Nursing Homes in California
California seniors have easy access to affordable health care. According to Becker’s Hospital Review, California has some of the nation’s best hospitals, with Cedars-Sinai Medical Center, Ronald Reagan UCLA Medical Center, Stanford Hospital and UCSF Medical Center making the 2022–23 top 20 list. The Golden State is home to more than 39 million people, with seniors 65 or older accounting for around 15.2% of the state’s population. As of July 2022, more than 93,000 older adults in California resided in one of the state’s 1,176 nursing homes.
Nursing homes provide 24/7 care and monitoring for seniors who can’t live alone and have significant medical or therapeutic needs. The care team may include registered nurses, certified nursing aides, doctors and rehabilitation specialists. Services may include support with personal care tasks, skilled nursing, medication administration and management of chronic conditions. Nursing homes provide adequate nutrition and mental stimulation. They can also reassure seniors and their loved ones.
This guide provides an overview of nursing home care in California, including how to pay for care and relevant rules and regulations.
Popular Cities in California
Cost of California Nursing Homes
The average cost of nursing homes in California is $245 per day. This is higher than the national average which is $228 per day.
Can You Use Medicaid to Pay for Nursing Home Care in California?
California’s state Medicaid program, which is called Medi-Cal, covers the full costs of nursing home care for eligible seniors. It's an entitlement program for those who qualify. In California, more than 15 million people are enrolled in Medi-Cal, representing about one-third of the state’s total population. Of all enrollees, around 1.5 million are seniors 65 or older.
Seniors who wish to receive nursing care and support at home rather than moving into a residential facility may be eligible for financial assistance via a Home- and Community-Based Services Waiver. This isn't an entitlement program, and qualified applicants may be wait-listed for services.
Eligibility for Medicaid in California
To qualify for Medi-Cal for institutional nursing home care, individuals must satisfy financial criteria. There's no upper income limit. However, individuals must use all of their income to pay for their care except for a $35 monthly personal needs allowance and other limited exceptions. Asset limits apply; single applicants can own a maximum of $130,000 in assets, and joint-applicant couples have an enhanced resource cap of $195,000.
| Income Limits* | Asset Limits | |
|---|---|---|
| Single Person | No Limit | $130,000 |
| Two-Person Household | No Limit | $195,000 |
*Per year
Seniors must also meet criteria related to medical needs, citizenship and residency. Applicants must:
- Be permanent, full-time residents of California
- Be U.S. citizens, U.S. nationals or qualifying legal aliens
- Meet functional requirements of needing a nursing home level of care
Applying for Medicaid in California
Individuals can apply for the state Medi-Cal program online at Covered California. Seniors can also apply over the phone or in person by calling or visiting their nearest county office. Alternatively, older adults can download a printable application form from the DHCS website and return it to their local county office or mail it to:
Covered California
P.O. Box 989725
West Sacramento, CA 95798-9725
Forms are available in multiple languages.
What Information You Will Need
Applicants typically need to provide various confirmation documents in support of their Medi-Cal application. These may include:
- Proof of identification
- Proof of citizenship status
- Proof of in-state residency
- Proof of all sources of income, including benefits, pensions and wages
- Proof of all countable assets, such as bank statements, insurance policies, stocks, shares and bonds
Additional Medicaid Support & Resources in California
Seniors can obtain information and assistance related to Medicaid from various organizations and agencies. Advisors can typically perform an eligibility assessment and assist seniors with the application process.
| Contact | Service | |
|---|---|---|
| California Department of Health Care Services | Call (800) 541-5555 or visit a local county office for assistance | California DHCS maintains a toll-free Medi-Cal helpline that individuals can call to access assistance with navigating the Medicaid system and completing applications. Staff members in local county offices can also provide in-person help. |
| Area Agencies on Aging | Contact the local Area on Aging for assistance | Individuals can find their local Area on Aging’s contact details through the California Department of Aging’s website. They can connect with an advisor who can provide Medicaid information and assistance, including help to complete application forms and appeal adverse decisions. |
| Benefits.gov | (800) 786-4346 | Benefits.gov provides information about Medi-Cal, including eligibility requirements and how to apply. The website has a useful tool for checking basic eligibility, and seniors can also take advantage of the Benefit Finder questionnaire, which can help to identify all appropriate benefits. |
Can You Use Medicare to Pay for Nursing Home Care in California?
