Nursing Homes in Colorado

Out of the 5,758,736 people living in Colorado in 2019, more than 840,000 (14.6%) were aged 65 or older. During the same year, just over 16,000 people lived in certified nursing facilities. Colorado has plenty to offer older adults in need of skilled nursing and other medical services. The Centennial State has 66 hospitals with a total of 8,132 staffed beds, along with 223 certified nursing facilities, giving residents access to a wide network of physicians and other healthcare providers.

Nursing homes, also known as skilled nursing facilities, provide a variety of medical and personal services to older adults who are unable to live independently. In Colorado, nursing home care costs an average of $8,517 per month for a semiprivate room and $9,733 per month for a private room.

This guide contains detailed information to help older adults and their loved ones understand their options for long-term care. It includes an overview of nursing home costs, a list of agencies that provide information and referrals to relevant resources, and an overview of the regulations Colorado nursing homes must follow.

The Cost of Nursing Home Care in Colorado

When compared to nearby states, Colorado is the most expensive when it comes to nursing home care. The average cost of care in the Centennial State, which comes in at $8,517 per month for a semiprivate room, also exceeds the national average of $7,756. Average costs vary based on several factors, including the location of the facility and the combination of services and amenities provided. With an average of $5,323 per month, Oklahoma has the lowest cost in the region by far. Aside from Colorado, New Mexico has one of the highest average costs at $7,406 per month. Kansas and Utah fall somewhere in the middle with average monthly costs of $6,692 and $6,388 per month, respectively.

The cost of nursing home care ranges from just over $8,000 to more than $9,000 per month in Colorado’s most populous cities. With an average cost of $9,064 per month, Denver is the most expensive; Boulder isn’t far behind at $9,049. Fort Collins comes in at $8,971, while Pueblo and Colorado Springs are at the lower end of the range with average costs of $8,425 and $8,289 per month, respectively.

Several types of care are available to Colorado seniors, including assisted living, adult day care, nursing home care and in-home care services. The cost of these services varies based on the provider and the amount of care provided. With monthly costs averaging $1,625 in Colorado, adult day care is the least expensive. Assisted living facilities offer assistance with some activities, but they don’t provide around-the-clock medical care, so they cost an average of $4,575 per month in Colorado. In-home care eliminates the expense of room and board; as a result, homemaker services and home health care services in Colorado have an average cost of $5,339. Nursing home care is the most expensive option, averaging $8,517 per month for a semiprivate room and $9,733 for a private room.

Financial Assistance for Nursing Home Care in Colorado

Most people do not pay for skilled nursing care entirely out-of-pocket. Rather, they utilize financial assistance programs to help cover the cost of nursing care. Of public financial assistance programs, Medicaid provides the most comprehensive coverage of nursing home care. But, not all seniors are eligible for Medicaid. And because each state operates its own Medicaid program within federal guidelines, eligibility and benefits vary from state to state. Below, we provide more information on Medicaid in Colorado.

Colorado’s Medicaid Program

Colorado’s Medicaid program, Health First Colorado, covered 1,159,629 individuals as of December 2020. This total includes 37,798 adults aged 65 and older, and 11,025 disabled adults between the ages of 60 and 64. In 2016, the program spent an average of $320 per person on long-term care services and supports for older adults and adults with physical disabilities; as a result, Medicaid Home & Community-Based Services accounted for 66% of all LTSS spending in the state.

Health First Colorado may cover some of the costs of nursing home care for Colorado seniors. To qualify for nursing home coverage, the enrollee must require the type of care provided in a skilled nursing facility, such as assistance with activities of daily living, 24/7 supervision and nutrition management. Colorado has 223 certified nursing facilities ready to provide this type of care. Applicants must also meet eligibility requirements regarding their income and financial resources to qualify for coverage under Colorado Medicaid.

Medicaid Eligibility in Colorado

Health First Colorado is available to low-income residents who are U.S. citizens, legal aliens, permanent residents or U.S. nationals. Applicants must not have income totaling more than 133% of the federal poverty level (FPL), which is $16,971 before taxes for a single individual. As household size increases, the income limits also increase; for example, a household of four people has an annual limit of $34,846 before taxes.

Seniors can apply for coverage on the Health First Colorado website.

Alternative Financial Assistance Options

• Medicare: Medicare will cover the cost of one’s care in a skilled nursing facility for the first 20 days of their stay, and a portion of the costs up until day 100. After 100 days, the individual is responsible for all costs. Seniors must also have a “qualifying hospital stay” of at least 3 days prior to their admission to a nursing home in order to qualify for Medicare coverage.
• Aid and Attendance: 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: 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. This type of funding can be especially useful for married couples when only one partner needs nursing care, as the other residents of the home may continue living there. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.
• Long-Term Care Insurance: Seniors who already have long-term care insurance may be covered for skilled nursing care. Most policies cover at least a portion of the cost of nursing home care, but it depends on the specific policy terms. Note that older adults who are already in need of skilled nursing care will not be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in Colorado

Several government agencies and nonprofit organizations have resources available to help Colorado seniors who need more information on nursing home care. Some of these organizations provide referrals to local services, while others oversee nursing homes and make sure they meet the basic standard of care for residents.

