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Nursing Homes in New Hampshire
New Hampshire is an aging state with a growing population of older adults. Senior citizens aged 65 and older already account for more than 18.7% of the state’s 1,359,711 residents, and this number is expected to increase as more baby boomers enter their golden years.
It’s estimated that 70% of older adults will require long-term services and supports, and nearly half will require paid care during their lifetimes. Many older adults receive personal care and medical services from assisted living centers or home health agencies. Individuals with more significant needs can choose from 74 licensed nursing homes that provide skilled 24-hour care for subacute medical conditions.
The average cost of skilled nursing in New Hampshire is $10,646 for a semiprivate room or $11,315 for a private room, which is higher than the national average and most neighboring states. This guide explores long-term care costs in New Hampshire as well as financial assistance programs, such as Medicaid. It also includes helpful information about state regulations, nonprofit resources and free services that are available to seniors and caregivers.
The Cost of Nursing Home Care in New Hampshire
Nursing homes in New Hampshire typically charge $10,646 per month according to provider responses collected in the Genworth Cost of Care Survey 2020. Average rates are $2,890 higher than the U.S. median of $7,756, which represents an increase of 37%. New Hampshire is also more expensive than most neighboring states with the exception of Massachusetts, where seniors pay $12,623 per month for skilled nursing. In other parts of New England, rates are more competitive. Seniors in Vermont pay $9,779 per month, or $867 less, and rates in Maine are about $1,000 lower at $9,642. Rhode Island is also more affordable. Seniors in the nation’s smallest state pay $1,977 less per month of skilled care than their counterparts in New Hampshire.
Manchester is one of 440 metropolitan areas included in Genworth Financial’s long-running Cost of Care Survey. Most of the state’s largest cities, including Nashua, Concord and Derry, fall within this geographic region. In these communities, seniors can expect to pay $11,330 per month for skilled nursing, which is $686 more than the state median. New Hampshire compares favorably to cities in Massachusetts, including Worcester and Boston where seniors pay $12,486 and $13,383 per month, respectively. Burlington, Vermont, is slightly more affordable than Manchester at $10,737, and nursing homes in Maine provide a more competitive value. Seniors in Portland pay $10,220 per month, and average rates in Lewiston are $1,521 lower than the New Hampshire median at $9,125.
Manchester
$11330
Burlington, VT
$10737
Portland, ME
$10220
Lewiston, ME
$9125
Boston, MA
$13383
Worcester, MA
$12486
Long-term care prices vary significantly depending on the type of services provided. In New Hampshire, adult day health care is the most affordable option. Programs that provide recreational activities and daytime care in a group setting cost $1,842 per month on average. In-home care costs $5,434 per month or $5,577 with added medical support. Assisted living facilities in New Hampshire cost $6,650 per month, which is significantly higher than the U.S. median of $4,300. At $10,646 per month, nursing homes charge almost $4,000 more due to the level of skilled care they provide 24 hours a day.
In-Home Care
$5434
Home Health Care
$5577
Adult Day Care
$1842
Assisted Living Facility
$6650
Nursing Home Care
$10646
Does Medicaid Cover Nursing Home Care in New Hampshire?
Over 227,000 residents are enrolled in New Hampshire’s Medicaid program. For qualifying seniors looking for long-term care, the program can pay for the cost of room and board, as well as various types of rehabilitation therapies and assistive devices. Pharmaceutical services and visits with in-house physicians are also covered by Medicaid.
New Hampshire is home to over 70 nursing homes, all of which accept Medicaid. Seniors who may benefit from in-home care can apply for home and community-based services waivers, which can delay nursing home placement and allow seniors to remain in their own home while still receiving the appropriate level of care. Services typically include housekeeping and nursing care, in addition to emergency response system installation.
Medicaid Eligibility in New Hampshire
When applying for Medicaid in New Hampshire, single applicants can have a monthly income of $2,742 or less ($32,904 per year), along with $2,500 in assets. The requirements are the same for a two-person household with only one applicant. However, the Spousal Impoverishment Act allows non-applicant spouses to have up to $148,620 in assets. For couples, the monthly income cap is $5,484 ($65,808 per year), and assets can’t exceed $5,000.
| Household Size | Number of Applicants | Income Limits Per Year* | Asset Limits: Applicant(s) | Asset Limits: Non-Applicants |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,500 | |
| Two People | 1 | $32,904** | $2,500 | $148,620 |
| Two People | 2 | $65,808*** | $5,000**** |
*Except for a $74/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.
