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. 

$9247

California

$7756

The United States

$10114

Oregon

$9262

Nevada

$6844

Arizona

$9581

Washington

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. 

$9946

Sacramento

$8060

Los Angeles

$10722

San Diego

$12471

San Francisco

$12547

San Jose

$7787

Fresno

$8060

Bakersfield

$7756

Riverside

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.

$5529

In-Home Care

$5529

Home Health Care

$1733

Adult Day Care

$5000

Assisted Living Facility

$9247

Nursing Home Care

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 $17,772 for a single person or $24,036 for a two-person household.

Seniors are permitted to have $2,000 in disregarded assets or $3,000 for a couple. A person’s primary home and vehicle are not considered when evaluating assets, and a nonapplicant spouse can retain $137,400 in nonexempt assets.

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.

Resource

Contact

Service

(916) 552-9200

The myMedi-Cal program includes a variety of informational resources to help seniors understand and apply for the financial support that's available to them. Medi-Cal includes waivers to help seniors pay for long-term care as well as in-home care, day care and services that allow seniors to remain in the community for as long as possible.

(916) 554-0111

This association is a statewide organization providing a network of services for older adults living in California. It is a nonprofit organization representing the 33 Area Agencies on Aging covering the state. Seniors can contact the C4A to be connected with their local AAA to request information and support with home- and community-based services, Medicare, Medi-Cal and other programs.

(800) 541-5555

The Department of Health Care Services oversees the provision of Medicare and Medi-Cal in the state. It also offers a helpline for seniors who need information about Medi-Cal, would like to know more about the benefits available or have a concern or complaint about the program.

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.

Resource

Contact

Service

(800) 434-0222

The California Health Insurance Counseling and Advice Program provides information and support for seniors who need help understanding Medicare and Medi-Cal. The program is open to those aged 65 and over as well as those who are living with a disability that makes them eligible for Medicare. Trained counselors answer questions and provide help with the application process.

(800) 434-0222

The California Department on Aging oversees a variety of services for older adults in the state, including a helpline for those who need advice about their current and future health insurance options. Seniors can call the helpline to get advice about planning for the future and ways to maximize their current insurance coverage.

(916) 465-8104

California Health Advocates is a nonprofit offering Medicare advocacy and education for seniors living in the state. It works alongside other state and nationwide organizations to advocate for seniors about Medicare-related issues. It also runs outreach sessions and offers support to seniors who need help understanding their Medicare options.

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.

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 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.

Resource

Contact

Service

(800) 952-5626

The Department of Veterans Affairs offers advice and support to veterans and their immediate families. This support includes information about health benefits and insurance as well as help completing application forms.

(800) 231-4024

The Long-Term Care Ombudsman represents residents of long-term care facilities, including assisted living communities and nursing homes. Seniors and their loved ones can call the ombudsman with concerns about the quality of care being provided, rehabilitation or safety. The ombudsman can also assist with some issues relating to Medicare, Medi-Cal and certain benefits.

(800) 677-1116

Eldercare Locator is a service that connects older adults and their families with local care providers and other supportive services. The service is run by the U.S. Administration on Aging and offers free advice about housing, transportation, benefits and health care services for seniors. The service can also provide some advice about support for caregivers.

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

Rules for California Communities

Are loved ones allowed to visit to provide emotional support?

Yes (Conditions Apply)

Are relatives allowed to visit for end-of-life care?

Yes

Are residents required to quarantine after visiting with a loved one?

No (Conditions Apply)

Are visitors required to wear PPE (including masks) in order to visit residents?

Yes

Are non-medical contractors (such as hairdressers and entertainers) allowed in senior living facilities?

Yes (Conditions Apply)

Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?

Yes

Are visitors checked for elevated temperatures?

Yes

Are visitors required to answer questions about health, travel, and potential virus contact?

Yes

Outings & Social Activities

Rules for California Communities

Are residents allowed to leave (errands, visiting family, etc.) for non-medical reasons?

Yes

Are residents who leave required to quarantine when they return?