Resource	Contact	Service
Colorado Association of Area Agencies on Aging	(970) 264-0501	The Colorado Association of Area Agencies on Aging is made up of 13 regional agencies that provide information and referrals to seniors in need of skilled nursing care and other long-term services and supports. The CAAoA website also maintains a list of national and Colorado-based resources for seniors.
Colorado Facility Comparison Tool	(303) 692-2000	The Colorado Department of Public Health & Environment offers a facility comparison tool for seniors in need of long-term care. Seniors can search by facility name, city, county, facility type and/or type of service provided to find information on recent inspections and citations.
Colorado State Health Insurance Assistance Program	(888) 696-7213	Colorado SHIP has trained staff available to help seniors and their family members make decisions regarding long-term care and other aspects of aging. The goal of SHIP is to help seniors maximize their insurance benefits and ensure they have access to the care they need.
Long-Term Care Ombudsman	Contact Your Local Area Agency on Aging	Colorado’s long-term care ombudsman advocates for the health and safety of seniors living in nursing homes and other long-term care facilities. Each ombudsman is responsible for inspecting nursing homes and following up on complaints submitted by Colorado seniors and their caregivers.
Colorado Medicaid In-Home Support Services	(800) 221-3943	Seniors who are eligible for the Elderly, Blind and Disabled Medicaid waiver may qualify for in-home support services to delay their admission to a skilled nursing facility. A case manager works with each beneficiary to determine which services are needed, hires attendants, arranges for backup services and ensures that attendants are supervised by a nurse. Under the IHSS program, seniors can get help with bathing, getting dressed and performing other activities of daily living. Homemaker assistance, or help with housekeeping, laundry and other household tasks, is also available.

Nursing Home Laws and Regulations in Colorado

Licensing Requirements	Each private nursing home in Colorado must obtain a license to operate from the Colorado Department of Public Health & Environment. Governmental facilities must obtain a certificate of compliance. Facilities with more than one location must obtain a separate license for each location. To obtain a license, facility administrators must submit a completed application and licensing fee, schedule an inspection and demonstrate that the facility is in compliance with all relevant regulations.
Staffing Requirements	Every facility must have a staffing plan with details on the distribution of personnel and an explanation of how personnel will be replaced if they leave the facility. Each facility must also have a medical director who’s responsible for acting as a liaison between the nursing home and outside medical providers. The facility administrator must have an active Colorado nursing home administrator license in good standing.
Staff Training Requirements	Nursing homes must provide on-the-job training to ensure employees have the knowledge and skills needed to provide quality care to residents. All staff members must receive annual training on topics such as infection control, accident prevention, fire safety, resident rights, disaster preparedness and person-centered care, among others. The facility must document all completed training and retain the records.
Admission Restrictions	SNFs are only permitted to admit residents whose needs can be met with the facility’s existing services. A new resident can’t be admitted unless a standard resident bedroom is available. State law prohibits SNFs from putting more than four residents in one room.
Care Planning Requirements	Each resident must have a care plan developed to address his or her individual medical and psychosocial needs. Staff members must also identify residents with an elevated risk of accidents and develop a care plan with strategies for preventing injury.
Dietary and  Nutritional Services Requirements	SNFs must give residents some flexibility on when to eat their main meals. All meals must be well-balanced, appealing and nutritious. Meals must also meet any special dietary requirements recommended by a medical professional, such as low-carb meals for diabetics. Each facility must have a registered dietitian in charge of its dietary services.
Specialized Rehabilitative Services	Residents must receive the rehabilitative care they need to maintain their highest possible levels of independence and well-being. Care plans must document any rehabilitative needs and outline how those needs will be met by staff members.
Medication and Pharmaceutical Services	Medications must only be administered when ordered by a physician or other licensed medical practitioner. Staff members are required to verify the identification of each medication when it’s prepared as well as when it’s administered. Staff members must document the resident’s name, the name of the medication, the dosage, the route of administration and the reason for giving the medication each time medication is administered. Each facility must have a licensed pharmacist oversee its pharmaceutical services.
Activities Requirements	To preserve quality of life, residents of SNFs must be given some degree of choice in their activities. Within 21 days of a resident’s arrival, staff members must develop an activities care plan designed to meet the new resident’s unique needs.
Infection Control Requirements	Every facility must have an infection control program that includes annual training on infection prevention for all staff members. Facilities must also have written policies regarding the transmission of communicable diseases. Policies should address topics such as the handling of soiled linens, the use of gloves when handling soiled items and proper disposal of medical waste.
Medicaid Coverage	Health First Colorado covers SNF care for seniors who meet income and other eligibility requirements. For Medicaid to cover their long-term care costs, seniors must also be assessed as needing 24-hour nursing care.