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Nursing Homes in Vermont
Vermont is the country’s second least populous state with a total population of more than 620,000, yet it has a significant senior population, with 20% of its residents 65 and older. The Green Mountain State projects an increase in this age group by 2030, when over one out of four Vermonters are expected to be seniors. Thankfully, Vermont is among the highest ranking states when it comes to health care access, and a large majority of its long-term care facilities accept Medicaid. Likewise, a majority of Vermont’s nursing home residents are Medicaid recipients.
Nursing facilities accommodate individuals who may need 24-hour nursing services in an institutional setting. Based on Genworth Financial’s 2020 Cost of Care Survey, Vermont’s average monthly cost for nursing home care in a semiprivate room costs $9,779, while the private-room option averages $10,311 per month.
This guide offers helpful information about nursing home care in Vermont, its associated costs, available financial support programs and licensing regulations. A list of free statewide resources is also provided.
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The Cost of Nursing Home Care in Vermont
Compared to most states in the American Northeast, Vermont is on the moderate side with an average nursing home care cost of $9,779 per month. According to the Genworth Financial’s 2020 Cost of Care Survey, this amount is about $2,000 more than the national average of $7,756. However, Vermont’s neighboring states are significantly more expensive. New Hampshire’s average cost of $10,646 is nearly $900 more expensive than the Green Mountain State, while New York, at $12,319, costs over $2,500 more. Massachusetts is the most expensive bordering state at $12,623, costing seniors approximately $2,800 more per month than Vermont. Maine is less expensive at $9,642, which is only about $130 less.
Burlington, which is Vermont’s largest city, is more expensive than most areas in the state with an average monthly nursing home care cost of $10,737. This is slightly greater than the average cost of New Hampshire’s Manchester area at $10,646. The nearby New York areas are even more expensive. Glens Falls and Albany, both in New York’s Capital District, have respective nursing home care costs of $14,068 and $12,973. In neighboring Massachusetts, Pittsfield and Springfield have costs of more than $11,100 per month. Seniors opting for Maine can expect to pay $10,220 monthly in the Portland area.
Burlington Area
$10737
Manchester Area, NH
$10646
Glens Falls, NY
$14068
Albany Area, NY
$12973
Pittsfield, MA
$11102
Springfield, MA
$11568
Portland Area, ME
$10220
Several noninstitutional care options in Vermont may be considered based on budget and the required level of care. Assisted living at $5,310 costs slightly lower than in-home care and home health care, which cost $5,434 and $5,529, respectively. The costs for these three types of care are somewhat comparable, but assisted living includes monthly accommodations, meals and most utilities. Adult day care at $2,979 is the cheapest option and may be amenable to homebound seniors who need intermittent nursing or moderate levels of medical care instead of 24-hour skilled care.
In-Home Care
$5434
Home Health Care
$5529
Adult Day Care
$2979
Assisted Living Facility
$5310
Nursing Home Care
$9779
Does Medicaid Cover Nursing Home Care in Vermont?
The state Medicaid program benefits over 180,000 individuals. Nursing home residents are covered for the cost of nursing care services, along with living accommodations and housekeeping costs. On-site visits with physicians and rehabilitation therapists are also charged to Medicaid, in addition to medically related social and pharmaceutical services.
In Vermont, there are over 160 nursing homes, with over 6,400 beds collectively. There are alternatives for qualifying seniors who need skilled nursing care but may not need to reside in an institutionalized care setting. Choices for Care is Vermont’s Medicaid program dedicated to long-term care services. Through the program, the waiver allows seniors to age in place at home or in other residential settings while also receiving skilled nursing and personal care services.
Medicaid Eligibility in Vermont
There are a few requirements that applicants must meet to qualify for Medicaid coverage. Single applicants’ monthly income can be no more than $2,742 and they can have no more than $2,000 in assets. The income and asset limits are the same if only one spouse is applying; however, the Spousal Impoverishment Act allows the non-applicant to have up to $148,620 in assets. Couples can make up to $5,484 per month and have $3,000 in assets at most.
| Household Size | Number of Applicants | Income Limits Per Year* | Asset Limits: Applicant(s) | Asset Limits: Non-Applicants |
|---|---|---|---|---|
| One Person | 1 | $32,904 | $2,000 | |
| Two People | 1 | $32,904 | $2,000** | $148,620 |
| Two People | 2 | $65,808 | $3,000 |
* Except for a $72.66/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.
