Nursing homes in Washington, DC are licensed and inspected by DC Health, and a home's inspection reports are public, including the home's own plan for fixing what inspectors found., If a hospital discharge planner has just handed you a list of DC nursing homes, those reports, read alongside Medicare's star ratings, are a practical way to narrow it down.

Cost is the other half of the decision. CareScout's 2025 Cost of Care Survey put the DC-area median for a semi-private nursing-home room at $146,730 a year, well above the national median of $114,975 a year, so knowing which program pays for which part of a stay matters as much as the star ratings.

In This Guide

What a Nursing Home Is in DC

DC law defines a nursing home as a 24-hour inpatient facility, or a distinct part of one, that is primarily engaged in providing professional nursing services, health-related services and other supportive services a resident needs. It is unlawful to operate one in the District without a license, and under D.C. Code § 44-502 a nursing-home license expires one year from the date it was issued or last renewed unless it ends sooner. That yearly renewal matters to you as a shopper, because it means every home on your list has been licensed or relicensed by the District within the past year.

Nationally, nursing homes are also called skilled nursing facilities, and their services focus more on medical care than most assisted living. A nursing home typically provides nursing care, 24-hour supervision, three meals a day and help with everyday activities, and rehabilitation services such as physical, occupational and speech therapy are also available. If you're weighing a DC nursing home against a less medical setting, that difference in nursing care is the line to hold on to.

Families usually arrive by one of two routes, and it helps to know which one you're on because they're paid for differently. The first is short-term rehab after a hospital stay, where the goal is to recover and go home, and that's the stay Medicare helps with. The second is long-term care for someone who can no longer be safely cared for at home. Medicare does not pay for that long-term custodial care, and it's where the cost and payment questions below come in.

How to Check a DC Nursing Home Before You Choose

Start with the District's own records. The DC Department of Health, known as DC Health, licenses and certifies health care facilities, including nursing homes, for compliance with District and federal health and safety standards. Its Health Care Facilities Division conducts regular on-site surveys covering health, safety, sanitation, fire and quality of care, and the deficiencies it finds can affect a home's District license and its eligibility for Medicare and Medicaid payments. That makes DC Health's inspection reports the first record to pull on any DC nursing home you're considering.

DC Health publishes those findings. According to its inspection reports page, DC Health's inspection reports are generated for annual, recertification and complaint inspections, and the reports include the deficiencies DC Health identified along with the facilities' corrective action plans for addressing them. Nursing homes have their own survey-reports page, which lists homes under "Current" and "Inactive" headings, and DC Health also posts a Nursing Homes Directory. The corrective action plan is the part to read closely, because it shows what the home says it did about each problem inspectors found.

Read the reports with DC Health's own caution in mind. DC Health says inspection reports reflect a snapshot in time and are not necessarily a reflection of long-term or ongoing conditions at a facility. One citation from years ago tells you little. The same kind of deficiency showing up in inspection after inspection tells you a lot.

You can also ask the home directly. Federal rules require a nursing home to post the results of its most recent survey where residents and families can readily see them, and to make its reports on surveys, certifications and complaint investigations from the past 3 years, with any plan of correction in effect, available to anyone who asks. The CMS statements of deficiencies posted online don't include any plan-of-correction information, so the DC Health reports and the home's own copies are where you'll see what was done about a problem.

How to Read Care Compare for a DC Nursing Home

DC Health itself points families to Medicare's website for more on nursing homes. On Medicare Care Compare, each certified nursing home gets an overall star rating built from three separately rated parts: health inspections, staffing and quality measures. The health-inspection rating carries the most weight, and the staffing and quality ratings move the overall rating up or down from there. On Care Compare, when a nursing home's health-inspection rating is one star, its overall star rating can't be raised more than one star above that. So a strong overall rating sitting on a weak inspection record deserves a second look.

The most important thing for a DC family to understand is the curve. Care Compare grades each nursing home's health inspections against other homes in the same state: in each state the top 10% of homes get 5 stars, the bottom 20% get 1 star, and the middle 70% are split evenly across 2, 3 and 4 stars. A 5-star health-inspection rating in one state is therefore not equivalent to a 5-star rating in another. Many DC families look at homes in the District and in the Maryland and Virginia suburbs at the same time. A DC home's inspection stars rank it against other DC homes, and a Maryland home's stars rank it against other Maryland homes, so don't treat a star count as a cross-border score. Compare the inspection reports themselves instead, and use our guides to nursing homes in Maryland and nursing homes in Virginia for each state's oversight agency.

