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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.
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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.
Baltimore
$11984
Bethesda
$11726
California
$8137
Cumberland
$8213
Hagerstown
$9794
Salisbury
$10768
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.
In-Home Care
$4576
Home Health Care
$4767
Adult Day Care
$1842
Assisted Living Facility
$5000
Nursing Home Care
$10190
Does Medicaid Cover Nursing Home Care in Maryland?
Medicaid currently covers the costs of nursing home care for four out of every eight nursing home residents in Maryland. The state has an expanded coverage system that includes low-income adults. Around 18% of the population — just over 1.5 million people — is covered by Medicaid in Maryland. The program can cover the costs of a semiprivate room, board and laundry services for enrolled seniors residing in nursing homes. In addition, it covers basic medical equipment and supplies, medications, on-site physicians, nursing support and social services.
Maryland has approximately 230 nursing homes, and all of them accept Medicaid. An estimated 30,000 beds are available for nursing home care in the state, and residents can expect 24/7 hospital-like levels of care. The Statewide Medicaid Nursing Home Care Program helps seniors cover some of the fees associated with nursing home care. Those who’d prefer to remain in their own homes or communities may be eligible for the Medicaid Long Term Services and Supports program.
Medicaid Eligibility in Maryland
Applicants must meet certain medical and financial requirements to be eligible for Medicaid.
Financial eligibility is determined by the Department of Social Services. People who receive Supplemental Security Income (SSI) are automatically financially eligible for Medicaid. For 2023, those who require institutional care cannot have incomes that exceed the cost of care, whether as a single applicant or as a married couple. Asset limits are $2,500 per person and $148,620 for a non-applicant spouse. For couples where both people are applying, assets are limited to $3,000 per spouse, but that number drops to $2,500 per spouse after six months.
| Household Size | Number of Applicants | Income Limits Per Year* | Asset Limits: Applicant(s) | Asset Limits: Non-Applicants |
|---|---|---|---|---|
| One Person | 1 | Cannot exceed the cost of nursing home care | $2,500 | |
| Two People | 1 | Cannot exceed the cost of nursing home care | $2,500 | 148,620 |
| Two People | 2 | Cannot exceed the cost of nursing home care | $6,000** |
*Except for a $93/mo. personal needs allowance, Medicare premiums and possibly a spousal income allowance for a non-applicant spouse, all of a recipient's monthly income must be put toward the cost of nursing home care.
**The initial asset limit is $3,000 per spouse. After six months, this limit goes to $2,500 per spouse.
Additionally, the senior applying:
- Must be a U.S. citizen or legal resident
- Must reside in the state of Maryland
Hospitals will apply for medical eligibility on behalf of seniors who are in hospital care prior to admission to a nursing home facility. Those who are in another setting prior to admission require a physician to complete a Medical Eligibility Review Form DHMH 3871. This form must be mailed with supporting documents to the Delmarva Foundation for consideration.
How To Apply for Medicaid in Maryland
Seniors in Maryland have several options when applying for Medicaid. They can apply online through the MDThink website, mail their completed application to their local Department of Social Services or apply in person at the Department of Social Services. Seniors can phone (877) 463-3464 for assistance in completing the online or downloaded forms. Applicants can ensure the process runs smoothly by having all the required documents available before starting the application process. The process normally takes three to four months but may be delayed by insufficient documentation.
Information You Will Need
- Copy of birth certificate
- Proof of citizenship or legal residency if born outside the United States
- Social Security card
- Medicare details if applicable
- Property deeds
- Bank statements for the past 60 months before the application date, including any closed accounts
- VA discharge papers if a veteran
- Proof of income for the past 60 months before the application date, including 1099s
- Verification of any pension income
- Copies of life insurance documents
- Car registration papers
- Proof of property sold or transferred in the 60 months prior to the application date
- If applicable, final will, power of attorney and trust documents
- Any other documents the applicant feels may support their case
Additional Medicaid Support & Resources in Maryland
The following free resources are dedicated to helping families and seniors navigate the complicated process that surrounds Medicaid applications.
| Resource | Contact | Service |
|---|---|---|
| Maryland Department of Aging | (800) 243-3425 | The Maryland Department of Aging is operated by the Maryland Department of Health. It provides information regarding long-term care in the state and the steps required to obtain financial assistance toward nursing home care. Seniors and their families can obtain information from the website or visit their local office to ask any questions they may have. |
| American Council on Aging | Online Only | The American Council on Aging runs the Medicaid Planning Assistance Website. The site contains step-by-step guides for seniors and their families looking to apply for Medicaid coverage. The website offers a screening test that enables families to find out if their loved one is eligible for Medicaid. In addition, the website contains information on Medicaid basics and income regulations by state. |
| Benefits.gov | (800) 456-8900 | Benefits.gov is a federal website that contains an overview of Medicaid coverage in Maryland. This information is a useful starting point for families that are new to the process and are looking for contact details and general information regarding Medicaid. |
Does Medicare Cover Nursing Home Care in Maryland?
