Nursing Homes in Maryland

Seniors in Maryland can enjoy bustling cities such as Baltimore or settle into a sleepy seaside town on the Chesapeake Bay. Either way, they get access to a wide range of resources and services designed to help seniors enjoy a comfortable lifestyle. World-class hospitals abound in the state, including facilities with geriatric specializations, such as Johns Hopkins Hospital. In addition, health care costs in the state are lower than the national average. Almost 16% of the state’s 6 million residents are aged 65 and above, and approximately 230 nursing homes with 30,000 beds are available to provide services to this population. Nursing homes provide residents with long-term care that can include skilled nursing services, medical monitoring and treatments, as well as meals, personal care and activity programs. The average cost of nursing home care in Maryland is $10,190 for a semiprivate room and $10,646 for a private room.

This guide has detailed information about the cost of nursing home care in the state, financial assistance, other resources available and nursing home regulations to help seniors and their families make decisions about their future.

The Cost of Nursing Home Care in Maryland

Seniors in Maryland pay an average of $10,190 per month for nursing home care, according to Genworth Financial’s Cost of Care 2020 Survey. This is $2,434 more than the national average of $7,756. Compared to neighboring states, Maryland’s costs are in the middle of the range. Virginia has significantly lower costs at $7,665 per month, while in Pennsylvania, prices are slightly lower than Maryland, at $10,038. Seniors in West Virginia pay $11,376 per month, $1,186 more than those in Maryland. 

There is a wide range of prices for nursing home care across Maryland, and seniors in different cities can incur very different costs. California and Cumberland are the most affordable cities, with an average of $8,137 and $8,213 respectively. Seniors in Hagerstown pay $9,794, while in Salisbury the cost is $10,768. Bethesda has an average cost of $11,726, and Baltimore is the least affordable city at $11,984.

Nursing home care is the most expensive senior care option available, reflecting the skilled nursing and medical care it provides residents. The most affordable option is adult day care, at a cost of $1,842 per month. Assisted living in the state comes in at $5,000 monthly. In-home care and home health care are both more affordable than assisted living, averaging $4,576 and $4,767 respectively. This type of care, which offers services in the home, may be an option for people who need nursing home level care but want to age in place.

Financial Assistance for Nursing Home Care in Maryland

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. Medicaid provides the most comprehensive coverage for nursing home care, but not all seniors are eligible for Medicaid. 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 Maryland.

Maryland’s Medicaid Program

As of August 2020, almost 1.4 million people are enrolled in Medicaid in Maryland. The program helps low-income residents pay for health care. Around 42,000 Maryland residents receive Long-Term Services and Support. This program provides services to people who require long-term care, with services available in the home and assisted living facilities, as well as in institutional settings such as nursing homes. 

Seniors who live in one of the state’s approximately 230 nursing homes have their care paid for, as long as they meet the eligibility requirements. In addition to being financially eligible, applicants must be medically eligible, which means they require care under the full-time supervision of a licensed nurse. People who only require intermittent care or unlicensed care don’t meet the medical eligibility requirements. Medicaid also has a number of waiver programs available that pay for skilled nursing care in the community, such as the Medical Day Care Services Waiver.

Medicaid Eligibility in Maryland

To be eligible for Medicaid in Maryland, applicants must be a U.S. citizen or have qualified immigration status and be a resident of the state. Financial eligibility requirements differ depending on the type of support required. People applying for nursing home care can’t have an income that exceeds the cost of nursing home care. This income, minus a personal needs allowance, goes towards the cost of care. The asset limit is $2,000 for single applicants and $3,000 for married couples. People who receive Supplemental Security Income (SSI) are automatically eligible. 

People who require Long-Term Services and Supports can apply online via MDThink or in person or by mail to a local department of social services.

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 Maryland

Maryland has a wide range of resources available to help older adults in the state. Some help people living in nursing homes, while others are designed to assist those still living in the community. Many seniors prefer living at home or in the community in an assisted living facility, so resources often aim to help recipients age in place. As this is also a more affordable option, these resources can also help people save in case they need nursing home care in the future. 

