Of the 12.7 million people who live in Pennsylvania, 18.7% are aged 65 and older. The Pennsylvania Health Care Association estimates that one out of four residents of the state is aged 60 or older. The state has 705 licensed nursing homes with more than 88,000 beds, and the average nursing home is over 91% occupied. Pennsylvania seniors have a number of options for their health care and long-term care needs. Two hospitals, University of Pennsylvania-Penn Presbyterian and UPMC Presbyterian Shadyside, are ranked among the top 25 in the nation for senior care, according to US News and World Report.

Nursing home care provides an elderly person with extensive medical intervention and help with daily living needs. The average cost for Pennsylvania nursing home care, according to the 2020 Genworth Cost of Care Survey, is $10,038 for a semiprivate room and $10,828 for a private room. This is significantly higher than the national averages of $7,756 for semiprivate rooms and $8,821 for private rooms.

This guide discusses options for nursing home care in Pennsylvania, resources for seniors who need care and ways to pay for that care.

The Cost of Nursing Home Care in Pennsylvania

Pennsylvania has a high average cost for nursing home care compared to national averages. The 2020 Genworth Cost of Care Survey found that seniors in Pennsylvania pay an average of $10,038 for a semiprivate room in a nursing home, compared to $7,756 for the national average. However, Pennsylvania is among the most affordable in the area compared to neighboring states. In West Virginia, seniors pay $11,376 on average for nursing home care. New Jersey seniors pay an average of $11,254, while in New York, the average cost increases to $12,319. Maryland has an average cost for care of $10,190, while Delaware’s average is $12,349 a month. Only Ohio is less, at $7,148.

$10038

Pennsylvania

$7756

The United States

$7148

Ohio

$10190

Maryland

$11254

New Jersey

$11376

West Virginia

$12319

New York

$12349

Delaware

The cost for nursing home care varies based on the amenities and services available at the facility as well as its location within the state. While the state average is $10,038, in the northern part of the state in Erie, the cost is about $900 less, at $9,186 a month. Williamsport in the central part of the state has a cost of $9,604. In Gettysburg, the cost is higher than the state average, at $10,889, and Harrisburg has an average of $10,311. Philadelphia is much more expensive, with a monthly cost of $11,285. The York area has an average cost of $10,291, while Pittsburgh has an average cost of $9,125.

$10038

Pennsylvania

$9125

Pittsburgh

$9186

Erie

$9604

Williamsport

$10291

York Area

$10311

Harrisburg

$10889

Gettysburg

$11285

Philadelphia

In addition to nursing home care, seniors in Pennsylvania have other care options. The average cost for nursing home care is the highest, at $10,038. Seniors who choose to move to assisted living, which doesn’t provide skilled nursing care, pay an average of $3,955 per month. Home care and home health care both cost an average of $4,576. Adult day care, which provides care and interaction during the day, is the cheapest, with an average of $1,517.

$10038

Nursing Home Care

$1517

Adult Day Care

$3955

Assisted Living Facility

$4576

Home Care

$4576

Home Health Care

Financial Assistance for Nursing Home Care in Pennsylvania

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 Pennsylvania.

Pennsylvania’s Medicaid Program

Many seniors will use Medicaid to pay for nursing home care. Pennsylvania calls its Medicaid program Medical Assistance. The state has 3,096,382 people enrolled in Medicaid and CHIP. Many are seniors who use their benefits to pay for long-term care and skilled nursing help in one of the state’s 705 nursing home facilities. Medical Assistance has income-based eligibility guidelines. The state allows seniors to use Medical Assistance to pay for long-term care if it’s medically necessary, which means a doctor has determined the senior needs round-the-clock medical care from a skilled nurse.

Medicaid-eligible seniors in Pennsylvania can use Medical Assistance to pay for long-term care in one of two ways. They can use their benefit to either pay for a care facility or pay for nursing care at home using the Aging Waiver. With the Aging Waiver, seniors who wish to age at home can apply their Medical Assistance benefit to nursing care and home-based services, rather than using it to move into a nursing home facility. 

Medicaid Eligibility in Pennsylvania

To be eligible for Medicaid coverage for long-term care, a senior must make at or below 300% of the Federal Benefit Rate, which was $2,349 a month in 2020, according to the American Council on Aging. The program also limits the value of assets the seniors can have in their name to $2,000. Seniors must also be citizens of the United States and residents of Pennsylvania. Those who think they’re eligible can apply online using COMPASS.  

  • Monthly income limit: $2,349
  • Assets: $2,000
  • Citizenship: U.S. citizen with Social Security number
  • Residency: Resident of Pennsylvania

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 Pennsylvania

The state of Pennsylvania has robust services for seniors living in long-term care facilities or choosing to age at home. From help with Medicare to local community-based services, these programs are available at little to no cost to make nursing home care or home-based nursing care easier to afford.