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 and Resources in Maryland
Families considering nursing home care for their loved ones may be interested to know the extent to which Medicare will assist in covering costs. Trained advisers from the following organizations are able to assist families in finding information and guidance that could help in their particular situation.
| Program | Contact | Service |
|---|---|---|
| SHIP | (410) 767-2077 | The State Health Insurance Assistance Program is administered by the Maryland Department of Aging and operated by local offices throughout the state. Volunteers provide free and unbiased information to seniors and their loved ones regarding Medicare. The trained volunteers don't receive a commission or promote any particular private insurance companies while discussing alternatives to Medicare. Sessions can be conducted in person or by phone. The volunteers are able to guide seniors through the process of applying for coverage that best suits their unique situation. |
| Medicare.gov | (800) 633-4227 | Medicare.gov is a website operated by the federal government that provides information on all aspects of Medicare. It has a live chat function that ensures seniors and their families can ask questions and get the information they require 24/7. The website gives a general overview of Medicare as well as state-specific information such as phone numbers and links to useful websites. |
| Benefits Checkup | (800) 794-6559 | Benefits Checkup is a national resource operated by the National Council on Aging. Seniors or their family members can take a short online quiz that will link them to benefits that may be available to them. Some of these benefits include Medicare Savings Programs and state-specific waivers. In addition, families can call the helpline to have their questions regarding Medicare or any other benefits answered by trained volunteers. |
Other Financial Assistance Options for Nursing Home Care in Maryland
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 Maryland
There are many resources in Maryland that assist seniors in their retirement. Caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.
Area Agency on Aging
Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| Maryland Area Agencies on Aging | Maryland's Area Agencies on Aging are nonprofit organizations that support the needs of older adults, their families and caregivers across the state. They offer a range of services and programs that promote independent living and help enhance seniors' quality of life. AAAs provide personalized care planning, home-based services, transportation assistance and meal programs. They also offer information and referral services, benefits counseling and caregiver support. Through Maryland's AAAs, seniors can access the resources they need to age with dignity. |
Cash Assistance Programs
Cash assistance programs in Maryland provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.
| Program Name | Phone Number | Description |
|---|---|---|
| Maryland Lifeline Program | 800-234-9473 | The LifeLine Program offers a discount on landline or mobile telephone service, ensuring that participants can stay in contact with loved ones. |
Financial Assistance for Senior Care and Senior Living
Whether living in their own home or in a senior living community, Maryland seniors can find financial assistance from numerous local resources. These organizations help residents cover some of the costs associated with in-home or long-term care and connect them with other helpful community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| Maryland Access Point (MAP) | 844-627-5465 | Maryland Access Point locations can help you find assistance programs available in your community. |
Food Assistance Programs
Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help Maryland seniors afford the nutritious food they need.
| Program Name | Phone Number | Description |
|---|---|---|
| Maryland 211 Food Pantries | Low-income seniors in Maryland who are able to leave their homes have many options for free and affordable food. Food pantries and banks throughout the state provide free produce, grains and other staples, and many have no eligibility requirements | |
| Maryland Meals on Wheels | Maryland Meals on Wheels offers nutritious home-delivered and congregate meals for qualifying seniors ages 60 and over. Eligibility is open to those who cannot easily shop for groceries and prepare meals due to limited mobility. With home-delivered meals, seniors receive friendly daily visits that provide valuable social interaction and safety checks for those at risk of falls or accidents. Congregate meals are served at local senior centers and are available on a sliding fee scale. | |
| Maryland Supplemental Nutrition Assistance Program (SNAP) | 800-332-6347 | SNAP gives you a card that can be used at grocery stores, convenience stores, online food delivery services and even some restaurants. |
Financial Assistance for Senior Living
Low-income elderly individuals in senior living communities can access financial assistance through local-run programs. These Maryland resources offer advice, guidance and support to help older adults pay for the services offered by long-term care providers.
| Program Name | Phone Number | Description |
|---|---|---|
| Maryland Senior Assisted Living Subsidy Program | 410-767-1100 | Seniors facing Nursing Home placement may receive a direct financial subsidy to help pay for Memory Care as an alternative. Subsidies cover a maximum of $1,000 per month, and financial eligibility limits apply. This program is designed for moderate-income seniors who may not qualify for traditional Medicaid programs and for those aged 62 and older. |
Free Used Medical Equipment
Due to the high cost of purchasing new medical equipment, several organizations in Maryland collect lightly used medical devices such as wheelchairs, ramps and walkers and distribute them to local seniors and residents in need.