Resource	Contact	Service
In-Home Aides Services	Contact local department of social services	In-Home Aides Services (IHAS) is designed to support adults with a disability who want to remain living at home. The program provides home aides to assist with a range of services including personal care, such as bathing and eating, and homemaker services such as cooking and cleaning. The program also provides case management and self-care training. There is a waiting list for services, and funding is prioritized according to need.
Accessible Homes for Seniors	(301) 429-7821	Accessible Homes for Seniors helps seniors fund home modifications that improve accessibility. These modifications can include widening doorways and adding ramps or grab rails. Funding is available as a long-term, interest-free loan or through a grant and is available to households that meet eligibility requirements. Applicants must be aged 55 or older and own the house that is to be modified.
Area Agencies on Aging	1-844-627-5465	Area Agencies on Aging provide a local contact point for seniors looking for resources and information. Exact services differ between location, but include planning assistance, caregiver support, legal assistance and help identifying and applying for benefits. Communities for seniors provide group meals, senior center activities and health and wellness programs.
Long-Term Care Ombudsman	Contact local ombudsman	The Long-Term Care Ombudsman program provides advocacy for residents of long-term care, including nursing homes and assisted living facilities. The program investigates and helps to resolve complaints and concerns for individuals. It also educates residents about their rights and advocates for systemic changes.
Senior Care Program	Contact local Maryland Access Point	The Senior Care program provides assistance to residents aged 65 and over who are at risk for nursing home placement. In general, this means they need assistance with one to three activities of daily living. The program assesses an individual’s needs, and a case manager coordinates services. The program provides a range of services and resources including personal care, adult day care, medications and emergency response systems.
Maryland Department of Veterans Affairs	Contact a local office	Seniors who served in the military can access a range of services through the Maryland Department of Veterans Affairs. Service Officers help veterans identify and apply for benefits, including the Aid and Attendance benefit, which can be used to pay for nursing home care. Maryland also has a Veterans Home that may be a good fit for veterans looking for a nursing home.

Nursing Home Laws and Regulations in Maryland

Licensing Requirements	All nursing homes must be licensed by the state. These licenses last for two years, unless revoked. Facilities that have a dual function, such as providing skilled nursing and other care services, must be licensed for each level of health care provided.
Staffing Requirements	Nursing homes must employ a sufficient number of staff to provide at least three hours of bedside care per resident every day. This care can be provided by registered nurses, licensed practical nurses or support personnel. Facilities must employ RNs in the following ratios:2-99 residents: One full-time RN100-199 residents: Two full-time RNs200-299 residents: Three full-time RNs300-399 residents: Four full-time RNsAt least one registered nurse (RN) must be in the facility 24/7, and facilities must also employ a medical director and an administrator.
Staff Training Requirements	Unlicensed staff must undergo a geriatric nursing assistant training program prior to providing direct care. The curriculum must be approved by the Maryland Board of Nursing. All staff must also complete training on cognitive impairment and mental illness. The facility administrator must organize an ongoing educational program for staff.
Admission Restrictions	Nursing homes must not admit individuals who require care beyond the capabilities of the facility or people who are dangerous to themselves or others.
Care Planning Requirements	An interdisciplinary team must develop a care plan for residents within seven days of their admission. Plans must be revised after an individual’s annual assessment or quarterly assessment or after a significant change in their condition.
Dietary and  Nutritional Services Requirements	Nursing homes must provide at least three meals daily that meet the nutritional needs of residents, in accordance with physician’s orders. Facilities with more than 50 beds must hire a full-time qualified dietetic service supervisor, while smaller facilities may allow the supervisor to share cooking responsibilities with the cook. Regular consultation from a licensed registered dietitian must be organized if a dietitian isn’t on staff.
Specialized Rehabilitative Services	Specialized rehabilitative services are defined as:Occupational therapyPhysical therapySpeech pathologyAudiology servicesNursing homes do not have to admit people who require these services, but if they do, the services must commence within 48 hours of admission.
Medication and Pharmaceutical Services	Medications that are administered to residents must be prescribed by the resident’s physician. They can be administered by licensed personnel or graduates of a state-approved medicine aide course. The facility may employ a licensed pharmacist or arrange a written contract with a pharmacy to provide pharmaceutical services.
Activities Requirements	Facilities must provide a program of structured and unstructured activities that are designed to meet the needs and interests of residents. Nursing homes must employ a qualified resident activities coordinator to organize this program.
Infection Control Requirements	Nursing homes must establish an effective infection and control program that is managed by an infection preventionist. The infection preventionist must have training in infection surveillance.
Medicaid Coverage	Medicaid pays for nursing home care in Maryland for those who meet both financial and medical eligibility criteria.