1 | No set limit | $5,726 | |
| Two People | 1 | No set limit | $5,726 | 148,620 |
| Two People | 2 | No set limit |
*Except for a $50/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.
Other eligibility requirements include that the applicant:
- Be an American citizen or legal resident
- Reside in Missouri
- Be screened and certified for nursing home care by the Department of Health and Senior Services
How To Apply for Medicaid in Missouri
There are several ways a senior can apply for Medicaid in Missouri. The simplest and quickest for those comfortable with computers is through My DSS, an online portal available 24 hours a day. Seniors who prefer the paper method can download and print the application form and mail it to the Family Support Division, 615 East 13th Street, Kansas City, MO 64106. Alternatively, they can phone (855) 373-9994 and speak to an adviser who can guide them through the application process. Seniors can also call the number to arrange an in-person appointment with the nearest DSS office. Applications typically take up to 10 working days to process, after which the applicant receives a letter of approval or rejection. Successful applicants also receive an MO HealthNet ID card and clarification of their level of coverage.
Information You Will Need
- Social Security numbers
- Insurance document numbers if you’re a legal immigrant
- Income information for everyone in your household
- Current health insurance policy numbers
- Information regarding job-related health insurance for household members
Additional Medicaid Support & Resources in Missouri
Several organizations operating in Missouri provide free and authoritative information about Medicaid. The following list includes some, with contact details and a brief description of each.
| Resource | Contact | Service |
|---|---|---|
| American Council on Aging | Online Only | The website for the American Council on Aging provides a wealth of information for seniors and their families. It also includes helpful resources, such as a Medicaid Eligibility Test and a Spend Down Calculator. The former helps families determine if their loved ones are eligible for Medicaid, while the latter helps them see where they can spend down their assets to qualify for long-term care benefits. |
| Benefits.gov | (573) 751-3425 | Benefits.gov is a federal website that provides a basic overview of Medicaid in Missouri and examples of eligibility requirements. Users can also check out the maximum pre-tax incomes per household size to see if they're within range and find useful links and telephone numbers to Missouri's MO HealthNet service. |
| Missouri Care Options | (866) 835-3505 | Missouri Care Options is a program administered by the Department of Health & Senior Services to help families choose the best long-term care solutions for their loved ones. The program's primary focus is to help seniors who need nursing home levels of care determine if they're better served in a facility or in their community. This support includes consideration of Medicaid and how the state-sponsored benefit may be used most effectively to fund their care costs. |
| Missouri Foundation for Health | (800) 655-5560 | The Missouri Foundation for Health is an independent philanthropic foundation. It has strong connections to charities and nonprofits throughout the state that assist families in need of Medicaid and other health care resources. The foundation can provide information directly and refer families to more suitable support networks in their communities. Due to the opportunities afforded by Medicaid Expansion, it can offer more support to often-marginalized communities, including Missourians living in rural areas. |
Does Medicare Cover Nursing Home Care in Missouri?
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 Missouri
Medicare can’t pay for long-term nursing home care. However, many resources in Missouri can help seniors gain the most advantage from the state health insurance program to pay for some of their medical care. The following list includes some examples of free-of-charge resources that may be able to help.
