Located along the northern Atlantic coast just east of New York, Massachusetts is known for its deep historical roots, stunning coastal scenery and abundance of world-class medical facilities. The state is home to 97 hospitals, including the top-ranked Brigham and Women’s Hospital in Boston and the Bedford VA hospital

Seventeen percent of the state’s 6,892,503 residents are aged 65 and older, and as of 2019, 34,363 people lived in nursing facilities in Massachusetts. Nursing homes provide 24/7 skilled medical care, accommodations and recreational programming for those who have complex medical needs due to advanced age, illness or disability. 

According to Genworth Financial’s 2020 Cost of Care Survey, the average monthly cost of nursing home care in Massachusetts is $12,623 for a semiprivate room and $13,535 for a private room. This guide provides a comprehensive overview of nursing home care in Massachusetts, including a look at the costs, links to financial aid programs and services, and a summary of the state laws and regulations that apply to skilled nursing facilities. 

The Cost of Nursing Home Care in Massachusetts

At a monthly average cost of $12,623 for a semiprivate room, nursing home rates in Massachusetts are similar to rates in Connecticut ($12,927) and New York ($12,319). Rates are notably lower in Rhode Island ($8,669), Vermont ($9,779) and New Hampshire ($10,646). Rates throughout the northeastern region are well above the national average of $7,756. 

$12623

Massachusetts

$7756

The United States

$8669

Rhode Island

$9779

Vermont

$10646

New Hampshire

$12319

New York

$12927

Connecticut

The cost of semiprivate nursing home care across Massachusetts varies from a low of $11,102 in Pittsfield to a high of $13,383 in the state capital of Boston. Costs are also above the state average of $12,623 in Barnstable Town on Cape Cod. Rates in Worcester ($12,486), Springfield ($11,586) and Pittsfield ($11,102) are all below the state average. 

$11102

Pittsfield

$11586

Springfield

$12486

Worcester

$13326

Barnstable Town

$13383

Boston

Nursing home care, also known as skilled nursing care, is the costliest long-term option for those who need assistance because this level of care involves around-the-clock medical care in a specialized residential facility. Seniors and adults with disabilities who don’t need the level of care provided in a nursing home have a variety of options in Massachusetts.

The least-expensive care option is adult day health care for $1,598 per month, which includes nonmedical care and supervision in a communal setting. Seniors who want residential care may also be eligible for placement in an assisted living facility, which costs an average of $6,085 per month. Those who prefer to remain in their home can expect to pay about $5,529 per month for 44 hours of weekly homemaker service, while a home health aide costs an average of $5,649 per month. 

$1598

Adult Day Health Care

$5529

Homemaker Services

$5649

Home Health Aide

$6085

Assisted Living Facility

Financial Assistance for Nursing Home Care in Massachusetts

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 Massachusetts.

Massachusetts’s Medicaid Program

Close to 1,650,000 Massachusetts residents are enrolled in MassHealth, the state’s Medicaid program. MassHealth benefits for seniors aged 65 and older include long-term care services through the Home and Community-Based Services Waivers program. These services include placement in one of the state’s 413 skilled nursing facilities, which have a total of 47,176 beds available to seniors and adults with disabilities. 

The HCBS covers the cost of direct care services delivered in a nursing home, including personal care, skilled nursing care, rehabilitation therapies and behavioral support. HCBC benefits are assigned based on the needs of the covered individual, and MassHealth beneficiaries who qualify for nursing home benefits are required to cover the Patient Paid Amount on a monthly basis. The PPA is adjusted annually by MassHealth, and nursing home residents are allowed to retain a modest Personal Needs Allowance to buy personal items and services not provided by the nursing home. 

Medicaid Eligibility in Massachusetts

To qualify for Medicaid coverage in Massachusetts, residents need to meet specific criteria that include income and asset limits and residency requirements. Individual applicants aged 65 and older must

  • Live in Massachusetts
  • Have a monthly income no greater than $2,349
  • Own a home in which they reside and valued at no more than $893,000
  • Have no more than $2,000 worth of countable assets, including cash, stocks and real estate other than their principal residence

Residents can apply online.

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 Massachusetts

Massachusetts seniors have access to a number of free and low-cost resources, including Medicaid counseling, advocacy services and legal assistance. 