***Income is limited to $2,742 per month per spouse.
****Assets are limited to $2,500 per spouse
Along with financial limitations, individuals must be medically needy and meet citizenship requirements. In some cases, the applicant can “spend down” on necessities to meet the income and asset limits, if they meet the other requirements as well. To be approved, applicants are required to:
- Be 65 years of age or older
- Reside in New Hampshire
- Be in need of skilled nursing care
How To Apply for Medicaid in New Hampshire
Individuals can apply for Medicaid online using the NHEASY Gateway to Services. For questions or issues using the website, call customer service at (844) 275-3447. The Medicaid application can be printed out and mailed in or faxed to (603) 271-8604. Applications are also accepted in person at local Department of Health and Human Services (DHHS) offices or over the phone by calling (800) 852-3345. Applicants should prepare the appropriate documents beforehand to prevent delays in the application process. It can take up to 3 months for an application to be reprocessed and approved.
Information You Will Need:
- Birth certificate or other proof of age
- Medicare cards
- Social Security card, or green card if born outside the United States
- Proof of earned and unearned income, including stocks and 1099s
- Bank statements from the previous 60 months prior to the date on the application
- Proof of private and government pensions, including a letter of verification from the provider
- Car registration and insurance
- Copies of life insurance
- Proof of any real property sold or transferred in the previous 60 months
- VA discharge papers (DD 214), for veteran applicants
- Any other documents supporting the applicant’s claim
Additional Medicaid Support & Resources in New Hampshire
Seniors and families applying for Medicaid in New Hampshire may find assistance through any of the websites listed below. Both the Medicaid Planning Assistance and Benefits.gov sites go into detail about eligibility requirements and offer free online eligibility tests.
| Resource | Contact | Service |
|---|---|---|
| Medicare Savings Program | (603) 271-9700 | The Medicare Savings Program helps low-income seniors and families pay for medical costs associated with Medicare Parts A and B. There are three tiers to the program to assist individuals based on their needs and eligibility. The program can cover premiums and deductibles, along with full medical assistance coverage for qualifying individuals. |
| Medicaid Planning Assistance | Online Only | Medicaid Planning Assistance, a website overseen by the American Council on Aging, provides in-depth and state-specific guides to Medicaid eligibility and nursing home placement. Individuals can also read about how Medicaid works with other benefits, such as VA pensions, and how to apply for HCBS waivers. In addition to a Medicaid eligibility test, the website can also help find affordable Medicaid planners. |
| Benefits.gov | (800) 852-3345 | Benefits.gov, which is administered by the U.S. Government, is the official website for resources ranging from disaster assistance to medical programs that focus on the long-term care needs of seniors. Financial assistance, such as tax relief and housing assistance programs, is also available. The Social Security Administration provides a Benefit Eligibility Screening Tool (BEST) to give seniors peace of mind during the application process. |
Does Medicare Cover Nursing Home Care in New Hampshire?
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 New Hampshire
Medicare doesn’t cover the cost of nursing care past the first 2 days, but it does give families time to find other ways to pay for long-term care. Below is a short list of organizations and programs that can assist seniors with applying and maintaining their Medicare benefits.
| Program | Contact | Service |
|---|---|---|
| New Hampshire State Commision on Aging | (603) 271-0527 | The New Hampshire State Commission on Aging advocates for aging adults and coordinates their efforts with the Department of Health and Human Services and the Bureau of Elderly and Adult Services to help seniors find the resources they need. Seniors and families can subscribe to a monthly newsletter that covers topics such as new laws affecting seniors and how to spot common Medicare scams. |
| New Hampshire State Health Insurance Assistance Program (SHIP) | (866) 634-9412 | Provided by the ServiceLink Aging and Disability Resource Center, New Hampshire SHIP offers free and unbiased insurance counseling to Medicare beneficiaries. Counselors are certified by the state to assist seniors with filing claims and appealing claim denials, as well as reporting fraudulent transactions found on monthly statements. Qualifying seniors can apply for financial aid to cover out-of-pocket expenses for prescription medication and medical supplies. |
| BenefitsCheckUp | (800) 794-6559 | BenefitsCheckUp is a free online tool provided by the National Council on Aging. It helps users find services and programs that can assist with long-term care and financial aid. After answering a quick questionnaire, users use their zip code to find resources closest to them. Available in English and Spanish, the website connects users to over 2,500 federal and state benefits. |
| Medicare.gov | (800) 633-4227 | The official Medicare website provides a self-service portal for applying and managing benefits, as well as finding local Medicare-registered providers and medical equipment suppliers. Seniors can find information about health insurance policies and supplemental plans, as well as a 24/7 live chat feature and a directory for finding local professionals. |
