Missouri has a lot to offer seniors, including big-city amenities, small town living and beautiful rural scenery. The state has a comfortable climate and a low cost of living that can help stretch budgets. It’s home to around 6.1 million people, and more than 17% are aged 65 and over. Older adults in the state can access a variety of resources and services to help them age comfortably, including world-class hospitals and around 504 nursing homes that provide long-term care. Nursing homes in the state have an average monthly cost of $5,080 for a semiprivate room and $5,749 for a private room. These facilities provide skilled nursing and medical monitoring in addition to rooms, meals and activity programs.

Seniors and their families can use this guide to help plan for their future care. It includes detailed information about the cost of nursing home care, financial assistance and other programs that support seniors as well as details about the rules and regulations governing nursing homes in the state.

The Cost of Nursing Home Care in Missouri

Genworth Financial’s Cost of Care Survey 2020 shows that the average cost of nursing home care in Missouri is $5,080 per month. This is $2,676 lower than the national average of $7,756 monthly. Missouri also has the lowest price among its neighbors. Arkansas has the next highest cost at $5,931, and seniors in Illinois pay $6,235 per month. In Iowa, the average cost is $6,570, while Kansas has the least affordable nursing home care at a cost of $6,692.




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Seniors in Missouri may find a wide range of nursing home prices depending on their location. St. Joseph and Columbia have the lowest rates with averages of $4,867 and $4,940 respectively. In Jefferson City, seniors pay $5,019 per month, while the cost in both Cape Girardeau and Springfield is $5,171. In St. Louis, the average is $5,355, and in Joplin, seniors pay $5,566. At $6,844 per month, Kansas City has the least affordable nursing home care in the state.


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Due to the skilled nursing and medical services provided, nursing home care is the most expensive senior care option. The most affordable is adult day care, which provides care in a group setting, such as a community center, to people who live at home. This type of care has an average cost of $1,788 per month. The cost of assisted living facilities that provide room, board and personal care is $3,000 per month. In Missouri, care in the home is more expensive than assisted living. Nonmedical in-home care costs $4,372. Home health care, which provides skilled nursing care in the home, has a slightly higher cost at $4,385. This may be an option for seniors who wish to age in place.


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Nursing Home Care

Financial Assistance for Nursing Home Care in Missouri

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 Missouri.

Missouri’s Medicaid Program

Medicaid in Missouri is known as MO HealthNet. As of August 2020, more than 959,000 people are enrolled in the state’s Medicaid and CHIP programs, which provide medical care and financial assistance to low-income people in the state. There are two funding options available for seniors who require long-term care. The first is nursing home, or vendor, coverage. With this program, all of a senior’s income goes towards their care minus a small personal needs allowance, and the state pays the remainder of the costs. People receiving this payment must be screened and certified by the Department of Health and Senior Services as requiring nursing facility care. The second program is the Supplemental Nursing Care program, which provides a cash payment to residents and is usually used by people in residential care facilities or assisted living facilities. There are approximately 1,165 long-term care facilities in Missouri with more than 81,000 licensed beds. Skilled nursing facilities make up 504 of these facilities.

Medicaid Eligibility in Missouri

To be eligible for Medicaid in Missouri, seniors must be aged 65 or over, live in Missouri and intend to remain in the state. Applicants must also be a United States citizen or qualified noncitizen. For regular Medicaid, applicants must earn  less than 85% of the Federal Poverty Level; however, for nursing home coverage, there’s no specific income level. Instead, the majority of the applicant’s income is used to pay for care. The asset limit for all Medicaid programs in Missouri is $5,000 for singles and $10,000 for married couples applying jointly.

To access Medicaid, seniors can apply online or send a completed paper application to the Missouri Department of Social Services, Family Support Division.

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 Missouri

Missouri seniors have access to a variety of resources and services to assist them as they age. Some resources are aimed at people in nursing homes, while others are designed to help people still living in the community. Most governments prefer to help seniors age in place as this is the preference of most seniors. It’s also more cost-effective for governments. Many of these services can help older adults stay at home or save money in case they need to enter a nursing home in the future.

