Delaware is home to the nation’s fifth-oldest population, based on residency data. Nearly 20% of its 973,764 residents are 65 or older, which means that there’s increased demand for long-term care and geriatric specialists. Seniors who have significant medical needs often turn to nursing homes for assistance. These facilities provide skilled nursing and subacute medical care 24 hours a day. They also offer physical therapy, psychosocial care and rehabilitative services to help residents recover from an injury, an illness or a hospitalization and maintain optimal function.

Delaware is home to 50 nursing facilities that care for approximately 4,000 residents. These facilities typically charge $12,699 per month for a private room or $12,349 for a semiprivate room, which is well above the national average. In this guide, you’ll find information about average nursing home costs, state regulations, Medicaid long-term care benefits and resources provided by government agencies and nonprofits.

The Cost of Nursing Home Care in Delaware

According to the  Genworth Cost of Care Survey 2020, nursing homes in Delaware cost $12,349 per month for semiprivate accommodations. Local rates are 60% higher than the U.S. median of $7,756, which costs residents an additional $4,593 every month. Seniors in Virginia pay slightly less than the U.S. median with average rates of $7,665. However, when compared to other states in the Chesapeake region, prices are moderate. Seniors in Delaware pay roughly $1,095-$2,300 more than their counterparts in Pennsylvania, Maryland and New Jersey, which all have above-average rates.

$12349

Delaware

$7756

The United States

$11254

New Jersey

$10038

Pennsylvania

$10190

Maryland

$7665

Virginia

Nursing home rates vary by state and by city. Seniors in Dover, the state capital, pay $12,882 for skilled nursing, which is $533 more than average. In Wilmington, which is part of the Philadelphia metropolitan area, seniors pay $11,285 per month, or $1,064 less than the state median. Overall, Delaware tends to be more expensive than neighboring areas. Seniors in Baltimore, Maryland, pay $11,984 on average followed those in Salisbury, Maryland, at $10,768. Nursing homes in the southern New Jersey city of Vineland are also more affordable than Delaware with median rates of $10,950 per month. In Virginia Beach, nursing homes charge about $90 less than the U.S. median at $7,665 per month.

$12882

Dover

$11285

Wilmington

$10950

Vineland, NJ

$10768

Salisbury, MD

$11984

Baltimore: MD

$7665

Virginia Beach, VA

Skilled nursing is the most expensive form of long-term care in Delaware. With average rates exceeding $12,000, it costs almost twice as much as assisted living, which averages $6,690. Families may also consider in-home care as a possible alternative. Home health agencies provide household assistance and medical care for $4,767 per month based on 44 hours of weekly care. Individuals who are interested in light personal care and structured daily activities may consider adult day health care, which costs just $1,645 per month, a rate that’s similar to the U.S. average of $1,603.

$4767

In-Home Care

$4767

Home Health Care

$1645

Adult Day Care

$6690

Assisted Living Facility

$12349

Nursing Home Care

Financial Assistance for Nursing Home Care in Delaware

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 Delaware.

Delaware’s Medicaid Program

Medicaid is a health insurance program available to seniors, adults and children who meet income and assist limits. Medicaid and CHIP cover approximately 246,820 individuals who represent more than 18% of the state’s population. Due to Delaware’s strict eligibility standards, enrollment has increased by just 10.5% since regulations changed in 2013. Preventive care, emergency medical services and diagnostic screenings that are covered by the Diamond State Health Plan are typically provided by Managed Care Organizations operated by private insurance companies.

Medicaid also includes three components that can pay for long-term care. These include the Nursing Facility program, the Long-Term Acute Care program and waivers for home and community-based services. While Medicare only covers a limited number of nursing home days for residents who meet other requirements, Medicaid provides ongoing coverage as long as residents continue to meet medical and financial eligibility criteria. According to the Kaiser Family Foundation, Medicaid is the primary source of funding for 60% of the state’s 3,937 nursing home residents, and approximately 47 of the state’s 50 nursing homes are certified to accept Medicaid benefits.

Medicaid Eligibility in Delaware

To qualify for regular Medicaid, Delaware residents must earn $794 or less per month or $1,191 for couples, and they must have no more than $2,000 in nonexempt assets or $3,000 for couples applying jointly. Individuals who require nursing home care can qualify if they earn no more than $1,985 per month for individuals or $2,977.50 for couples applying jointly. Additionally, beneficiaries must use all of their income to pay for nursing home care minus a $44 personal needs allowance and a spousal allowance if permitted. Applicants must be a U.S. citizen or legal resident to qualify. You can begin the process online at Delaware ASSIST or by calling the long-term care helpline at (866) 940-8963.

