Nursing Homes in Maryland
Seniors with complex health problems can find it challenging to remain living in the community. People who can no longer manage their health at home or in an assisted living facility may find nursing home care a good option. Also called skilled nursing facilities, these communities have nurses available around-the-clock to provide care for residents. Other medical assistance is offered on-site so seniors don’t have to travel to different facilities. Nursing homes also provide meals, social activities and personal care, such as help with bathing or eating.
Over 16% of Maryland’s 6.1 million residents are 65 and over. In 2022, 21,336 of these seniors resided in Maryland’s 224 nursing homes. This guide has information about ways to pay for nursing home care in Maryland and resources that can help individuals apply for benefits, including Medicaid and Medicare. It also details the rules and regulations that govern nursing homes in the state.
Popular Cities in Maryland
Cost of Maryland Nursing Homes
The average cost of nursing homes in Maryland is $278 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 Maryland?
In Maryland, Medicaid is also known as Medical Assistance or MA. It is a state and federally funded program that pays for nursing home care for eligible people. This includes the cost of room, board and all services. It also has a number of waiver programs that help fund skilled nursing care in the community for seniors who prefer to stay living at home. As of December 2022, over 1.6 million Maryland residents are enrolled in Medicaid. The number of Marylanders in Medicaid has increased by 95% since expanded coverage started.
Eligibility for Medicaid in Maryland
People applying for Medicaid must meet both financial and other criteria that differ depending on the state and type of benefit the individual is applying for. In Maryland, there is no specific income limit. Instead, an applicant’s income can’t exceed the cost of nursing home care. The nursing home resident can keep a Personal Needs Allowance of $93 per month, Medicare premiums and a Spousal Income Allowance. All other income goes towards the cost of the nursing home.
Applicants must also meet asset limits. For single people, this limit is $2,500. When both people apply, married couples can have up to $6,000 in assets, or $3,000 per person. However, after six months this has to decrease to $2,500 per person. If only one spouse applies, the limit is $2,500 for the applicant, but the nonapplicant can have up to $148,620 in assets. Exempt assets include personal belongings, furniture and an automobile. A home is only exempt if the applicant intends to return or if their spouse still lives there.
| Income Limits* | Asset Limits | |
|---|---|---|
| Single Person | Cannot exceed the cost of nursing home care | $2,500 |
| Two-Person Household | Cannot exceed the cost of nursing home care | $6,000 ($3,000 per spouse) After 6 months, $2,500 per spouse |
*Per year
There are also general eligibility requirements. Applicants must:
- Be a Maryland resident
- Be a U.S. citizen or qualifying noncitizen
- Provide a Social Security Number
- Require a nursing home level of care
Applying for Medicaid in Maryland
Seniors can apply for Medicaid online through MDThink. Application forms can be printed from the Medicaid website and returned by mail to the local Department of Social Services. People can also apply in person at local offices.
What Information You Will Need
In order to process the application, seniors may need to provide the following documents:
- Proof of identity
- Proof of citizenship and residency
- Social Security Number
- Proof of income and assets
- Proof of expenses
Additional Medicaid Support & Resources in Maryland
The Maryland government has a range of resources available to help people apply for Medicaid.
| Contact | Service | |
|---|---|---|
| Department of Human Services | (800) 332-6347 | The Department of Human Services has customer service representatives who can help people apply for benefits, identify documents needed or provide translation services. |
| MDThink | (800) 997-2222 | The MDThink website has a comprehensive help section with information on applying and using the customer portal. There are also answers to frequently asked questions about Medicaid. |
| Maryland Access Point (MAP) | (844) 627-5465 | MAP is the Aging and Disability Resource Center for the state. In-person and phone assistance are available. It helps people identify benefits they may be eligible for, connect with local Medicaid assistance and navigate systems to make application easier. |
Can You Use Medicare to Pay for Nursing Home Care in Maryland?
Medicare provides limited coverage for short-term stays in a skilled nursing facility following a hospital stay, but seniors must meet several 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 several 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 Maryland
There are several groups in Maryland that can help seniors navigate Medicare plans and enrollment. Government and nonprofit organizations offer advice on choosing the right plan, understanding benefits and navigating billing and claims disputes.
| Contact | Service | |
|---|---|---|
| Maryland Health Connection | (855) 642-8572 | Maryland Health Connection has a range of options for people to find Medicare help, including local navigators, consumer support officers and enrollment events. Assistance can be provided with choosing a plan, identifying cost savings and using the enrollment tools. |
| State Health Insurance Assistance Programs (SHIP) | (410) 767-1100 or (800) 243-3425 | SHIP helps Medicare beneficiaries understand Medicare. Trained volunteers provide assistance by phone or in person. Help is offered on a range of topics, including benefits, plan choice, billing issues and Medicare fraud and abuse. |
| Health Care Access Maryland | (410) 649-0521 | Health Care Access Maryland is a nonprofit organization that helps connect people to public health care coverage. It can help enroll people in health insurance and navigate systems and services. |
| Maryland Insurance Administration | (800) 492-6116 | Maryland’s Insurance Administration has information available on its website to help people understand Medicare. This includes answers to frequently asked questions and information about premiums, plans and supplemental policies. |
Other Financial Assistance Options for Nursing Home Care in Maryland
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 Maryland
| Licensing Requirements | Nursing homes are licensed by the Maryland Department of Health and are valid for two years. Facilities that offer multiple levels of care, such as nursing homes and assisted living, must be licensed for each level of care provided. |
| Staffing Requirements | Facilities must employ enough nursing staff and support personnel to provide at least three hours of bedside care to each resident every day. At least one registered nurse must always be on-site. Facilities must publicly post the ratio of staff to residents each day. |
| Staff Training Requirements | All nursing staff must participate in a continuing in-service education program. All new personnel must complete a thorough job orientation. |
| Admission Restrictions | Residents can’t be admitted if they require care beyond the facility's capabilities, based on the attending physician's judgment. They also can’t be admitted if they’re a danger to themselves or others. |
| Care Planning Requirements | An interdisciplinary team must develop a care plan within seven days of any resident assessment. It must detail the resident’s needs, goals and how care shall be accomplished. The plan must be updated quarterly or whenever the resident requires it. |
| Dietary and Nutritional Services Requirements | Residents must be provided with at least three meals a day that meet recommended daily allowances as much as medically possible. Therapeutic meals must be provided if prescribed by a physician. Residents must be allowed to participate in planning menus. |
| Specialized Rehabilitative Services | Nursing homes don’t need to offer specialized rehabilitative services. If residents are admitted who require these services, facilities must have qualified personnel to provide them, either on staff or through a contract. Services must begin within 48 hours of the physician’s direction, excluding weekends and holidays. |
| Medication and Pharmaceutical Services | All staff who administer medications must complete the appropriate course. Facilities must have a pharmaceutical services committee to oversee medication policies, including procedures for storing and labeling drugs. |
| Activities Requirements | Nursing homes must provide structured and unstructured activities encouraging resident self-care, engagement and socialization. A qualified activities director must oversee this, and there must be enough space and supplies to conduct these activities. |
| Infection Control Requirements | Facilities must have an infection prevention and control program. A trained infection preventionist must be assigned to monitor the program. Infectious employees must not have direct contact with residents or their food. Employees must also be immunized against infectious diseases, including tuberculosis and influenza. |
| Medicaid Coverage | Medicaid pays for nursing home care in Maryland for seniors who meet both financial and medical eligibility. |
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