A nursing home in Illinois runs about $94,900 a year for a shared room, less than most states charge but more than almost any family can pay out of pocket for long. The thing that makes that bearable is that Medicaid covers this care as an entitlement, with no waitlist, for those who qualify.
This guide walks through what a nursing home is, how to check a facility's quality before you choose one, what it actually costs in Illinois, and how Illinois Medicaid pays for long-term nursing-facility care.
In This Guide
- Key Takeaways
- What a Nursing Home Is
- How to Check a Facility's Quality
- What a Nursing Home Costs in Illinois
- Does Illinois Medicaid Pay for Nursing Homes?
- Frequently Asked Questions
What a Nursing Home Is
In Illinois, a nursing home is a skilled nursing facility. It provides 24-hour licensed nursing care, help with daily activities like bathing and dressing, and rehabilitation services such as physical, occupational, and speech therapy. That round-the-clock nursing is the line that separates it from assisted living. An assisted living community is non-medical and built for people who need help with daily tasks but not constant skilled care. A nursing home exists for medical needs an assisted living facility can't legally meet, like managing a feeding tube, IV medications, or an open pressure wound.
People arrive at a nursing home along two different paths, and it's worth keeping them straight because they're paid for differently. The first is short-term rehabilitation, often after a hospital stay for a stroke, a fall, or surgery, where the goal is to recover and go home. Medicare helps with that short rehab stay under specific conditions, covering up to 100 days per benefit period after a qualifying three-day inpatient hospital stay, with a daily coinsurance after day 20. The second path is long-term custodial care, where someone needs ongoing nursing and supervision they can't safely get at home. Medicare does not pay for that long-term custodial stay. That is the care families worry about affording, and it's where Medicaid becomes the main payer.
How to Check a Facility's Quality
Quality varies widely from one nursing home to the next, and Illinois gives you several free tools to vet a place before you commit. Use more than one. Each shows you something the others don't.
Start with state oversight. The Illinois Department of Public Health (IDPH) licenses and inspects every nursing home in the state through its Bureau of Long-Term Care, under the Nursing Home Care Act, and it conducts roughly 1,300 on-site licensure inspections a year. If you see something that worries you, IDPH runs a 24-hour Nursing Home Hotline at 800-252-4343, which takes complaints about resident care, abuse, and neglect. When you tour a facility, ask to see its most recent inspection results and look for a pattern of repeat deficiencies rather than reacting to a single old citation.
Next, check the federal star rating on Medicare Care Compare. For every Medicare- and Medicaid-certified nursing home, the Centers for Medicare & Medicaid Services publishes an overall rating from 1 to 5 stars, where 5 means much above average and 1 means much below average. That overall rating combines three things: health inspection results, staffing levels, and quality measures. The staffing component deserves a close look on its own. How many nurses and aides a facility keeps per resident shapes day-to-day care more than almost anything else.
Finally, know who to call for help. The Illinois Long-Term Care Ombudsman Program, administered through the Illinois Department on Aging, advocates for nursing-home residents and investigates complaints. A local ombudsman can be a candid, on-the-ground source of information about specific facilities in your area before you ever sign anything.
What a Nursing Home Costs in Illinois
Nursing-home care is expensive everywhere, but Illinois costs less than most of the country. According to the CareScout (Genworth) Cost of Care Survey, the 2024 statewide medians were about $94,900 a year (roughly $7,908 a month) for a semi-private room and about $109,500 a year (roughly $9,125 a month) for a private room. That semi-private figure runs well below the national median of about $111,325. Those are medians from an industry survey, not government rates and not maximums, and downstate costs differ from the Chicago metro. The figure at any one facility can land higher or lower depending on location, room type, and level of care.
| Room type | Illinois (year) | Illinois (month) | National (year) |
|---|---|---|---|
| Semi-private room | ~$94,900 | ~$7,908 | ~$111,325 |
| Private room | ~$109,500 | ~$9,125 | ~$127,750 |
To put that in context, the same 2024 survey put Illinois assisted living at a median of about $5,836 a month, roughly $70,032 a year. A semi-private nursing-home room costs noticeably more than that. The gap is the reason families look hard at whether assisted living or in-home care can meet the need before moving to a nursing home, and it's the reason most long-term nursing-home residents end up relying on Medicaid rather than paying privately for years.
