A semi-private nursing-home room in Maryland runs about $150,015 a year, well above the national median and more than most families can pay out of pocket for long. What makes it survivable for most long-term residents is Maryland Medicaid, which pays for nursing-facility care as an entitlement for those who qualify.
This guide covers what a nursing home is, how to check a facility's quality before you choose one, what it actually costs in Maryland, and how Maryland Medicaid pays for long-term care.
In This Guide
- Key Takeaways
- What a Nursing Home Is
- How to Check a Facility's Quality
- What a Nursing Home Costs in Maryland
- Does Medicaid Pay for Nursing Homes?
- Frequently Asked Questions
What a Nursing Home Is
In Maryland, 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 program is built for people who need help with daily tasks but not constant skilled care. A nursing home exists for medical needs those settings can't 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 pays to keep them straight because they're funded 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 full coverage for the first 20 days and a daily coinsurance starting on day 21. 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's 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 Maryland 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. Maryland's roughly 230 licensed nursing homes are licensed and inspected by the Maryland Office of Health Care Quality, part of the Maryland Department of Health, which also runs the federal certification surveys at the direction of CMS. When you tour a facility, ask to see its most recent survey results and look for a pattern of repeat deficiencies rather than reacting to a single old citation. You can also file a complaint about a facility directly with OHCQ.
Next, check the federal star rating on Medicare Care Compare. For every Medicare- and Medicaid-certified nursing home, CMS publishes an overall rating from 1 to 5 stars, where 5 means much above average and 1 means much below. That overall rating combines three things: health inspection results, staffing levels, and quality measures. The staffing component deserves a close look on its own, because 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. Maryland's Long-Term Care Ombudsman works through your county's Area Agency on Aging, or Department of Aging, advocating for nursing-home residents and investigating 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 Maryland
Nursing-home care is expensive everywhere, and in Maryland it runs well above the national midpoint. According to the CareScout (Genworth) Cost of Care Survey, the 2024 statewide medians were about $150,015 a year (roughly $12,501 a month) for a semi-private room and about $173,375 a year (roughly $14,448 a month) for a private room. Both sit well above the national medians, which were about $111,325 for a semi-private room and $127,750 for a private room. These are medians from an industry survey, not government rates and not maximums, and the Washington-area and Baltimore suburbs tend to cost more than rural parts of the state. The figure at any one facility can land higher or lower depending on location, room type, and level of care.
| Room type | Maryland (year) | Maryland (month) | National (year) |
|---|---|---|---|
| Semi-private room | ~$150,015 | ~$12,501 | ~$111,325 |
| Private room | ~$173,375 | ~$14,448 | ~$127,750 |
To put that in context, the same 2024 survey put Maryland assisted living at a median of about $7,083 a month, roughly $84,990 a year. A semi-private nursing-home room costs about three-quarters more. 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 at these prices it's the reason most long-term nursing-home residents in Maryland end up relying on Medicaid rather than paying privately for years.
Does Medicaid Pay for Nursing Homes?
Yes, and this is the single most important thing to understand about paying for a Maryland nursing home. Maryland Medicaid, called Medical Assistance, covers nursing-facility care as an entitlement for those who qualify through Maryland Medicaid's Long Term Services and Supports program. Because it's an entitlement, there's no waiting list for nursing-facility coverage the way there can be for home and community-based waiver services.
Qualifying turns on two findings that run on separate tracks. Here's how the pieces fit together.
Level of care. Anyone seeking Medical Assistance for a nursing facility must first be certified as meeting the nursing-facility level of care. This is the medical side of eligibility, separate from the money side below. The same level-of-care finding is also the gateway to community-based options, principally the Community Options Waiver, which can deliver long-term care in your own home instead.
The financial test. You apply through your local Department of Social Services, and the financial side has two parts: income and assets. For 2026, the long-term-care income limit is 300% of the SSI federal benefit rate, about $2,982 a month for an individual. There is also a low countable-asset limit. A married couple with one spouse staying in the community is protected by spousal-impoverishment rules, which let that community spouse keep a share of the couple's resources and income. Because these rules depend on your household and can change, confirm the current income and asset figures with Maryland Medicaid before you apply.
The five-year look-back. Maryland reviews asset transfers made for less than fair market value during the 60 months before an application. Gifts or below-value sales in that window can trigger a penalty period during which Medicaid won't pay for nursing-facility care, so this is one area where planning well ahead matters.
Estate recovery. After a resident dies, Maryland pursues Medicaid estate recovery for long-term-care costs it paid on behalf of people 55 or older. There are exemptions, including a surviving spouse and a child who is under 21, blind, or disabled, so recovery is not automatic in every case.
Frequently Asked Questions
The 2024 CareScout (Genworth) Cost of Care Survey put Maryland's median at about $150,015 a year (roughly $12,501 a month) for a semi-private room and about $173,375 a year (roughly $14,448 a month) for a private room. Those are statewide medians from an industry survey, not maximums, and both run well above the national median. Facilities in the Washington-area and Baltimore suburbs tend to cost more than rural ones.
Yes. Maryland Medicaid, called Medical Assistance, pays for nursing-facility care for people who meet the nursing-facility level of care and the financial rules, and for those who qualify this coverage is an entitlement. A nursing-facility level-of-care finding also opens the door to home and community-based care through the Community Options Waiver, though those slots can be limited.
Eligibility has two parts that run separately. A level-of-care finding approves the nursing-facility level of care, and the financial side, which you apply for through your local Department of Social Services, uses a 2026 income limit of 300% of the SSI benefit rate, about $2,982 a month, along with a low countable-asset limit. Spousal-impoverishment protections let a spouse who stays in the community keep a share of the couple's resources and income. Confirm the current income and asset figures with Maryland Medicaid before applying.
Only for short-term rehab, not long-term custodial care. Medicare Part A covers up to 100 days of skilled nursing facility care per benefit period after a qualifying three-day inpatient hospital stay, with full coverage for the first 20 days and a daily coinsurance after that. It does not pay for long-term custodial nursing-home care, which is the care most families need to fund through private pay, long-term care insurance, or Medicaid.
Check the facility's 1-to-5-star overall rating on Medicare Care Compare, paying attention to the staffing component, and review its license and survey results through the Maryland Office of Health Care Quality. You can also contact your county's Long-Term Care Ombudsman, through the Area Agency on Aging or Department of Aging, for on-the-ground information about specific facilities and to report concerns.
Learn More
- Assisted Living in Maryland
- Memory Care in Maryland
- Home Care vs. Home Health in Maryland
- Medicaid Estate Recovery, Explained
- Medicaid Personal Needs Allowance, Explained
- Medicaid Planning Strategies
Find personalized help comparing nursing homes in Maryland 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.