| Program Name | Phone Number | Description |
|---|---|---|
| Maryland Assistive Technology Reuse Center (MATR) | 443-326-9703 | The Maryland Assistive Technology Reuse (MATR) Center provides high-tech assistive equipment to individuals who have some form of disability. Funded entirely by donations, MATR provides pre-used assistive technologies at no cost. The only requirement is that equipment be re-donated to the center once it's no longer needed. MATR maintains an online inventory of all available equipment. Devices include assisted vision equipment, assisted listening devices and augmentative and alternative communication devices for individuals with speech impediments. |
| Maryland Bay Area Center for Independent Living - Free Loan Closet | 443-260-0822 | The Bay Area Center for Independent Living, Inc., a nonprofit agency in Salisbury, MD, connects adults with disabilities and their families to various services and programs across nine counties. The center works closely with the Maryland Technology and Assistance Program to provide temporary ramps to people who need wheelchair access to their homes. Workshops and resources are also available at the center to help disabled individuals navigate the complex social security system. |
| Maryland Durable Medical Equipment Re-Use Program | 240-230-8000 | The Durable Medical Equipment Re-Use program collects donations of equipment from sites throughout Maryland and distributes them to seniors in need. Sites offer basic DME, such as canes and bedrails, and complex DME, such as power wheelchairs, home hospital beds and mechanical lifts. |
Home Repair and Modifications
Seniors and those with disabilities can access a variety of local resources to help them pay for home repairs and modifications. Programs in Maryland have different eligibility criteria and often assist retirees by providing grants or loans.
| Program Name | Phone Number | Description |
|---|---|---|
| Maryland Accessible Homes for Seniors | 844-369-4150 | This program provides zero-interest loans and grants to seniors for modifications to their homes. The funds are available for improvements that make the property accessible and functional, such as widening of doorways, installation of ramps and modifying bathrooms with grab bars. The maximum loan amount is 110% of the value of the property. |
Legal Resources
Many organizations offer free or low-cost legal services to Maryland seniors. Older adults can access advice on issues such as estate planning, living wills and power of attorney. Some firms also act as long-term care ombudsmen, advocating for the rights of seniors in senior living communities.
| Program Name | Phone Number | Description |
|---|---|---|
| Maryland Legal Aid | 866-635-2948 | Maryland Legal Aid's Senior Legal Helpline offers counseling and advice to the elderly. It helps low-income individuals locate pro bono representation in civil matters (although not in criminal cases). Other services include preparing legal documents and helping seniors file for divorce or bankruptcy. |
| Maryland Long-Term Care Ombudsman Program (LTCOP) | 301-265-8483 | The Maryland Long-Term Care Ombudsman Program is dedicated to upholding the welfare of long-term care residents throughout the state. The program's volunteers and paid staff work together to provide services such as informing individuals of their rights, resolving concerns and complaints and making suggestions to improve care quality in facilities. All services provided by LTCOP are free and confidential. Residents and concerned parties can access the state's ombudsman by county. |
Medicaid Resources
Navigating the Medicaid system is often difficult and confusing. Several Maryland resources help older adults by providing advice on Medicaid options, waiver programs and eligibility criteria to help seniors receive the right health care benefits.
| Program Name | Phone Number | Description |
|---|---|---|
| Maryland's Community First Choice Program | 877-463-3464 | This program enables seniors to remain in their own homes by providing a variety of services, including personal assistance, home-delivered meals, accessibility adaptations, assistive technology and support planning. It also covers nurse monitoring and other home health services. |
Social Security Offices
Social Security offices in Maryland help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.
| Program Name | Phone Number | Description |
|---|---|---|
| Maryland Social Security | Social Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working. |
Tax Assistance
Seniors can apply for tax assistance from several Maryland resources. Elderly residents and those with disabilities could be eligible for tax exemptions on medical expenses, reductions on property tax and other tax assistance programs.
| Program Name | Phone Number | Description |
|---|---|---|
| Homeowners' Property Tax Credit Program | 410-767-5900 | This tax credit program limits the amount seniors pay on their property taxes based on their income. The credit is applied directly to the tax bills of homeowners, and it does not apply to the value of the property exceeding $300,000. |
Utility & Energy Bill Assistance
Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. Maryland retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices.
| Program Name | Phone Number | Description |
|---|---|---|
| Maryland Low Income Household Water Assistance Program (LIHWAP) | 800-332-6347 | Seniors at risk of losing their access to water due to a lack of funds may be eligible for assistance through LIHWAP. The program gives eligible households up to $2,000 to pay for water and wastewater bills. You can apply for LIHWAP online or over the phone. |
| Maryland Office of Home Energy | 800-332-6347 | The Maryland Office of Home Energy offers a financial assistance program for low-income families who are unable to afford their electricity or heating bills. The program pays your utility bills directly if you're short on funds, and you don't need a turn-off notice to qualify. |
Veteran's Services
Maryland retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.
| Program Name | Phone Number | Description |
|---|---|---|
| Maryland VA Benefits and Health Care | Maryland's VA Benefits and Health Care provides assistance to eligible senior veterans through medical centers located in Baltimore, Perry Point and at other facilities across the state. The program offers older vets access to service-connected disability support as well as physical therapy, hearing and vision care, cancer treatment and pain management. Veterans can receive help navigating VA benefits, compensation and social services, including guidance with senior housing options and financial planning. |
Nursing Home Laws and Regulations in Maryland
| Topic | Rule |
|---|---|
| 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. |
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