Nursing Homes in Florida
Florida is well-known as one of the top retirement destinations in the United States, and it has seven out of the 10 best places to retire in the United States. Out of a population of over 21 million people, more than 4 million Floridians are aged 65 and older.
Florida has several nationally ranked hospitals across many cities, from Miami to Gainesville. Florida also ranks number one for nurse staffing rates among the 10 most populous states. The state has over 600 licensed nursing homes, representing approximately 84,448 beds. With about 72,161 seniors residing in nursing homes, these facilities roughly have an 85% occupancy at any given time.
In addition to room and board, nursing home facilities provide skilling nursing care, therapies, rehabilitation, personal care and medication 24 hours a day. The average cost of a semi-private room in a nursing home facility is $8,669 per month, and the cost of a private room is $9,817, according to the Genworth Cost of Care Survey 2020.
This guide covers everything related to nursing home care in Florida, including the average monthly cost, Medicaid eligibility, financial assistance options, free and low-cost services and nursing home rules and regulations.
The Cost of Nursing Home Care in Florida
According to the Genworth Cost of Care Survey 2020, Florida has a monthly average nursing home care cost of $8,669 for a semi-private room. Compared to neighboring states and the country, Florida has the most expensive option for nursing home care. The national average of nursing home care is $7,756 per month, over $900 less than Florida’s average. The neighboring state of Alabama has a monthly average nursing home cost of $6,540, over $2,000 less than Florida. Georgia’s prices are also less costly at $6,722 per month.
The cost of nursing home care across Florida varies from city to city. In general, the larger cities tend to have some of the highest nursing home care costs in the state. Jacksonville, the largest city in Florida, has an average monthly nursing home care cost of $8,638 per month for a semi-private room, almost on par with the Florida average. Miami and Orlando have nursing home care costs of $9,095 and $9,125, respectively, and Tampa has an average price of just under $10,000 per month. The least expensive nursing home care option in Florida is Sebring, located in the state’s center, with a cost of $7,451. However, despite having a population of less than 30,000, Naples has the most expensive nursing home care cost in Florida at $10,391 per month.
A semi-private room in a nursing home facility is the priciest care option in Florida. Seniors can expect to pay over $4,000 more for a room in a nursing home facility than receiving care in their own home. The least expensive choice in the state is adult day care at $1,408 per month. Assisted living facilities cost half the price of nursing home care at an average of $4,195 per month in Florida.
Adult Day Care
Nursing Home Care
Does Medicaid Cover Nursing Home Care in Florida?
Over five million Floridians are enrolled in Medicaid, which accounts for about 23.2% of the senior population. For enrollees residing in nursing homes, the program can cover the costs of their room and board and laundry services, as well as medical equipment and supplies, general nursing support and social services. It also covers specific medical costs, such as medications and on-site physicians. Florida has over 700 nursing homes, all of which accept Medicaid. They collectively house almost 86,000 beds and provide their residents with hospital-like levels of care 24/7. The Statewide Medicaid Managed Care Long-Term Care Program helps cover some nursing home care fees, in addition to other costs, such as transportation. Elders in need of skilled nursing care who prefer to remain at home or in the community may be eligible for the Long-Term Care Waiver Program.
Medicaid Eligibility in Florida
The applicant must satisfy certain financial and medical criteria to be eligible for Medicaid. A registered nurse and/or assessor from the nearest Aging and Disability Resource Center conducts a medical screening session by phone, which typically takes 45 to 60 minutes. The senior’s score determines their medical eligibility and position on the waiting list, with higher scores taking priority over lower ones already listed. The Department of Children and Families conducts the financial assessment.
As of 2022, a single applicant can have an annual income of up to $11,964 and assets not exceeding $5,000. For a two-person household, the figures are $16,116 and $6,000. However, if only one person from the household applies, the spouse remaining at home can retain assets of up to $137,400 if the applicant is in a nursing home or in receipt of a Home and Community Based Waiver.
2022 Basic Medicaid Income Limits for Seniors in Florida
|Income Limits Per Year||Asset Limits|
|Married (One Spouse Applying)||$16,116||$6,000|
|Married (Both Spouses Applying)||$16,116||$6,000|
To qualify as of 2022, the applicant must:
- Be an American citizen or legal resident
- Reside in Florida
- Have an annual income of no more than 300% of the Federal Benefit Rate
- Be aged 65 or older
- Own countable assets of up to $2,000, if unmarried, or up to $137,400, if the applicant has a spouse
How to Apply for Medicaid in Florida
Seniors have several options for applying for Medicaid in Florida. They can go online to the ACCESS Florida website, call the ACCESS Florida Customer Call Center at (850) 300-4323, post their application to P.O. Box 1770, Ocala, FL, 34478-1770 or visit their local ACCESS Service Center. Applicants should prepare all necessary documentation prior to applying. The process can take up to three months but may take longer if the documentation provided is insufficient.