**Income limit is for applicant only.
Along with the financial requirements, applicants must be residents of Vermont and need hospital-level nursing care. To qualify for Medicaid in Vermont, applicants must:
- Be 65 years of age or older
- Be a United States citizen
- Reside in Vermont
How To Apply for Medicaid in Vermont
Seniors and families can use the Vermont Health Connect website to submit an application or call (855) 899-9600 to request a paper application to send by mail. The program also offers one-on-one assistance with certified application counselors. Directories for professional application counselors can be found on the Find an Assister page. There are some cases when an application may need to be updated or changed due to a lack of proper documentation, which can add three weeks to the waiting period. To avoid a longer wait time, be sure to collect all the necessary documents before starting the application process.
Information You Will Need:
- Birth certificate
- Medicare cards
- Social Security card or other proof of citizenship, such as a green card
- Proof of earned and unearned income up to 60 months prior to the date of the application
- Bank statements for the previous 60 months
- Proof of private or government pension(s), including a letter of verification from the provider
- Copies of life insurance documents
- Car registration and insurance
- Proof of real properties sold or transferred in the previous 60 months
- VA discharge papers (DD 214) for veteran applicants
- Any other documents supporting the applicant’s claim
Additional Medicaid Support & Resources in Vermont
While the Medicaid application process may seem difficult, there are a few resources for families in Vermont for application assistance, including Medicaid Planning Assistance. Medicaid also manages additional programs, such as Medicare Savings Programs, to help low-income seniors with out-of-pocket medical expenses.
| Resource | Contact | Service |
|---|---|---|
| Medicare Savings Programs | (800) 250-8427 | For seniors and families who need assistance paying for Medicare premiums, Medicare Savings Programs cover the cost of Parts A and B. There are four programs for different levels of income and other eligibility factors. To find out if an individual or couple qualifies, contact the Vermont Medicaid program. |
| Medicaid Planning Assistance | Online Only | The Medicaid Planning Assistance website has an in-depth guide on Medicaid eligibility in Vermont and HCBS waivers, as well as an online tool to determine an individual's eligibility. Seniors and loved ones can also read about estate planning and the role of elder law attorneys. The website has search tools to find Medicaid nursing homes and a VA pension planner. |
| Benefits.gov | (800) 250-8427. | Benefits.gov is the official website for public benefits provided by the U.S. Government. Users can search by category or for a specific program. Categories range from financial assistance to educational opportunities. Partnered with numerous federal agencies, the website has a Benefit Eligibility Screening Tool (BEST) provided by the Social Security Administration. |
Does Medicare Cover Nursing Home Care in Vermont?
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 Vermont
Medicare may not cover the cost of long-term care, but it can help seniors pay for the first 21 days. This gives families more time to find ways to pay in the long term without delaying care to seniors who need it. Below are a few resources that help seniors learn about Medicare and manage their benefits.
| Program | Contact | Service |
|---|---|---|
| Vermont Area Agencies on Aging | (800) 642-5119 | With five offices located throughout the state, the Area Agencies on Aging provide workshops at local senior centers regarding nutrition and wellness. Seniors can also contact the agency for help finding a local health insurance counselor or long-term care ombudsman. Case managers can assist families with assessing long-term care needs and resolving issues with Social Security and other public benefits. |
| Vermont State Health Insurance Program (SHIP) | (800) 642-5119 | The State Health Insurance Program (SHIP) offers free and unbiased counseling to Medicare beneficiaries. Seniors and loved ones can find assistance with maintaining benefits, along with learning about the basics and supplemental coverage options. Counselors have experience with appealing denials of claims and reporting fraudulent transactions on the beneficiaries' behalf. Additionally, qualifying individuals can apply for financial aid to cover out-of-pocket medical costs. |
| BenefitsCheckUp | (800) 794-6559 | BenefitsCheckUp is a free website that provides a list of statewide and nationwide resources to users based on their location and a short questionnaire. There are financial assistance programs that can help seniors and families cover the various costs of living, including state supplemental income programs. Seniors can also find programs, such medication assistance and in-home chore services, that can promote independence. |
| Medicare.gov | (800) 633-4227 | The official Medicare website has a self-service portal for applying for benefits, as well as viewing enrollment status and medical history. Individuals and families can find articles and guides about Medicare and supplemental health plans, in addition to information on how to find help from a local Medicare professional. Users can find detailed guides about managing benefits, such as how to file an appeal and the free “Medicare & You” handbook. |
Other Financial Assistance Options for Nursing Home Care in Vermont
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 Vermont
There are many resources in Vermont 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 |
|---|---|---|
| Vermont Area Agencies on Aging | Vermont's Area Agencies on Aging are a vital resource for older adults to remain independent. Services available include pickup and home delivery of hot and healthy meals, access to free online classes to socialize and learn new skills, caregiver support and home medication help. Older adults in Vermont can also get help through various AAA programs, such as tai chi for fall prevention classes and phone services for keeping housebound seniors connected. |
Cash Assistance Programs
Cash assistance programs in Vermont 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 |
|---|---|---|
| Vermont 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, Vermont 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 |
|---|---|---|
| Vermont Choices for Care (CFC) Waiver | 802-241-0294 | Vermont seniors who need nursing home level care may be eligible for the Choices for Care waiver. This waiver provides long-term services to avoid nursing home placement, allowing seniors to live more independently in their own homes or a lower-level facility. With a set number of slots available, some applicants may find themselves on a waiting list before approval. |
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 Vermont seniors afford the nutritious food they need.
