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.

$5080

Missouri

$7756

The United States

$5931

Arkansas

$6570

Iowa

$6235

Illinois

$6692

Kansas

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.

$4867

St. Joseph

$6844

Kansas City

$4940

Columbia

$5019

Jefferson City

$5355

St. Louis

$5171

Cape Girardeau

$5171

Springfield

$5566

Joplin

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.

$4372

In-Home Care

$4385

Home Health Care

$1788

Adult Day Care

$3000

Assisted Living Facility

$5080

Nursing Home Care

Does Medicaid Cover Nursing Home Care in Missouri?

MO HealthNet, Missouri’s Medicaid program, can cover some or all of the costs of nursing home care for eligible seniors aged 65 and older. Also known as vendor coverage, the program fulfills the remaining costs after the senior has paid what they can from their existing income. 

Approximately 17.5% of Missouri’s population gets assistance from Medicaid. This equates to around 1,081,802 people, although this figure includes younger residents with disabilities and other care needs, not just seniors in residential care facilities. The benefits of long-term care and nursing home services include 24/7 support from qualified medical professionals and affordable access to medications and health care treatments. Missouri has over 81,100 beds in its 1,165 long-term care communities, with 504 of these communities specializing in skilled nursing. For seniors in need of nursing home levels of care who prefer to remain at home, the Department of Social Services provides the Aged and Disabled Waiver. It’s available to adults aged 63 and older, providing in-home services such as home-delivered meals, adult day care and homemaker support. 

Medicaid Eligibility in Missouri

In Missouri, a nursing home resident must pay for as much of their care as possible before claiming MO HealthNet nursing home coverage as the program is designed to only cover shortfalls. The assessor will also factor in the applicant’s sales of real or personal property up to five years prior to the application date. If the applicant has a spouse, their income and assets will be considered too, although the Prevention of Spousal Impoverishment federal law provides a degree of protection.

2020 Medicaid Income Limits for Seniors in Missouri



Annual Income Limits

Asset Limits

Single Applicant

All countable income*

$5,035

Two-Person Household
(Only One Person Applying)

All countable income*

Applicant: $5,035
Non-Applicant: $137,400

Two-Person Household
(Both People Applying)

All countable income*

$10,070

*Minus a $50 per month personal needs allowance per person. Countable income includes Medicare and possibly the non-applicant spouse’s income.

Other eligibility requirements include that the applicant:

  • Be an American citizen or legal resident
  • Reside in Missouri
  • Be screened and certified for nursing home care by the Department of Health and Senior Services

How To Apply for Medicaid in Missouri

There are several ways a senior can apply for Medicaid in Missouri. The simplest and quickest for those comfortable with computers is through My DSS, an online portal available 24 hours a day. Seniors who prefer the paper method can download and print the application form and mail it to the Family Support Division, 615 East 13th Street, Kansas City, MO 64106. Alternatively, they can phone (855) 373-9994 and speak to an adviser who can guide them through the application process. Seniors can also call the number to arrange an in-person appointment with the nearest DSS office. Applications typically take up to 10 working days to process, after which the applicant receives a letter of approval or rejection. Successful applicants also receive an MO HealthNet ID card and clarification of their level of coverage.

Information You Will Need

  • Social Security numbers
  • Insurance document numbers if you’re a legal immigrant
  • Income information for everyone in your household
  • Current health insurance policy numbers
  • Information regarding job-related health insurance for household members

Additional Medicaid Support & Resources in Missouri

Several organizations operating in Missouri provide free and authoritative information about Medicaid. The following list includes some, with contact details and a brief description of each.

Resource

Contact

Service

Online Only

The website for the American Council on Aging provides a wealth of information for seniors and their families. It also includes helpful resources, such as a Medicaid Eligibility Test and a Spend Down Calculator. The former helps families determine if their loved ones are eligible for Medicaid, while the latter helps them see where they can spend down their assets to qualify for long-term care benefits.

(573) 751-3425

Benefits.gov is a federal website that provides a basic overview of Medicaid in Missouri and examples of eligibility requirements. Users can also check out the maximum pre-tax incomes per household size to see if they're within range and find useful links and telephone numbers to Missouri's MO HealthNet service.

(866) 835-3505

Missouri Care Options is a program administered by the Department of Health & Senior Services to help families choose the best long-term care solutions for their loved ones. The program's primary focus is to help seniors who need nursing home levels of care determine if they're better served in a facility or in their community. This support includes consideration of Medicaid and how the state-sponsored benefit may be used most effectively to fund their care costs.

(800) 655-5560

The Missouri Foundation for Health is an independent philanthropic foundation. It has strong connections to charities and nonprofits throughout the state that assist families in need of Medicaid and other health care resources. The foundation can provide information directly and refer families to more suitable support networks in their communities. Due to the opportunities afforded by Medicaid Expansion, it can offer more support to often-marginalized communities, including Missourians living in rural areas.

Does Medicare Cover Nursing Home Care in Missouri?

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 & Resources in Missouri

Medicare can’t pay for long-term nursing home care. However, many resources in Missouri can help seniors gain the most advantage from the state health insurance program to pay for some of their medical care. The following list includes some examples of free-of-charge resources that may be able to help.

Resource

Contact

Service

(800) 633-4227

Medicare.gov is the federal government's main resource for seniors who want more information about the benefit. It informs visitors about the different plans and provides helpful contact details for local resources. There's also a live chatbot open all year round, except federal holidays, that allows visitors to get information any time of day.

(800) 390-3330

CLAIM is Missouri's State Health Insurance Assistance Program. Trained counselors provide unbiased advice and information about the different Medicare plans, including private health insurance related to Medicare Advantage. The counselors can also help seniors complete and submit their applications and challenge decisions if Medicare is refused.