Three more signals are worth checking on every home you're considering:

  • Staffing: The staffing rating comes from payroll-based data the nursing home submits itself each quarter, not from an independent head count, though CMS audits those submissions for accuracy. Treat it as useful, and ask on your tour how many nurses and aides actually work each shift.
  • The abuse icon: Care Compare puts an abuse icon on homes recently cited for abuse or neglect that harmed, or could have harmed, a resident. On Care Compare, a nursing home carrying the abuse icon has its health-inspection rating capped at 2 stars, which limits its overall rating to 4 stars at best.
  • Special Focus Facility status: The Special Focus Facility program singles out nursing homes with a long history of serious quality problems, and those homes are inspected about twice a year. CMS says about half of Special Focus Facility nursing homes significantly improve within 24 to 30 months, while about 16% tend to be terminated from Medicare and Medicaid. Ask any home you're considering whether it is, or recently was, a Special Focus Facility.

For a walkthrough of what each star component measures, see what Medicare nursing home star ratings really mean.

What a Nursing Home Costs in Washington, DC

Nursing-home care in the District costs well above the national midpoint. The CareScout Cost of Care Survey, whose DC results were released in March 2026, put the 2025 median at $146,730 a year for a semi-private room and $173,740 a year for a private room, based on 365 days of care. CareScout's 2025 national medians were $114,975 a year for a semi-private nursing-home room and $129,575 a year for a private room.

Room type DC area (per year) National (per year)
Semi-private room $146,730 $114,975
Private room $173,740 $129,575

Two cautions come with these figures. First, CareScout collects its rates at the metropolitan-area level, and its DC region also takes in Arlington and Alexandria; CareScout says its regions can often include counties from nearby states. Second, the DC numbers move a lot from year to year: CareScout reported the DC semi-private median up 50% from 2024 and the private-room median down 13%. These are survey medians, not prices or caps. Ask each home for its daily rate in writing, and ask what is included in it.

Who Pays for a Nursing Home in DC

Medicare pays for a nursing-home stay only in narrow circumstances. Medicare Part A covers skilled nursing facility care on a short-term basis after a hospital stay, generally when you've had an inpatient stay of at least three consecutive days and enter a Medicare-certified facility for skilled care related to that stay. Time spent under observation or in the emergency room before admission doesn't count toward Medicare's three-day inpatient requirement for skilled nursing facility coverage. Medicare covers up to 100 days per benefit period: days 1 through 20 cost $0 after the Part A deductible, days 21 through 100 carry a daily coinsurance of $217 in 2026, and Medicare pays nothing after day 100. If your family member doesn't have a qualifying three-day stay, ask about exceptions before assuming there's no coverage, because some Medicare Advantage plans and doctors in certain Accountable Care Organizations can waive the three-day requirement.

For long-term care, the public program that can pay is DC Medicaid, run by the DC Department of Health Care Finance (DHCF). In 2026, DC Medicaid's long-term care rules for older adults include a $4,000 countable asset limit for one person, with the home and one vehicle excluded, and an income standard of $2,982 a month. DC residents over DC Medicaid's $2,982 monthly long-term care income standard who have high medical costs may qualify through a medically needy spend-down instead, and a person already receiving Supplemental Security Income (SSI) isn't held to DC Medicaid's income or asset limit. A DC Medicaid nursing-home resident keeps a personal needs allowance of $109 a month. The full eligibility rules, including what happens when a spouse stays at home, are in our guide to DC Medicaid long-term care.

One more thing to know early: after a Medicaid beneficiary who received coverage at 55 or older dies, DHCF must ask their estate to repay what Medicaid spent, including on nursing-facility care, with protections for certain surviving family members. Our guide to DC Medicaid estate recovery explains who is protected.

Your Rights in a DC Nursing Home, and Who to Call

DC law limits when a nursing home can make a resident leave. Under the District's nursing-home protections law, unless the resident and their representative agree otherwise, a DC nursing home may discharge, transfer or move a resident only to meet the resident's documented health needs, to protect the resident or others from physical or emotional injury, for nonpayment after reasonable notice, when the facility's reasonable administrative needs require it and there's no practical alternative, or when the facility is closing or reducing its licensed capacity. A DC nursing home that takes DC Medicaid can't discharge a resident because their payment switched from private pay or Medicare to Medicaid, or because of a temporary hospital stay while payment for the bed continues.