| Program | Contact | Service |
|---|---|---|
| Medicare.gov | (800) 633-4227 | Medicare.gov is the federal government's main resource for seniors who want more information about the benefit. It informs visitors about the different plans and provides helpful contact details for local resources. There's also a live chatbot open all year round, except federal holidays, that allows visitors to get information any time of day. |
| CLAIM | (800) 390-3330 | CLAIM is Missouri's State Health Insurance Assistance Program. Trained counselors provide unbiased advice and information about the different Medicare plans, including private health insurance related to Medicare Advantage. The counselors can also help seniors complete and submit their applications and challenge decisions if Medicare is refused. |
| Senior Medicare Patrol program | (888) 515-6565 | The Senior Medicare Patrol program is staffed by volunteers who work with Medicare and Medicaid beneficiaries to detect and report fraud. The long-term purpose of the program is to prevent benefits from being abused by fraudsters who undermine these programs' integrity. Volunteers educate seniors on how to protect their personal details and recognize deceptive behavior by potential fraudsters. They can also help Medicare beneficiaries spot and act upon discrepancies in their health care bills. |
| Medicare Cost Savings Programs | (855) 373-4636 | The Missouri Department of Social Services operates two Medicare Cost Savings Programs to help pay premiums for seniors struggling to meet their commitments. The Qualified Medicare Beneficiary program pays for Medicare Part B premiums, coinsurance and deductibles for seniors already in receipt of Medicare Part A. To qualify, the senior's income must be below 100% of the Federal Poverty Level. The Specified Low Medicare Beneficiary program pays Medicare Part B premiums for seniors whose excess income prevents them from accessing the Qualified Medicare Beneficiary program. |
Other Financial Assistance Options for Nursing Home Care in Missouri
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 Missouri
There are many resources in Missouri 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 |
|---|---|---|
| Missouri Area Agencies on Aging | Missouri's Area Agencies on Aging provide information and assistance that older adults and their families can use to enhance their daily quality of life. They help support seniors' health and wellness through food assistance programs, exercise classes and transportation to medical appointments. The agencies also connect seniors to groups providing in-home services, home modifications and legal assistance. Older Missourians can use local AAA's resources, including case management, respite and caregiver services, to help them maintain their independence and autonomy. |
Cash Assistance Programs
Cash assistance programs in Missouri 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 |
|---|---|---|
| Missouri Lifeline Program | 800-234-9473 | The Missouri Lifeline program grants seniors a price reduction on phone and internet prices, helping them stay connected to loved ones, medical professionals and the rest of the outside world. Interested eligible Missourians within a particular income range must register with a participating internet or phone company if their current provider isn't part of the program. Seniors must submit an application and the appropriate documentation to apply for the program. |
| Missouri Temporary Assistance (TA) | 855-373-4636 | Missouri residents, including seniors, may qualify for Missouri Temporary Assistance if they are the parent or guardian of a child under 18. This cash assistance program provides a monthly payment to those who are eligible. The value of any assets, other than a home and one automobile, must not exceed $1,000. Seniors applying for this program must also meet income requirements. Residents can call (855) 373-4636 to learn more about this financial assistance program. |
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 Missouri seniors afford the nutritious food they need.
| Program Name | Phone Number | Description |
|---|---|---|
| Missouri Meals on Wheels | Missouri Meals on Wheels provides nutritious meals and socialization for statewide seniors ages 60 and over. Those who are mobile enough can attend congregate meals with their peers, while those who are immobile can receive daily meal deliveries to their homes. Each meal delivery includes a safety check, and emergency authorities will be alerted if a fall, accident or emergency situation does arise. Meals are provided on a sliding-fee scale, so they range from free to full cost. | |
| Missouri Supplemental Nutrition Assistance Program (SNAP) | 855-823-4908 | The Missouri Supplemental Nutrition Assistance Program provides qualified seniors with financial help to buy healthy foods. Missouri residents who meet the income requirements for participants ages 60 and older qualify for an electronic benefit once a month that's accepted at food retailers across the state. Other eligibility factors include having resources under $2,750 per person, excluding home, vehicle, life insurance and prepaid burials. Seniors can use the funds to supplement their current food budget, so they can prepare nutritious meals. |
Financial Assistance for Senior Living
Low-income elderly individuals in senior living communities can access financial assistance through local-run programs. These Missouri resources offer advice, guidance and support to help older adults pay for the services offered by long-term care providers.