| Program Name | Phone Number | Description |
|---|---|---|
| Vermont Meals on Wheels | Vermont Meals on Wheels is part of a nationwide network of food assistance programs. Seniors must be 60 years of age or older to start the application process. Nutritious meals, a watchful eye and companionship are important components of the program. Well-balanced meals are served in congregate settings such as senior centers for those mobile enough to attend, and they're delivered daily to the homes of immobile seniors. Additional services may include pet meal delivery, emergency meals and transportation to doctor appointments. | |
| Vermont Foodbank | 800-585-2265 | The Vermont Foodbank works with partner agencies throughout the state to connect seniors and low-income residents with emergency food providers in their local areas. Its late-summer Apple Days program provides 2,000 free pecks of apples to Vermont residents every year. The organization also plans fundraisers, such as the annual Point to Point bicycle ride, that support local food bank operations. |
| Vermont 3SquaresVT | 800-479-6151 | Vermont's 3SquaresVT program helps seniors and low-income state residents purchase healthy, nutritious food at grocery stores, convenience stores and farmers' markets. Single adults of 65 years of age or older receive their monthly benefits as direct deposits to bank accounts, while individuals under 65 receive electronic benefit transfer cards. To qualify, seniors should have a gross household income that's under 185% of the federal poverty level, though in some cases seniors with limited resources may still qualify. |
Free Used Medical Equipment
Due to the high cost of purchasing new medical equipment, several organizations in Vermont 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 |
|---|---|---|
| Vermont Assistive Technology Program | 800-750-6355 | The Vermont Assistive Technology Program offers seniors the opportunity to borrow assistive technology to try it out. If the device is acceptable, the program provides vendor information or seniors can search for the product on the exchange site. |
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 Vermont have different eligibility criteria and often assist retirees by providing grants or loans.