Does Illinois Medicaid Pay for Nursing Homes?
Yes, and this is the single most important thing to understand about paying for an Illinois nursing home. The Illinois Department of Healthcare and Family Services (HFS) administers Medicaid in the state, and it covers nursing-facility care as an entitlement with no waitlist for those who qualify financially. If a person qualifies and needs that level of care, Medicaid covers it. That sets nursing-facility care apart from home- and community-based programs, which help people stay at home but can carry a waitlist when their enrollment slots are full. The trade-off with the entitlement is that it pays for care in a facility, not at home.
Qualifying turns on an asset test and an income contribution, plus a medical finding that you need a nursing-facility level of care. Here is how the money side works.
Assets. A single applicant may keep no more than $2,000 in countable assets; a married couple with both spouses applying may keep $3,000. Some assets don't count, including a primary home (while it remains the principal residence), one vehicle, and personal belongings. A married couple with one spouse staying in the community gets federal spousal-impoverishment protections, so that community spouse can keep a protected share of the couple's resources and income.
Income. A nursing-home resident on Medicaid contributes nearly all of their monthly income toward the cost of care, keeping only a small personal needs allowance for incidentals like clothing and a haircut. Medicaid then pays the facility the difference between that contribution and the cost of care.
The five-year look-back. Illinois applies a five-year (60-month) look-back to asset transfers made for less than fair market value. Gifting money or property away in that window can create a penalty period that delays eligibility, so giving assets to family in a rush to qualify often backfires.
Estate recovery. After death, Illinois pursues Medicaid estate recovery against the estates of recipients who were 55 or older and permanently institutionalized, unless the person is survived by a spouse or certain dependents. The home is protected while it remains the principal residence of the recipient or certain close relatives. Applicants apply through the Illinois Department of Human Services and obtain a level-of-care screening through the Department on Aging or DHS.
Frequently Asked Questions
The 2024 CareScout (Genworth) Cost of Care Survey put Illinois's median at about $94,900 a year (roughly $7,908 a month) for a semi-private room and about $109,500 a year (roughly $9,125 a month) for a private room. Those are statewide medians from an industry survey, not maximums, and Illinois runs below the national median. Chicago-metro facilities tend to cost more than downstate ones.
Yes. Illinois Medicaid, administered by HFS, is the main public payer for long-term nursing-facility care, and that care is an entitlement with no waitlist for those who qualify financially and need that level of care. That sets it apart from the state's home- and community-based programs, which can carry a waitlist because their enrollment slots are limited.
A single applicant may keep no more than $2,000 in countable assets, and a married couple with both applying may keep $3,000. A primary home, one vehicle, and personal belongings generally don't count, and a married couple with one spouse staying at home gets federal spousal-impoverishment protections for that community spouse.
A nursing-home resident on Medicaid contributes nearly all monthly income toward the cost of care, keeping only a small personal needs allowance, and Medicaid pays the facility the rest. Illinois also applies a five-year look-back to asset transfers, so gifting assets away shortly before applying can trigger a penalty period that delays eligibility.
Check the facility's 1-to-5-star overall rating on Medicare Care Compare, paying attention to the staffing component, and review its IDPH inspection results. You can report concerns to IDPH's 24-hour hotline at 800-252-4343 and contact the Illinois Long-Term Care Ombudsman for on-the-ground information about specific facilities.
Learn More
- Assisted Living in Illinois
- Memory Care in Illinois
- Home Care vs. Home Health in Illinois
- Medicaid Estate Recovery, Explained
- Medicaid Personal Needs Allowance, Explained
- Medicaid Planning Strategies
Find personalized help comparing nursing homes in Illinois 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.