ResourceContact Service
Department of Veterans’ Services(617) 210-5480The Massachusetts Department of Veterans’ Services provides free support and information to veterans, survivors and dependents. The goal of the Department is to ensure all eligible veterans and their families receive their maximum entitlements through local, state and federal programs, including VA enhanced pension programs. 
Attorney General’s Elder Helpline(888) 243-5337Open Monday through Friday, the Elder Helpline is staffed by volunteer operators who help seniors with questions about health insurance, long-term care, elder abuse, fraud and consumer issues. 
SHINE Health Insurance Counselling(800) 243-4636Serving the Health Insurance Needs of Everyone helps Massachusetts seniors navigate their health insurance options. Trained SHINE counselors provide free, unbiased information on Medicare plans, benefits and costs, as well as other programs geared toward those who need help paying for health care expenses. 
Massachusetts Senior Legal Helpline(800) 342-5297Operated by the Volunteer Lawyers Project of Boston, the Massachusetts Senior Legal Helpline is open to calls from low-income seniors aged 60 and older. Helpline operators can refer callers to a low-cost or free attorney who specializes in elder law issues such as guardianship, estate planning and Social Security benefits appeals. 
Alzheimer’s Association — Massachusetts/New Hampshire Chapter(800) 272-3900The Massachusetts/New Hampshire Chapter of the national Alzheimer’s Association provides a range of services to those living with memory loss. The AA facilitates a number of in-person and online support groups for people with dementia and their families, helping people with memory loss secure long-term care services and advocating at the local, state and federal levels for additional funding for Alzheimer’s-related research and programming. 
Massachusetts Councils on Aging(413) 527-6425The Massachusetts Councils on Aging is a nonprofit organization that represents 350 senior centers and local councils on aging statewide. Seniors and their caregivers can contact the COAs to connect with local resources such as health screenings, transportation, meal delivery services and long-term care programs. 
Massachusetts Long-Term Care Ombudsman(800) 243-4636The Massachusetts Long-Term Care Ombudsman works to protect the rights of long-term care residents statewide. Ombudsmen advocate on behalf of those living in nursing homes who have concerns related to their care, living conditions, health and safety. 

Nursing Home Laws and Regulations in Massachusetts

Nursing homes in Massachusetts are licensed and regulated by the Department of Public Health in accordance with Regulation 105 CMR 150.00

Licensing RequirementsFacilities that accept Medicare or Medicaid funding must comply with federal nursing home regulations. Under state law, nursing homes are licensed as either Level 1 or Level 2, with Level 1 homes providing the highest level of care and support. 
Staffing RequirementsLicensed nursing homes must have a full-time administrator who is on-site at least five days a week, as well as a substitute administrator. The administrator must be licensed as a Nursing Home Administrator by the Board of Registration of Nursing Home Administrators, which requires that license holders complete at least 40 hours of continuing education annually. 
Staff Training RequirementsStaff must complete an approved Resident Care Assistant course or higher before being hired to work in a licensed nursing home. 
Admission RestrictionsNursing homes may only admit those who cannot be safely supported in a less-restrictive setting, such as an assisted living facility. Individuals who pose a threat to the health and safety of other residents due to behavior or communicable disease cannot be admitted to a nursing facility. 
Care Planning RequirementsNew residents should have a comprehensive care plan that includes a health assessment within 14 days of admission. This care plan is to be reviewed every 90 days or more often for residents who experience frequent changes to their health conditions. 
Dietary and  Nutritional Services RequirementsNursing homes must provide three dietician-approved meals daily plus snacks, and meals need to be prepared in a way that is safe for residents who have difficulty swallowing. Dietary preferences and special requirements should be accommodated. 
Specialized Rehabilitative ServicesNursing home residents can receive specialized rehabilitative services, such as speech and language, occupational and physical therapy, either on-site or at a nearby clinic. 
Medication and Pharmaceutical ServicesMedications may only be administered with the consent of the resident or their legal guardian except in emergency situations where the medication is approved by a licensed medical expert. 
Activities Requirements Long-term care facilities must provide age-appropriate recreational programming for residents. 
Infection Control Requirements Nursing homes are required to comply with public health guidelines related to the prevention and control of infectious diseases. 
Medicaid CoverageMassHealth, the state Medicaid program, covers the care costs for eligible MassHealth members residing in a skilled nursing facility certified by state regulations and complying with federal Medicaid participation requirements. Residents are responsible for their own room-and-board costs. 

Nursing Homes Facilities in Massachusetts (91)