| Program Name | Phone Number | Description |
|---|---|---|
| Supplemental Nursing Care Waiver | MO HealthNet does not directly pay for nonmedical expenses, such as an assisted living community's board and service fees. If you have MO HealthNet coverage and need help paying for assisted living, you may be eligible for a Supplemental Nursing Care waiver. This waiver helps nursing home-eligible seniors stay out of more intensive levels of senior care by paying for assisted living expenses, including the monthly fee and caregiver help. The program provides a monthly cash allowance that can be paid directly to the assisted living provider to cover common costs of assisted living. |
Free Used Medical Equipment
Due to the high cost of purchasing new medical equipment, several organizations in Missouri 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 |
|---|---|---|
| Missouri Accessibility Medical Equipment | 866-201-3829 | AME provides free in-home assessments to establish participants' equipment needs. Durable medical equipment is available new or used, at a discount for income-eligible participants. |
| Missouri Swap 'n Shop Equipment Exchange Program | 816-655-6700 | Swap 'n Shop operates as a free online exchange program for people in Missouri to trade durable medical equipment and to share information about where to find needed mobility and health aids. |
Legal Resources
Many organizations offer free or low-cost legal services to Missouri seniors. Older adults can access advice on issues such as estate planning, living wills and power of attorney. Some firms also act as long-term care ombudsmen, advocating for the rights of seniors in senior living communities.
| Program Name | Phone Number | Description |
|---|---|---|
| Missouri Coalition for Quality Care | 888-262-5644 | This nonprofit organization advocates for the safety and interests of seniors in long-term care settings throughout Missouri. It strives to hold assisted living facilities accountable for the quality of their care and helps ensure seniors get the assistance they need to live a healthy, comfortable life. MCQC also accepts reports of abuse online and over the phone. |
| Missouri Long-Term Care Ombudsman Program | 800-309-3282 | The Ombudsman program cultivates a network of individuals around the state to assist residents in long-term care facilities in the preservation of their rights. The program coordinates regular visits with residents to help them resolve any challenges they might encounter, and advocates and educates those unable to do so for themselves. |
| Missouri Senior Legal Helpline | 800-235-5503 | As an Older American Act funded program, the Missouri Senior Legal Helpline gets seniors aged 60 and above in contact with a regional lawyer. Older adults can get assistance and limited representation on civil matters such as living wills, advance directives, power of attorney and guardianship. The helpline doesn't provide assistance on criminal matters or traffic-related incidents. |
Senior Centers
Senior centers in Missouri 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 |
|---|---|---|
| Missouri Care Planning Council (MCPC) | 800-989-8137 | The Missouri Care Planning Council (MCPC) is an organization that connects seniors in the state with a wide range of local service providers, long-term care advisors and informational resources. MCPC is focused on long-term planning but is also available for emergency situations. It accepts specific requests for help both over the phone and through its online form. |
Senior Engagement
Senior engagement resources and programs in Missouri 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 |
|---|---|---|
| Missouri Community Options and Resources (MOCOR) | 855-834-8555 | Missouri Community Options and Resources is partnered with the state departments of Health and Senior Services and Social Services to connect residents to appropriate programs in all 114 counties. Through MOCAR, older adults can access help with the activities of daily living, transportation, meals, housework, cooking and caregiver respite. Seniors must be on Medicaid to be eligible for MOCOR services. The minimum age is 63 for some resources, while most are available at age 65. |
| Missouri DHSS Division of Senior and Disability Services | 573-751-6400 | The Missouri DHSS Division of Senior and Disability Services preserves the health and independence of the state's seniors through an extensive roster of programs. These include adult day care, a meal program to help seniors meet their nutritional needs and a 24/7 Alzheimer's response service that provides emergency medical treatment. The agency also maintains an elder abuse hotline families can contact around the clock to report health and safety concerns in long-term care. |
Social Security Offices
Social Security offices in Missouri 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 |
|---|---|---|
| Missouri 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. |
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. Missouri 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 |
|---|---|---|
| Missouri Low Income Home Energy Assistance Program (LIHEAP) | 855-373-4636 | LIHEAP programs are administered on the local level in Missouri, and which program you apply to depends on where you live. These programs can pay a portion (up to 50%) of your gas and electricity bills, while a related program helps with the cost of water and sewer fees. Emergency bill payment assistance may also be available if you're in danger of disconnection. |