ResourceContact Service
MO HealthNet(855) 373-4636In addition to funding nursing home care, MO HealthNet has a range of waivers that can assist seniors who choose to remain in the community whether at home or in assisted living. Most programs only provide nonmedical services; however some, particularly Missouri Care Options, also include nursing services.
Area Agencies on AgingContact your local officeMissouri has 10 Area Agencies on Aging that provide local information and resources to seniors. All AAAs in Missouri provide legal services, congregate and home-delivered meals, in-home services, health promotion and access services, such as information, advocacy and outreach. Most also provide a range of other services, including housing assistance, recreation and minor home repairs.
Long-Term Care Ombudsman(800) 309-3282The ombudsman program provides advocacy and support to people living in long-term care facilities, including nursing homes and assisted living communities. Ombudsmen regularly visit facilities to build relationships with residents. They also resolve complaints and grievances often by empowering residents to act on their own behalf.
Missouri Veterans CommissionContact a local Veterans Services OfficerThe Missouri Veterans Commission has a range of services to help U.S. veterans. Seniors who served in the military can contact the commission to get help applying for benefits, including the Aid and Attendance supplement, which can help pay for nursing home care. Missouri also has Veterans Homes located in seven cities. They provide skilled nursing care and may be an option for veterans looking for a long-term care facility in the state.
Missouri Assistive Technology(816) 655-6700Missouri Assistive Technology (MoAT) helps people access assistive technology. For seniors, this can include technology that may help them remain at home longer. The service provides equipment loans and also has a recycle and reuse program that allows people to access free and low-cost equipment. MoAT has financial loans available that can be used to make home modifications that improve accessibility.

Nursing Home Laws and Regulations in Missouri

Licensing RequirementsNursing homes in Missouri must be licensed by the Department of Health and Senior Services, and licenses are valid for up to two years unless revoked earlier.
Staffing RequirementsMissouri nursing homes must hire a director who has a current license as a nursing home administrator in the state. There must also be a supervising physician available to coordinate medical care, and a registered nurse (RN) must be appointed as director of nursing. Nursing personnel must be on duty at all times on each resident-occupied floor with an RN on duty during day shifts. An RN or licensed practical nurse (LPN) can be on-site during evening and night shifts.
Staff Training RequirementsStaff providing nursing services must be licensed to deliver those services. Nursing assistants must complete the state-approved training program. In addition, facilities must organize orientation and continuing education programs for all staff.
Admission RestrictionsFacilities must not knowingly admit residents who have needs that they can’t meet. Resident’s needs can be met by the facility directly or through contracts with outside providers.
Care Planning RequirementsCare plans must be completed within 14 days of admission. The plan should be revised at least once every 90 days or when a resident’s medical status changes.
Dietary and  Nutritional Services RequirementsResidents must be served three nutritious meals per day that are properly prepared. The menu must take into consideration residents’ preferences and physicians’ orders if applicable. Residents’ dietary needs must be regularly assessed by a qualified professional, such as a dietitian or registered nurse, and reported to the physician. Facilities must employ a food service supervisor who oversees dietary services.
Specialized Rehabilitative ServicesMissouri nursing homes must be able to provide rehabilitation services to residents according to their needs. A qualified therapist must perform the services according to a physician’s orders. If the facility can’t provide the service directly, they must make arrangements with an outside provider.
Medication and Pharmaceutical ServicesA licensed pharmacist must assist in developing policies and procedures relating to pharmaceutical services in the facility. Medication can only be provided with a written order from a licensed professional. The only individuals allowed to administer medications are licensed physicians, licensed nurses and medication technicians who have completed a state-approved course.
Activities Requirements Facilities must provide activity programs on a regular basis that take into account the needs and capabilities of residents, and a designated employee must be responsible for the program. Each resident should have a written recreation program that includes individual and group activities as well as events outside the facility.
Infection Control Requirements Nursing homes must have infection control policies and procedures, and all staff must receive training in these protocols. Facilities must report any communicable diseases to the state within seven days of diagnosis.
Medicaid CoverageThe cost of nursing home care for eligible seniors is covered by Medicaid in Missouri. To qualify, seniors must be assessed as requiring nursing home care, and they must meet income, asset and citizenship requirements.

Nursing Homes Facilities in Missouri (91)