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 California
Several organizations and agencies help California’s older adults understand their options regarding Medicare and health insurance. Resources may help individuals apply for coverage, report fraud and understand supplemental insurance options.
| Contact | Service | |
|---|---|---|
| Health Insurance Counseling and Advocacy Program | Call (800) 434-0222 or contact an Area Agency on Aging to locate HICAP services | The Health Insurance Counseling and Advocacy Program is a federally funded program that uses a network of trained volunteers to provide free Medicare and health insurance counseling. Advice is impartial and confidential. Seniors can access services as they approach their 65th birthday and any time afterward. |
| California Health Advocates | (916) 465-8104 | The nonprofit California Health Advocates offers Medicare education, advocacy and assistance with the aim of helping older adults to understand their options and coverage details. Seniors can also connect with the Senior Medicare Patrol program, which seeks to empower Medicare beneficiaries to identify and report scams and fraud. |
| California Department of Insurance | (800) 927-4357 | The California Department of Insurance provides online information about Medigap, Medicare Advantage and prescription drug coverage. Individuals can obtain further information by calling the consumer hotline. |
Other Financial Assistance Options for Nursing Home Care in California
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. 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 (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 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. |
Nursing Home Laws and Regulations in California
| Licensing Requirements | California Department of Public Health licenses all skilled nursing facilities (SNFs) throughout California. Such facilities may be stand-alone units or a separate part of a hospital. SNFs that operate across several locations under the same management must have a license for each distinct premises. |
| Staffing Requirements | There should be one member of direct care staff per five residents during the daytime. The staff-to-patient ratio drops to 1:8 in the evening and 1:13 at night. Additionally, an awake nurse must always be on duty. |
| Staff Training Requirements | All skilled staff, such as nurses and rehabilitation therapists, must have relevant job-related training and hold the appropriate licenses. Aides and nursing assistants must complete a comprehensive training program before providing care. All staff must complete ongoing professional development education and training. |
| Admission Restrictions | Skilled nursing facilities in California can only accept a resident if they're able to provide the necessary tailored care to meet their needs. Additionally, doctors must approve a resident's admission. |
| Care Planning Requirements | All residents must have a personalized care plan. Facility staff should create care plans in conjunction with the senior, their family and their physician. Care plans should be finalized within 14 days of admission and updated every 3 months or following a significant change in circumstances. |
| Dietary and Nutritional Services Requirements | California's facilities must employ or retain a dietitian. Facilities can either hire a full-time dietitian or a full-time dietetic services supervisor alongside a part-time dietitian or consulting dietitian. |
| Specialized Rehabilitative Services | California's SNFs may offer additional rehabilitative services, such as physical, speech or occupational therapy. They may also provide audiology and medical social work services. The California Department of Public Health must approve all extra services. |
| Medication and Pharmaceutical Services | SNFs may have on-site pharmacies if they're licensed by the California State Board of Pharmacy and approved by California DPH. Facilities must arrange for appropriate pharmaceutical services so residents can obtain prescription drugs, and all medications must be stored and labeled appropriately. |
| Activities Requirements | Each resident should have an activity plan as agreed with their doctor. Facilities must offer diverse daily activities designed to support physical, mental, emotional and social well-being. Programming must include a combination of small group, large group and one-on-one activities. |
| Infection Control Requirements | ESNFs should screen new residents and staff for tuberculosis. The facility must report all infectious, parasitic and communicable diseases to the local health officer. Each facility should develop infection control measures, which should be reviewed on a yearly basis. |
| Medicaid Coverage | California's seniors may qualify for Medi-Cal if they meet financial and functional need requirements. Asset limits apply, and an individual's doctor must assess them as needing a nursing home level of care. |
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Top Cities in California
- Los Angeles Nursing Homes
- San Diego Nursing Homes
- San Jose Nursing Homes
- San Francisco Nursing Homes
- Fresno Nursing Homes
- Sacramento Nursing Homes
- Long Beach Nursing Homes
- Oakland Nursing Homes
- Bakersfield Nursing Homes
- Anaheim Nursing Homes
- Santa Ana Nursing Homes
- Riverside Nursing Homes
- Stockton Nursing Homes
- Chula Vista Nursing Homes
- Fremont Nursing Homes
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