| Missouri Low Income Household Water Assistance Program (LIHWAP) | 855-373-4636 | The Low Income Household Water Assistance Program (LIHWAP) may be able to help you with a one-time payment for your water and/or wastewater (sewer) bill from November - September. The maximum amount you could get is $750.00. LIHWAP can help with: • Disconnection or reconnection fees • Threat of disconnection • Past due and current bills |
| Missouri Water/Wastewater Utility Bill Credit Program | 816-439-4460 | Qualified seniors are eligible for a 15% reduction in their water and wastewater rates through Liberty's Utility Bill Credit Program. Older adults must provide paperwork proving they meet certain requirements to receive the bill credit. |
Veteran's Services
Missouri 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 |
|---|---|---|
| Missouri VA Benefits and Health Care | Missouri VA Benefits and Health Care provides medical services to senior veterans. These centers are located throughout the state and provide claims assistance, counseling and other services that may help veterans and their families. Missouri also hosts multiple senior centers for veterans where recreational, social and education opportunities are available. All veterans can reach the Crisis Line by dialing 988 and pressing 1 for immediate telephone assistance. | |
| Missouri Veterans Care Coordination | 855-380-4400 | Veterans Care Coordination is a nonprofit organization based in Saint Louis that strives to connect veterans in the community with affordable long-term care options, including assisted living facilities. It works with veterans and their families to ensure they get the pensions and Aid & Attendance benefits they deserve. It also coordinates the delivery of care at home or in assisted living, making lives easier for eligible families. |
| Veterans Services Program | 314-253-4455 | The Veterans Services Program in Jefferson City, MO, provides counseling and support for veterans and their dependents. Accredited Veterans Services Officers can assist eligible seniors with completing applications for VA benefits. VSOs can also provide advice about survivor's benefits, burial payments, disability payments and health care. A VSO is available Monday to Friday from 7:30 a.m. to 3:30 p.m. |
Nursing Home Laws and Regulations in Missouri
| Topic | Rule |
|---|---|
| Licensing Requirements | Nursing homes in Missouri must be licensed by the Department of Health and Senior Services, and licenses are valid for up to two years unless revoked earlier. |
| Staffing Requirements | Missouri nursing homes must hire a director who has a current license as a nursing home administrator in the state. There must also be a supervising physician available to coordinate medical care, and a registered nurse (RN) must be appointed as director of nursing. Nursing personnel must be on duty at all times on each resident-occupied floor with an RN on duty during day shifts. An RN or licensed practical nurse (LPN) can be on-site during evening and night shifts. |
| Staff Training Requirements | Staff providing nursing services must be licensed to deliver those services. Nursing assistants must complete the state-approved training program. In addition, facilities must organize orientation and continuing education programs for all staff. |
| Admission Restrictions | Facilities must not knowingly admit residents who have needs that they can’t meet. Resident’s needs can be met by the facility directly or through contracts with outside providers. |
| Care Planning Requirements | Care plans must be completed within 14 days of admission. The plan should be revised at least once every 90 days or when a resident’s medical status changes. |
| Dietary and Nutritional Services Requirements | Residents must be served three nutritious meals per day that are properly prepared. The menu must take into consideration residents’ preferences and physicians' orders if applicable. Residents’ dietary needs must be regularly assessed by a qualified professional, such as a dietitian or registered nurse, and reported to the physician. Facilities must employ a food service supervisor who oversees dietary services. |
| Specialized Rehabilitative Services | Missouri nursing homes must be able to provide rehabilitation services to residents according to their needs. A qualified therapist must perform the services according to a physician’s orders. If the facility can’t provide the service directly, they must make arrangements with an outside provider. |
| Medication and Pharmaceutical Services | A licensed pharmacist must assist in developing policies and procedures relating to pharmaceutical services in the facility. Medication can only be provided with a written order from a licensed professional. The only individuals allowed to administer medications are licensed physicians, licensed nurses and medication technicians who have completed a state-approved course. |
| Activities Requirements | Facilities must provide activity programs on a regular basis that take into account the needs and capabilities of residents, and a designated employee must be responsible for the program. Each resident should have a written recreation program that includes individual and group activities as well as events outside the facility. |
| Infection Control Requirements | Nursing homes must have infection control policies and procedures, and all staff must receive training in these protocols. Facilities must report any communicable diseases to the state within seven days of diagnosis. |
| Medicaid Coverage | The cost of nursing home care for eligible seniors is covered by Medicaid in Missouri. To qualify, seniors must be assessed as requiring nursing home care, and they must meet income, asset and citizenship requirements. |
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