| Program Name | Phone Number | Description |
|---|---|---|
| Vermont Home Access Program | 802-224-1827 | Low-income Vermont seniors who need home modifications to improve accessibility in their homes may be eligible for assistance from the Home Access Program. The Vermont Center for Independent Living offers this program which provides modifications to bathrooms and home entrances. |
Legal Resources
Many organizations offer free or low-cost legal services to Vermont 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 |
|---|---|---|
| Vermont Legal Aid Senior Law Project | The Vermont Legal Aid Senior Law Program provides legal advice on civil matters to low-income seniors aged 60 and older in the state. The program provides advice on subjects including consumer issues and housing. |
Social Security Offices
Social Security offices in Vermont 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 |
|---|---|---|
| Vermont 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 Vermont 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 |
|---|---|---|
| Vermont Property Tax Credit for Disabled Veterans | 802-828-3379 | Seniors who classify as disabled veterans may be eligible for a property tax exemption. If they meet qualifying criteria, the program grants an assessment reduction of $10,000 to $40,000. Surviving spouses of previously qualified veterans may also be eligible if they have not remarried. |
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. Vermont 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 |
|---|---|---|
| Vermont Fuel Assistance | 800-479-6151 | Seniors who meet income guidelines may qualify for assistance with their home heating bills, whether they are homeowners or renters. Application approval also automatically qualifies the participant for free weatherization services |
| Vermont Green Mountain Power Energy Assistance Program (EAP) | 800-775-0516 | Seniors who qualify for the Green Mountain Power Energy Assistance Program will receive a 25% discount off the cost of their first 600 used kilowatt hours each month. If the account is already in arrears, the program also offers a one-time forgiveness of the outstanding charges. |
Veteran's Services
Vermont 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 |
|---|---|---|
| Vermont VA Benefits and Health Care | One of the benefits of serving in the military is access to health care and financial benefits from Veterans Affairs, which Vermont residents can access through the Vermont VA Benefits and Health Care offices spread throughout the state. To be eligible for these programs, seniors need to be qualified veterans. The primary benefits center and VA medical center are located in White River Junction, and satellite locations are spread throughout Vermont. |
Nursing Home Laws and Regulations in Vermont
| Topic | Rule |
|---|---|
| Licensing Requirements | All nursing homes must be licensed by the State of Vermont prior to operation. These licenses must be renewed annually as they expire one year after their dates of issuance. |
| Staffing Requirements | A nursing home must appoint an administrator who is licensed by the State of Vermont. A physician is designated as the medical director, and a registered nurse must serve as a full-time director of nursing. Sufficient nursing staff is required to provide 24-hour care in accordance to the residents’ care plans. The director of nursing may function as a charge nurse only if the nursing home has an average daily resident occupancy of 60 or less. |
| Staff Training Requirements | Nursing homes must employ nurse aides who are competent and included in the Vermont Nurse Aide Registry. Nurse aides with less than 4 months of experience prior to employment must demonstrate competence based on their performance in state-approved training and evaluation programs. Hired nurse aides receive performance reviews once every 12 months and at least 12 hours of regular in-service training/education annually. |
| Admission Restrictions | Anyone seeking nursing home placement must receive options counseling from an authorized agency prior to initial admission or within three working days after direct transfer from hospital discharge, unless it is a readmission, emergency admission or short-term stay no longer than 21 days. A nursing home may only admit clients beyond its licensed capacity for emergency reasons if approval for temporary authorization by the licensing agency is obtained. |
| Care Planning Requirements | A comprehensive care plan for each resident should describe the services to be provided to maintain or improve the client’s physical, mental and psychosocial well-being. The resident and/or family/legal representative may participate in developing a care plan, in cooperation with an interdisciplinary team consisting of the client’s attending physician, responsible registered nurse and other appropriate staff. Periodical reviews and revisions must be done based on routine and necessary assessments. |
| Dietary and Nutritional Services Requirements | A nursing facility must employ a qualified full-time dietitian or designate a director of food service who works frequently with a part-time or consultant dietitian. Nourishing and palatable meals should be offered based on well-balanced diets that meet the daily nutritional and special dietary needs of each resident. Individual therapeutic diets must be prescribed by the resident’s attending physician. Assistive utensils and special eating equipment are provided when needed. |
| Specialized Rehabilitative Services | Physical, occupational and speech therapy, as well as mental health and other specialized rehabilitative services, must be provided, based on the residents’ care plans and written orders by physicians/qualified staff. These services may also be obtained from outside providers. |
| Medication and Pharmaceutical Services | Each resident’s medication regimen must be free from unnecessary drugs and reviewed by a licensed pharmacist at least once a month. A resident may self-administer medications if determined safe by the interdisciplinary care team. Nursing facilities must prevent medication error rates of 5% or greater. |
| Activities Requirements | An ongoing program of activities is required to support the personal interests and physical, mental and psychosocial well-being of residents, in accordance with their comprehensive assessments. The activities program must be directed by a qualified therapeutic recreation specialist or licensed/registered/certified activities professional. |
| Infection Control Requirements | A nursing facility’s infection control program should include investigations and spread prevention, isolation procedures, recording of incidents and corrective actions. Handwashing is required for all employees after direct contact with each resident. Employees with communicable diseases and infected skin lesions are prohibited from direct contact with residents and their food. |
| Medicaid Coverage | The Choices for Care program of Green Mountain Care (Vermont Medicaid) pays for long-term care services provided in approved nursing homes, as well as in other residential care facilities and the private homes of recipients eligible for nursing facility level of care. |
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