Other Financial Assistance Options for Nursing Home Care in New Hampshire
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 New Hampshire
There are many resources in New Hampshire 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 |
|---|---|---|
| New Hampshire Adult & Aging Care | 800-351-1888 | New Hampshire Area Agencies on Aging are services that help adults ages 60 and older, or 18 and older with a disability, live independently. AAA programs in New Hampshire assist older adults with nutritious, hot, home-delivered meals and community dining, which offers socialization opportunities and promotes overall wellness. Other vital services include transportation to help seniors get to medical and dental appointments, obtain groceries and reach other destinations. |
Cash Assistance Programs
Cash assistance programs in New Hampshire 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 |
|---|---|---|
| New Hampshire Lifeline Program | 800-234-9473 | The LifeLine Program offers a discount on landline or mobile telephone service, ensuring that participants can stay in contact with loved ones. |
| New Hampshire Old Age Assistance | 844-275-3447 | New Hampshire residents aged 65 years or older can apply for Old Age Assistance cash benefits under the State Supplemental Program. An applicant must have a Social Security number and meet certain income and financial resources requirements. Income limits vary according to seniors' living arrangements, whether they're living on their own, with family members or in an assisted living facility. Seniors undergo interviews upon completion of application forms. |
Financial Assistance for Senior Care and Senior Living
Whether living in their own home or in a senior living community, New Hampshire seniors can find financial assistance from numerous local resources. These organizations help residents cover some of the costs associated with in-home or long-term care and connect them with other helpful community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| New Hampshire Choices for Independence Waiver | 800-351-1888 | The NH Choices for Independence Waiver helps seniors receive the support and care they need, whether in an institutional setting like a nursing home or other community facilities. The Waiver can be used to cover the cost of personal care services, home health aides, transition services, skilled nursing care and durable medical equipment. It can also be used for respite care and case management services. The program is open to seniors aged 65 and over, as well as younger adults who are living with a disability. Under Choices for Independence, seniors are given a case manager who will work with them to develop a care plan that either allows them to live independently in their home or helps them access the skilled nursing care they require in order to maintain a high quality of life. |
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 New Hampshire seniors afford the nutritious food they need.
| Program Name | Phone Number | Description |
|---|---|---|
| New Hampshire Meals on Wheels | New Hampshire Meals on Wheels runs independently operated food assistance programs throughout the state. Eligibility is open to seniors ages 60 and over and those unable to shop for groceries or prepare their own meals. Meals are served in a congregate setting to help reduce isolation or delivered to seniors' front doors with a friendly visit and safety check. Although additional services vary, they may include pet meal delivery, telephone reassurance and transportation services to local health care appointments. | |
| New Hampshire Supplemental Nutrition Assistance Program (SNAP) | 844-275-3447 | The New Hampshire Supplemental Nutrition Assistance Program helps low-income residents obtain healthy food. Adults 60 and over who meet household size, income, expense and resource guidelines are eligible. Qualified seniors receive Electronic Benefits Transfer cards that are accepted at most grocery stores and supermarkets statewide. EBT card funds can buy dairy products, bread, rice and pasta, meat, fish and fresh produce. However, they cannot be used to purchase alcohol, tobacco, prepared foods or personal care items. |
Free Used Medical Equipment
Due to the high cost of purchasing new medical equipment, several organizations in New Hampshire 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 |
|---|---|---|
| New Hampshire Loaner's Closet | 603-432-8077 | The Community Caregivers of Greater Derry maintains a large medical equipment loan closet that includes a variety of mobility aids and other equipment. |
Health Insurance & Prescription Drug Coverage for Seniors
New Hampshire 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 |
|---|---|---|
| New Hampshire Medication Bridge Program | 603-225-0900 | The NH Medication Bridge Program is sponsored by the Foundation for Healthy Communities. It helps individuals access prescription medications they might not otherwise be able to afford. |
| New Hampshire Rx Card | 800-9313-5542 | This is the state's free prescription assistance program. Residents can apply for a card that grants automatic discounts of up to 80% on prescription drugs at participating pharmacies. The program aims to help those who are uninsured or underinsured access affordable medication. |
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 New Hampshire have different eligibility criteria and often assist retirees by providing grants or loans.