(888) 515-6565

The Senior Medicare Patrol program is staffed by volunteers who work with Medicare and Medicaid beneficiaries to detect and report fraud. The long-term purpose of the program is to prevent benefits from being abused by fraudsters who undermine these programs' integrity. Volunteers educate seniors on how to protect their personal details and recognize deceptive behavior by potential fraudsters. They can also help Medicare beneficiaries spot and act upon discrepancies in their health care bills.

(855) 373-4636

The Missouri Department of Social Services operates two Medicare Cost Savings Programs to help pay premiums for seniors struggling to meet their commitments. The Qualified Medicare Beneficiary program pays for Medicare Part B premiums, coinsurance and deductibles for seniors already in receipt of Medicare Part A. To qualify, the senior's income must be below 100% of the Federal Poverty Level. The Specified Low Medicare Beneficiary program pays Medicare Part B premiums for seniors whose excess income prevents them from accessing the Qualified Medicare Beneficiary program.

Other Financial Assistance Options for Nursing Home Care in Missouri

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.

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 Missouri

Missouri’s seniors can access a wide range of resources to help improve their quality of life as they get older. This list includes organizations that can advocate for seniors in disputes with their care providers, provide gently used medical equipment on loan and deliver a range of services that allow frail seniors to remain comfortably at home. 

Resource

Contact

Service

(800) 309-3282

The Missouri Long-Term Ombudsman program assists seniors residing in residential care communities. Trained volunteers known as ombudsmen regularly visit facilities to engage with the residents, listen to their concerns and investigate complaints made by them, their families and third parties. The Long-Term Care Ombudsman can also supply seniors and families with copies of nursing home inspection reports so they can make more informed choices.

(573) 526-4542

Missouri has an Area Agency on Aging in every county. Although each is local and unique, they all provide similar services for seniors who may otherwise need to enter a nursing home. These include homemaker services that may provide personal care, home-delivered meals, legal support and transportation to medical appointments. Some services are location-specific and may include conducting minor home repairs, educating seniors on health matters and assisting with letter writing and form filling.

The Missouri Veterans Commission is a resource for U.S. military vets and their dependents. It provides a wide range of support for seniors in need of nursing home levels of care. These include information about the local, state and federal benefits they're entitled to. Veterans Services Officers can also help with benefits linked to active service that can cover some care costs, such as VA Aid and Attendance and the Homebound Allowance. 

(816) 655-6700

The purpose of Missouri Assistive Technology is to help the state's older residents gain access to technologies that can assist them in the home and delay entering a nursing home facility. Seniors in need of electronic devices that improve communications, such as tablets and vision devices, may be eligible for a short-term loan of equipment via the agency's Equipment Technology Consortium. Those in need of medical devices, including powered wheelchairs and portable shower chairs, should contact the agency to find out what's currently available on its list of donated used medical equipment.

(844) 836-7433

MO Rides is a free service supported by several state departments and charities. It helps seniors locate the most cost-effective transportation options within their communities. As each location is unique, not every ride program will offer the same services or operate during the same hours. However, they commonly provide rides for medical appointments, grocery shopping and attending senior centers.

(866) 628-9891

DHSS Hyperthermia is a state-sponsored program designed to help seniors in Missouri cope with extreme heat during summer. In addition to educating seniors on how to keep their homes safe and cool throughout the year, the program also manages many cooling centers across the state where seniors can go during a heat crisis. DHSS Hyperthermia also works with families and caregivers to prevent the state's older residents from suffering from heat exposure all year round.

COVID-19 Rules for Nursing Homes in Missouri

The following information is based on research done on several government websites, including ltc.health.mo.gov. These rules apply to Independent Living Communities and other types of senior living facilities. We’ve most recently updated this data on 2/8/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visitation Policies

Rules for Missouri Communities

Are loved ones allowed to visit to provide emotional support?

Yes (Conditions Apply)

Are relatives allowed to visit for end-of-life care?

Yes

Are residents required to quarantine after visiting with a loved one?

No

Are visitors required to wear PPE (including masks) in order to visit residents?

Yes

Are non-medical contractors (such as hairdressers and entertainers) allowed in senior living facilities?

Yes

Are visitors checked for elevated temperatures?

Yes

Are visitors required to answer questions about health, travel, and potential virus contact?

Yes

Outings & Social Activities

Rules for Missouri Communities

Are residents allowed to leave (errands, visiting family, etc.) for non-medical reasons?

Yes

Are residents who leave required to quarantine when they return?

No (Conditions Apply)

Are senior living communities required to cancel all group outings?

No

Are residents allowed to eat meals together in a common area?

Yes (Conditions Apply)

Are residents allowed to gather in common areas for group activites?

Yes (Conditions Apply)

COVID-19 Safety Measures for Staff and Residents

Rules for Missouri Communities

Are staff members regularly required to do a temperature check?

Yes

Are staff members regularly tested for COVID-19?

Yes (Conditions Apply)

Are staff members members regularly required to do a health and safety screening, including questions about travel, contact with positive cases, etc?

Yes

Are residents regularly screened for COVID-19 symptoms?

Yes

Are residents regularly checked for elevated temperatures?

Yes

Are residents regularly tested for COVID-19?

Yes (Conditions Apply)

Nursing Home Laws and Regulations in Missouri

NURSING HOME LAWS AND REGULATIONS IN MISSOURI
Licensing Requirements
Nursing 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 Requirements
Missouri 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 Requirements
Staff 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 Restrictions
Facilities 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 Requirements
Care 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 Requirements
Residents 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 Services
Missouri 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 Services
A 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 Coverage
The 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 (98)