Timing is part of the protection. A DC nursing home generally has to give the resident and their representative oral and written notice at least 21 calendar days before a discharge or transfer, or 7 days before a move within the building, explaining the reasons and how to contest them. There are exceptions for urgent medical needs spelled out in a doctor's signed orders, or when the Long-Term Care Ombudsman documents an emergency. Under DC law, a DC nursing-home resident has 7 days from receiving a discharge or transfer notice to request a hearing, or 5 days for a move within the facility. That 7-day window is short, so act the day a notice arrives.

The first call to make is to the DC Long-Term Care Ombudsman. The program is established in the D.C. Code to advocate for residents' rights, investigate and resolve complaints made by or for residents, and monitor the quality of care residents receive. The Office of the Long-Term Care Ombudsman sits within the DC Department of Aging and Community Living, which may contract with a nonprofit to run it, and the District lists it as DC Legal Counsel for the Elderly/DC Long-Term Care Ombudsman. The CMS contacts directory lists the DC program's local number as (202) 434-2120. Ombudsman services are free and confidential, and the ombudsman acts on what the resident wants, so expect them to ask your family member directly.

You can also take a complaint about a facility to DC Health, whose File a Complaint page has a route for complaints about a health care professional or facility. DC Health's published inspection reports cover complaint inspections as well as annual and recertification inspections.

Frequently Asked Questions

Is a nursing home the same as a skilled nursing facility in DC?

Nursing homes are also called skilled nursing facilities, and the two terms usually describe the same kind of place: 24-hour supervision, nursing care, meals, help with everyday activities and rehabilitation therapy. For Medicare to cover a short rehab stay, though, the facility has to be Medicare-certified, so confirm that before admission.

Does DC Medicaid pay for a nursing home if my parent owns a house?

Owning a home doesn't by itself rule out DC Medicaid, because the home is one of the things excluded from DC Medicaid's $4,000 countable asset limit for long-term care. The house can still matter later: DHCF must seek repayment from the estate of a beneficiary who received Medicaid at 55 or older, and an estate includes a home that doesn't pass to someone else at death.

What should I do if a DC nursing home says my parent has to leave?

Ask for the written notice, which DC law requires to state the reasons, the proposed date and how to contest it. Under DC law, a DC nursing-home resident has 7 days from receiving a discharge or transfer notice to request a hearing, so call the DC Long-Term Care Ombudsman the same day.

Can someone other than the resident call the DC ombudsman?

Yes. Anyone can contact a long-term care ombudsman program with a concern, and its services are free and confidential. When a family member files the complaint, the program will work out what the resident wants and follow that.

Learn More

Care TypesHow to Choose a Nursing Home: A Step-by-Step GuideHow to choose a nursing home step by step: use Medicare Care Compare correctly, read all four star ratings, check the Special Focus list, and tour. Care TypesWhat Medicare Nursing Home Star Ratings Really MeanMedicare nursing home star ratings blend three scores, and two are self-reported. Here's how the 5-star rating is built and how much to trust it. Care TypesNursing Homes by State: Costs, Medicaid Coverage, and How to ChooseWhat a nursing home costs, how Medicaid pays for it, and how facilities are rated all share a federal floor but vary by state. See yours, with a 50-state guide. MedicaidDC Medicaid Long-Term Care: Nursing Home and the EPD WaiverDC Medicaid pays for long-term care in a nursing home or at home through the EPD Waiver. See the 2026 income standard and how to qualify in the District. MedicaidDistrict of Columbia Medicaid Personal Needs Allowance: What Residents KeepDistrict of Columbia Medicaid lets a nursing-facility resident keep a $109 Personal Needs Allowance in 2026. Here's how it works and how it's protected. MedicaidDC Medicaid Spousal Impoverishment RulesDC Medicaid spousal impoverishment rules let the at-home spouse keep up to $162,660 in assets and all of their own income, brought up to $2,705 a month in 2026.

Find personalized help comparing nursing homes in Washington, DC at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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