| Program Name | Phone Number | Description |
|---|---|---|
| New Hampshire Section 504 Home Repair Program | 603-223-6035 | The Section 504 Home Repair Program offers loans of up to $40,000 and grants of up to $10,000 for senior homeowners to make essential home improvements. The program is aimed at seniors who would otherwise not be able to cover the cost of home repairs. |
Legal Resources
Many organizations offer free or low-cost legal services to New Hampshire 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 |
|---|---|---|
| New Hampshire Legal Aid | 800-639-5290 | New Hampshire Legal Aid provides free legal services to those aged 60 and over in Dover and can help individuals navigate issues such as wills and trusts, guardianship and powers of attorney. This agency can also help older adults apply for benefits, such as Social Security and Supplemental Security Income. |
Senior Centers
Senior centers in New Hampshire 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 |
|---|---|---|
| New Hampshire Catholic Charities | 603-669-3030 | This faith-based charity offers a variety of programs that may be of use to local seniors, including financial literacy education, mental health services and legal aid. Health care services are also available, including dental, podiatry and optometry consultations. The CareGivers program connects volunteers with elderly citizens in need of transportation, chore assistance or friendly visits. |
Social Security Offices
Social Security offices in New Hampshire 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 |
|---|---|---|
| New Hampshire 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 New Hampshire 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 |
|---|---|---|
| New Hampshire Elder Property Tax Exemption | 603-230-5000 | The Elder Property Tax Exemption offers a reduction in property taxes for seniors who are homeowners. The state has additional exemptions for veterans and those living with certain disabilities. |
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. New Hampshire 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 |
|---|---|---|
| New Hampshire Electric Assistance Program (EAP) | 800-735-2964 | The Low Income Home Energy Assistance Program helps those who live in eligible households meet their utility bills. It offers support in the form of a one-time payment during the coldest months of the year. |
| New Hampshire Fuel Assistance Program | 800-735-2964 | The New Hampshire Fuel Assistance Program, part of the Low Income Home Energy Assistance Program, helps qualifying New Hampshire seniors stay warm during the cold months. The primary way it assists is by providing financial help for heating costs ranging from $243 to $2,419, with the average totaling $1,530.25. Aid may also be available for shut-off notices, emergency fuel delivery and referrals. Eligibility is based on income, the home's number of residents and energy costs totaling $100+. |
Veteran's Services
New Hampshire 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 |
|---|---|---|
| New Hampshire VA Benefits and Health Care | New Hampshire VA Benefits and Health Care provides resources for senior veterans, with supportive services available through VA health and benefit offices. Seniors and their families can receive medical care, apply for benefits, receive mental health counseling and learn about cemetery benefits for senior vets in New Hampshire. Seniors can call (800) 698-2411 for further assistance. |
Nursing Home Laws and Regulations in New Hampshire
| Topic | Rule |
|---|---|
| Licensing | Nursing homes and residential care facilities in New Hampshire are licensed and overseen by the Department of Health and Human Services, Health Facility Licensing Unit. |
| Staffing | Facilities must maintain sufficient staff to meet residents' needs during all hours of operation. Licensed nursing staff must be on-site 24 hours a day, and an RN must be available for at least eight hours during every 24-hour period. |
| Staff Training | All personnel, including nurses, clinical staff, administrators and food service employees, must be adequately trained and have demonstrated their ability to perform assigned tasks adequately. Additionally, facilities must conduct annual in-service training to instruct members on the facility's policies and procedures. Certified nursing assistants in New Hampshire must complete at least 100 hours of training through a state-approved program. |
| Admission Restrictions | Nursing homes may not admit residents under 18 unless the facility has appropriate age- and gender-segregated accommodations. |
| Care Planning | At the time of admission, nursing homes must obtain orders for medication, treatment, diet and direct care from a licensed practitioner to ensure the residents' health and safety. Individuals must undergo a comprehensive medical exam at least once every 30 days for the first 90 days and once every 60 days thereafter. Additionally, facilities must perform an initial needs assessment within 48 hours and a comprehensive needs assessment within 14 days of admission. |
| Dietary and Nutrition Services | Nursing homes must provide at least three daily meals to each resident, including therapeutic dietary options if ordered by a qualified medical provider. Facilities must have adequate dining facilities and food supplies, and they must follow record-keeping requirements, such as posting menus in advance and documenting residents' nutritional intake and compliance with special diets. |
| Specialized Rehabilitative Services | Skilled nursing facilities may provide rehabilitative treatments and therapeutic services as part of a physician-ordered direct-care plan. |
| Medication and Pharmaceutical Services | Nursing homes must provide all medications, including over-the-counter drugs, as directed by a qualified practitioner. Medications must be provided within 24 hours of the order, and facilities must meet strict standards for dispensing, labeling and tracking residents' medications. |
| Recreational Activities | Nursing homes must provide on-site or community-based activities that accommodate residents' interests and promote their physical, social and emotional well-being. |
| Infection Control | Nursing homes must establish a comprehensive infection control program that includes provisions to prevent the spread of diseases, manage residents who have contagious illnesses and monitor the health of employees who provide direct care. |
| Medicaid Coverage | Medical Assistance, the state's Medicaid program, pays for nursing home care, including room and board. Individuals must meet income and asset limits to qualify, and they must use the majority of their income to pay for nursing home care before benefits become available. |
Facilities in New Hampshire
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