What Information You Will Need:
- Social Security and Medicare cards
- Copy of birth certificate
- Bank statements for the previous 60 months before the application date, including for closed accounts
- Proof of income for the previous 60 months before the application date (including 1099s)
- Verification of pension income, which must include a letter from the pension provider
- Proof of citizenship, if born outside the United States
- Copies of life insurance documents
- Property deeds
- Proof of any real property sold or transferred in the 60 months before the application date
- Car registration or title, including insurance documentation
- Preneed burial contracts
- VA discharge papers (DD 214) if the applicant is a veteran
- If applicable, copies of power of attorney, final will and trust documents
- Any other documentation the applicant thinks may support their claim
Additional Medicaid Support & Resources in Florida
The following list contains contact details and a short bio about free resources in Florida dedicated to helping families navigate the often complicated processes surrounding Medicaid applications.
|Aging & Disability Resource Centers||(800) 963-5337||Florida's Aging & Disability Resource Centers are an interconnected network of Area Agencies on Aging that administer programs and services for elders. Families can get information about most aspects of long-term care in their area and be connected with advisors from other Aging & Disability Resource Centers in Florida if they are thinking of relocating. The centers can help families understand the Medicaid application process and refer them to other nonprofits that may be able to provide specific information not covered by the center.|
|American Council on Aging||Online Only||The American Council on Aging operates an online Medicaid Eligibility Test specifically for families who want to know if their loved ones qualify for assistance before applying. The organization also operates an online Spend Down Calculator that helps elders and their spouses determine how much of their assets need to be spent to become eligible for financial assistance from the Statewide Medicaid Managed Care program.|
|Benefits.gov||(866) 762-2237||Benefits.gov is a federal website that provides basic information about Medicaid in Florida, such as the current maximum income allowances for applicants. It's useful as a starting point for families who have limited knowledge about Medicaid and need to know who to contact in Florida to learn more and begin the application process.|
Does Medicare Cover Nursing Home Care in Florida?
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:
- A semiprivate room
- 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 Florida
Families considering nursing home care for their loved ones may wonder if Medicare can meet some of their costs. Although health insurance can’t help in the long term, it may provide initial assistance. Trained advisors associated with the organizations listed here may be able to provide families with information and guidance pertinent to their unique situations.
|SHINE||(800) 963-5337||SHINE (Serving Health Insurance Needs of Elders) is administered by the Florida Department of Elder Affairs and operated locally by Area Agencies on Aging. This free service offers trained advisors who provide unbiased information and support for seniors and their families on Medicare. The advisors don't operate on commission, so they don't promote specific private insurance policies when discussing alternatives to traditional Medicare. Sessions are entirely confidential and conducted one-on-one, either in person or by phone.|
|BenefitsCheckUp||(800) 794-6559||BenefitsCheckUp is a resource operated jointly by the National Council on Aging and the Florida Department of Elder Affairs. This online service compiles the available health care options for seniors based on the answers given to a short series of questions. The list of results provides links to the services that may be available, such as TRICARE for Life and Medicare Savings Programs. Families can call a helpline if they have additional questions regarding Medicare availability.|
|Medicare.gov||(800) 633-4227||Medicare.gov is a federal website with a wealth of information about Medicare that families and elders can access round the clock. It provides general information about the health care program, in addition to state-specific content and links to useful websites and phone numbers. Its live chat function operates 24/7 so visitors can ask questions of trained advisors, who can call visitors back if a chat is interrupted.|
Other Financial Assistance Options for Nursing Home Care in Florida
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 Florida
Families and elders considering nursing home care can sometimes feel overwhelmed by the often complex processes they need to navigate to find the best solutions for their needs. Fortunately, a wealth of free and subsidized resources throughout the state can help demystify the system and ease the transition into long-term care.