ResourceContactService
Area Agencies on Aging(717) 783-1550Each county in Pennsylvania is served by an Area Agency on Aging. Through the AAA, seniors can find the services and help they need in their local communities. This includes Medicare and Medicaid counseling, legal help, senior abuse help, senior centers, nutrition services and opportunities for socialization.
Pennsylvania’s Long-Term Care Ombudsman Program(717) 783-8975Through the Long-Term Care Ombudsman Program, seniors and their families who are utilizing long-term care options in the state have access to advocacy to help ensure they are getting quality care. This organization resolves complaints and problems for individuals who live in long-term care settings, including nursing homes. It also helps seniors understand their rights when they’re in these facilities.
APPRISE Medicare Counseling(800) 783-7067Seniors who are planning to use Medicare to help pay for long-term care need to understand their options. APPRISE provides free Medicare counseling over the phone or through the local AAA office. Seniors who already receive Medicare service can contact APPRISE to get help understanding their benefits and utilizing them well.
Older Pennsylvanians Legal Assistance Program(717) 783-1550The Older Pennsylvanians Legal Assistance Program helps older adults in Pennsylvania understand their rights in legal matters. This includes free legal counsel and advice. It also offers representation if the senior faces a legal case. Services are facilitated through the AAA.
Help at Home OPTIONS Program(717) 783-1550The Help at Home OPTIONS program helps seniors in Pennsylvania find ways to stay in their homes, even if they need long-term care. It has four programs, including Adult Day Care, Care Management, In-Home Meals and Personal Care Services, available at little to no cost for eligible seniors. Seniors can also get help with home modifications, emergency response systems and transportation through this program, which is offered through the senior’s local AAA.

Nursing Home Laws and Regulations in Pennsylvania

Licensing RequirementsAll skilled nursing facilities must be licensed with the state of Pennsylvania’s Division of Nursing Care Facilities, Bureau of Quality Assurance, Department of Health.
Staffing RequirementsPennsylvania has a minimum 1:20 nursing staff-to-patient ratio. This means there must be one licensed nursing staff member for every 20 residents. In addition, at least two nursing service personnel must be on duty at all times. Finally, all SNFs must have a Director of Nursing who is an RN on staff for a minimum of 35 hours and four days per week.Any nursing home with 120 or more residents must have a full-time social worker on staff to plan activities. Smaller facilities must have a social worker to plan and document activities, but they don’t have to be full-time staff members.
Staff Training RequirementsOngoing, coordinated education for all staff at SNFs in Pennsylvania is required by law. Employees also must have an orientation before starting their roles, and the orientation must include instruction on abuse and reporting. Annual service training on infections, fire, accident prevention, confidential information, psychosocial needs and abuse reporting is required.
Admission RestrictionsIndividuals can only be admitted to SNFs in Pennsylvania if the facilities can attend to their needs based on their physician’s recommendations and evaluation.
Care Planning RequirementsAll residents must have a care plan in place within seven days of admission. When possible, residents should participate in their care planning.
Dietary and Nutritional Services RequirementsSNFs must provide menus at least two weeks in advance and keep records for 30 days. A full-time, qualified dietary services supervisor must plan the menus. If the facility doesn’t employ a full-time dietitian, it must consult with one at appropriate times and frequency to ensure healthy meals. A diet manual must be approved by the dietitian and medical director and be available to attending physicians, nursing staff and dietetic personnel.
Specialized Rehabilitative ServicesPennsylvania doesn’t require SNFs to offer specialized rehabilitation services. However, if the SNF does, then the therapies in the resident’s care plan must start within seven days of admission.
Medication and Pharmaceutical ServicesSNFs must administer medications under the oversight of a pharmacist or licensed physician. All residents must have written physician’s orders for medications they take. Medications and biologics can be administered by qualified nurses and licensed practitioners only. The facility must have a monthly pharmacy consultation for each resident to check medication profiles. All medication, including over-the-counter, must remain in the original container and carry the resident’s name on the label.
Activities RequirementsPreserving physical and mental health is an important part of nursing home care. Pennsylvania requires all facilities to have activities that encourage physical, social and mental engagement.
Infection ControlNursing homes in Pennsylvania must take measures to prevent infections following current state and CDC standards for preventing the spread of communicable diseases. The state also requires that staff reports any reportable conditions to the Division of Nursing Care Facilities field office.
Medicaid CoveragePennsylvania Medicaid covers nursing home care for qualified seniors. To qualify, an individual must be a U.S. citizen with a Social Security number, meet income and asset requirements and have a medical need for nursing home care based on a physician’s evaluation.

Nursing Homes Facilities in Pennsylvania (138)