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 Delaware

Families and seniors in Delaware have access to a variety of government agencies and nonprofit resources that can help them locate long-term care providers and home- or community-based resources. Learn more about some of the programs that are available statewide.

ResourceContactService
Delaware Aging & Disability Resource Center(800) 223-9074The Aging & Disability Resource Center is a one-stop shop that provides information about age-related programs and services that are available in your area. It can assist with personal care, home-delivered meals, emergency response systems and respite care. It’s also home to the state’s long-term care ombudsman who represents the rights of individuals who live in nursing homes and other residential health care facilities.
Community Legal Aid Society, Elder Law Program(302)-575-0666 (New Castle County)
(302) 674-3684 (Kent County)
(302) 856-4112 (Sussex County)
Sponsored by the Community Legal Aid Society, Delaware’s Elder Law Program is a free legal resource available to residents aged 60 or older without income restrictions. Staff members can help with Medicare, Medicaid, Social Security, estate planning documents, powers of attorney and advance directives. They also handle consumer rights cases related to housing, insurance, long-term care and debt collection.
Delaware Division of Services for Aging and Adults with Physical Disabilities(800) 223-9074The DSAAPD offers an array of services for seniors, disabled adults and caregivers. It provides information, referrals and long-term supports, including home- and community-based services that let older adults remain in the comfort of their own home and delay or avoid the need for institutionalization. The agency also offers a Nursing Home Transition program for Medicaid-eligible residents who want to return to the community.
Meals on Wheels Delaware(302) 656-3257This longstanding nonprofit funds five regional Meals on Wheels programs that deliver nearly 900,000 meals to more than 6,200 homebound seniors and disabled adults every year. It hosts charitable fundraising events, accepts corporate donations and works with more than 1,000 volunteers to provide these services.
Delaware Medicare Assistance Bureau(800) 336-9500The DMAB is a free resource available to all Medicare beneficiaries and new enrollees. Specially trained volunteers can help with plan comparisons, long-term care insurance, Part D prescription drug coverage and Medigap supplements. Counselors can also assist with Extra Help benefits, billing problems and general questions or concerns.
Delaware Senior Resource Network(302) 858-6449The Delaware Senior Resource Network represents an interdisciplinary team of long-term care professionals, including nurses, social workers and geriatric care managers. It offers educational and informational services, hosts outreach events and supports charitable partners, including Meals on Wheels and Lori’s Hands.

Nursing Home Laws and Regulations in Delaware

LicensingIntermediate and skilled nursing facilities in Delaware are regulated by the Department of Health and Social Services, Division of Health Care Quality.
StaffingDelaware nursing homes must employ a medical director and full-time director of nursing. Facilities must have sufficient staff to provide 2.25 hours of daily direct care per resident, and an RN or LPN must be on-site during day and evening shifts and on-call at night.
Staff TrainingNursing facilities must provide training related to health, safety, personal protective equipment and infection control procedures. Additionally, all certified nursing assistants must complete at least 150 hours of training, which is double the federal minimum. Facilities that care for individuals with Alzheimer’s or similar conditions must provide dementia-specific training to their staff.
Admission RestrictionsNursing homes may admit residents who have an illness or impairment, are under a physician’s care and may benefit from palliative medical care or nursing services. Facilities that admit pediatric residents under the age of 18 are subject to additional requirements.
Care PlanningFacilities must conduct a needs assessment for each resident within 14 days of admission, and comprehensive care plans must be developed within seven days of the assessment to address the residents’ physical, nutritional and psychological needs.
Dietary and Nutrition ServicesNursing homes must conduct a comprehensive nutritional assessment for each resident and provide appropriate meals or snacks, including therapeutic or mechanical options if needed. Weekly menus must be posted in the kitchen and dining area, and the facility must maintain adequate pantry supplies and records while meeting standards for food safety and cleanliness.
Specialized Rehabilitative ServicesIntermediate and skilled nursing facilities may provide physical, occupational and speech therapy as well as psychosocial services. Rehabilitative care may be administered as needed to aid in residents’ recovery and to promote optimal functioning and self-sufficiency.
Medication and Pharmaceutical ServicesFacilities must employ a qualified pharmacist consultant who is responsible for reviewing residents’ medication records and overseeing pharmaceutical services. Staff members must follow strict standards for dispensing, labeling and recording residents’ prescriptions, including any provider-ordered, over-the-counter medications.
ActivitiesNursing homes must employ a qualified activities director and maintain adequate common areas designed for social and recreational activities.
Infection ControlHealth care facilities must employ an infection control coordinator and establish policies and procedures for detecting and preventing the spread of communicable diseases among residents and staff members.
Medicaid CoverageMedicaid will cover nursing home care if residents meet income and asset limits and use all of their income to pay for care, excluding a nominal personal needs allowance.