|Veterans Affairs Long-Term Care||(877) 222-8387||Veterans who have signed up for VA health care may be able to get nursing home services in a facility reasonably close to their homes. Depending on the vet's location, this may be a community living center, which is a VA nursing center designed to feel homelike; a community nursing home, which is a non-VA facility contracted to Veterans Affairs; or a state veteran home, which is a state-owned and managed center. All centers provide 24/7 skilled nursing care for applicants deemed medically eligible for their services. Several factors influence the amount of the costs that VA can pay, so some seniors may need to find additional funding elsewhere.|
|Home Care for the Elderly Program||(800) 963-5337||The Home Care for the Elderly Program is a state-sponsored service for Floridians aged 60 able to reside in family-like settings rather than nursing homes. Residents receive a subsidy of $160 per month to help cover some of their room and board costs, while an additional subsidy may be available to meet some medical services and supplies as well. The applicant must have an income and assets on or below the Institutional Care Program standard at the time of their application and be at risk of being placed in a nursing home.|
|Care Transitions Program||(800) 262-2243||The Care Transitions Program is a support service for people returning to their homes after a period in hospital or rehab. It's operated by Elder Options, a nonprofit agency with over 35 years of experience serving the needs of older residents. The program provides extensive support for up to 30 days, including home-delivered meals, transportation, homemaking services and care coaching for the elder's caregiver.|
|Respite for Elders Living in Everyday Families||(850) 414-2374||The program expands on other care services provided by the Florida Department of Elder Affairs, with a dual emphasis on helping the senior and family members acting as unpaid caregivers. It provides respite care services, including evenings and weekends, to assist people caring for frail seniors and those affected by cognitive conditions and other debilitating illnesses.|
|Community Care for the Elderly Program||(800) 963-5337||The Community Care for the Elderly program assists functionally impaired citizens aged 60 and over whose conditions don't require skilled nursing services. The program provides placements in adult daycare centers, issues consumable medical supplies, offers companionship services and provides legal assistance.|
|Florida Long-Term Care Ombudsman Program||(888) 831-0404||The Florida Long-Term Care Ombudsman Program is a free support service for seniors residing in nursing homes. Ombudsmen are trained volunteers who regularly visit residential care facilities to engage directly with residents, listen to their concerns and investigate complaints. The ombudsman advocates for seniors and tries to resolve their complaints with care providers. Families of residents and third parties can also contact the ombudsman if they have concerns about a facility's standard of care.|
Nursing Home Laws and Regulations in Florida
|Nursing Home Laws and Regulations in Florida|
|Licensing Requirements||All nursing home facilities must be licensed by the Agency for Health Care Administration to operate in Florida. Separate licenses are required for facilities managed in different sites, even if operated by the same management.|
|Staffing Requirements||Each nursing home must have a designated director of nursing and an assistant director of nursing in a facility with more than 120 residents. The facility must also have sufficient nursing staff on a 24-hour basis.Nursing staff cannot be scheduled for more than 16 hours within 24 hours unless there's an emergency.Each nursing home facility must also have a licensed physician to serve as medical director. In facilities with less than 60 residents, a physician can serve as a medical consultant instead.|
|Staff Training Requirements||Each nursing facility must have staff education in HIV/AIDS training and at least one-hour of training for Alzheimer's disease or related disorders. Staff education must also include prevention and control of infection, fire prevention and disaster preparedness, accident prevention and residents' rights.|
|Admission Restrictions||Residents suffering from an infectious disease cannot be admitted to a nursing facility unless there are adequate isolation measures in place to control the transmission of the disease. Residents who need services beyond what the facility is licensed or able to provide may not be retained in the facility.|
|Care Planning Requirements||Residents admitted to a nursing facility must have a care plan. The care plan must contain a preliminary nursing evaluation, an assessment of each resident's functional capacity, and physician's orders, diagnosis, medical history and rehabilitative potential. The facility must also create a comprehensive care plan that describes the services provided for the resident. The care plan must be completed within seven days after completion of the resident assessment.|
|Dietary and Nutrition Services Requirements||Nursing facilities must have a designated full-time director of food services (DFS). The DFS must be a qualified dietitian or the facility must receive consultation from a qualified dietitian. A facility must also maintain a one-week supply of non-perishable food and supplies.|
|Specialized Rehabilitative Services||Each facility must provide residents access to rehabilitative services, and residents have the right to receive therapeutic and rehabilitative services in accordance with their care plan.|
|Medication and Pharmaceutical Services||Nursing homes must either employ or obtain the services of a state-licensed consultant pharmacist. The consultant pharmacist is tasked with creating a drug record system and ensuring it's accurate and in order. Prescription and nonprescription drugs that require refrigeration must be locked and only accessible to licensed staff.|
|Activities Requirements||Nursing facilities must allow residents access to recreational and other health-related services that may not be directly provided by the facility.Residents must also have the right to participate in social, religious and community activities, receive planned recreational activities and join in community-based activities programs.|
|Infection Control||Nursing facilities must keep the premises and equipment sanitary and implement infection control policies and procedures. Facilities must also provide willing residents with influenza vaccinations.|
|Medicaid Coverage||Medicaid covers nursing home care for qualified Floridians. Seniors must be 65 years and older, require a nursing home level of care and meet the income requirements.|