No (Conditions Apply)

Are senior living communities required to cancel all group outings?

Not Available*

Are residents allowed to eat meals together in a common area?

Yes (Conditions Apply)

Are residents allowed to gather in common areas for group activites?

Yes (Conditions Apply)

*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

Rules for California Communities

Are staff members regularly required to do a temperature check?

Yes

Are staff members regularly tested for COVID-19?

Yes

Are staff members members regularly required to do a health and safety screening, including questions about travel, contact with positive cases, etc?

Yes

Are residents regularly screened for COVID-19 symptoms?

Yes

Are residents regularly checked for elevated temperatures?

Yes

Are residents regularly tested for COVID-19?

Yes (Conditions Apply)

Nursing Home Laws and Regulations in California

Nursing Home Laws and Regulations in California
Licensing Requirements
Skilled nursing facilities (SNFs) in California may be a health facility or distinct part of a hospital. All SNFs must be licensed by the California Department of Public Health. Separate licenses are required for SNFs that are maintained on different premises, even if they’re under the same management. California also has intermediate care facilities (ICFs), which offer a lower level of care, and must also be licensed.
Staffing Requirements
SNFs in California must employ sufficient nursing staff to provide a minimum daily average of 3.5 hours of nursing care per patient, per day. The staff-to-patient ratio is as follows:Day shift: one direct caregiver for every 5 patientsEvening shift: one direct caregiver for every 8 patientsNight shift: one direct caregiver for every 13 patientsIn addition, facilities must have a registered nurse or licensed vocational nurse awake and on duty at all times. Larger facilities must also have the director of nursing services available.
Staff Training Requirements
Staff provided skilled services, such as skilled nursing or physical therapy, must be trained and licensed to provide these services. Unlicensed caregivers, such as nurse assistants, must complete an approved training program prior to employment.All facilities must have an ongoing educational program that develops and improves the skills of staff. At least once every two years staff must also receive training in discrimination prevention. 
Admission Restrictions
California SNFs can only admit patients on a physician’s orders and cannot accept a resident if they can’t provide adequate care.
Care Planning Requirements
Residents of SNFs must have an individual care plan developed by their physician, the resident or their representative and facility staff. It must be completed within 14 days of admission and reviewed at least every 90 days or when the resident’s medical status changes.
Dietary and Nutritional Services Requirements
California SNFs must employ a dietitian either full-time, part-time or on a consulting basis. If there’s no full-time dietitian, a dietetic services supervisor must be employed to manage food services. 
Specialized Rehabilitative Services
SNFs can choose to provide optional services. The following types of optional services can be offered in a nursing home:Physical therapyOccupational therapySpeech therapySpeech pathologyAudiologySocial work servicesSpecial treatment program services. Each optional service unit in a SNF must be approved by the department. 
Medication and Pharmaceutical Services
SNFs must arrange for pharmaceutical services to be available to provide residents with prescribed drugs and biologics. Dispensing, labeling, storage and administration of these substances must comply with state and federal laws. In addition, if a pharmacy is located on the premises, it must be licensed by the California State Board of Pharmacy and approved by the department.
Activities Requirements 
California nursing homes must employ experienced activity program personnel to manage an activity program that meets the needs and interests of individual residents. It should be designed to support physical and mental health and help residents maintain social, physical and emotional functioning. The program should have individual, small and large group activities available daily. Each resident must also have an activity plan that is reviewed quarterly and approved by the attending physician. 
Infection Control Requirements 
All nursing homes must establish policies and procedures regarding infection control in the facility. This must be reviewed annually. The facility must report all incidents of communicable diseases and outbreaks of infectious or parasitic disease to their local health officer. In addition, all incoming residents and new staff must be screened for tuberculosis. 
Medicaid Coverage
In California, Medi-Cal covers nursing home care for eligible individuals. To qualify for Medi-Cal, applicants must meet asset requirements and a physician must deem that nursing home care is medically necessary for the applicant. 

Nursing Homes Facilities in California (203)