Nursing Homes in New Hampshire: Cost & Medicaid (2026)

A semi-private nursing-home room runs a national median of about $114,975 a year, and New Hampshire's median runs well above it, at about $146,913 a year.1 That is beyond what most families can pay out of pocket for long. What makes a long stay affordable for most residents is New Hampshire Medicaid, which pays for nursing-facility care once a person meets the level-of-care and financial rules.

This guide covers how New Hampshire oversees its nursing homes, what a stay costs, who pays for it (Medicare's limited skilled benefit versus Medicaid for long-term care), and how to check a facility's record before you choose one.

In This Guide

• Key Takeaways
• How New Hampshire Oversees Nursing Homes
• What a Nursing Home Costs in New Hampshire
• Who Pays: Medicare vs. Medicaid
• How to Vet a Facility
• Frequently Asked Questions

How New Hampshire Oversees Nursing Homes

A nursing home, often called a skilled nursing facility, 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 separating it from assisted living, which is built for people who need help with daily tasks but not constant skilled care. Before you weigh cost or payment, it helps to know who watches over these facilities in New Hampshire, because that oversight is what gives you a record to check.

Two layers of regulation apply, and they work together. At the state level, nursing facilities are licensed and inspected by the New Hampshire DHHS Health Facilities Administration under the state's nursing-home rules, He-P 803.2 A facility that takes part in Medicare or Medicaid is also federally certified, and the department's Health Facility Certification Unit runs those certification inspections on behalf of CMS. Their findings feed the federal Five-Star Quality Rating System published on Medicare Care Compare, which scores each facility from one to five stars on health inspections, staffing, and quality measures.2

There's also a free advocate you should know about before you need one. New Hampshire's Long-Term Care Ombudsman, housed within the Department of Health and Human Services, advocates for residents of nursing homes, assisted living residences, and other long-term care settings, and helps residents and their families resolve concerns at no cost.2 The ombudsman advocates and resolves complaints but does not license or inspect, so it's a different kind of help than the state survey process. An ombudsman who regularly visits facilities in your area can tell you things a brochure never will.

What a Nursing Home Costs in New Hampshire

Nursing-home care is the priciest long-term care in New Hampshire, and the numbers are large enough that paying privately for years is out of reach for most families. According to the CareScout (Genworth) 2025 Cost of Care Survey, released in 2026, the national median is about $114,975 a year (about $315 a day) for a semi-private room and about $129,575 a year (about $355 a day) for a private room.1 These are medians from an industry survey, not government rates and not maximums. The figure at any one facility can land higher or lower depending on location, room type, and how much care a resident needs.

What stands out about New Hampshire is how far above those national figures it runs. The same survey puts the 2025 New Hampshire median at about $146,913 a year ($12,243 a month) for a semi-private room and about $161,330 a year ($13,444 a month) for a private room, so families here should expect to pay more than the national figures above.1

A semi-private nursing-home room costs well over what assisted living does.1 That 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 in the state end up relying on Medicaid rather than paying privately for years.

Who Pays: Medicare vs. Medicaid

People often assume Medicare covers a nursing home. It does, but only in a narrow way, and confusing the two programs is one of the most expensive mistakes a family can make. Here's how they divide the work.

Medicare covers short rehab, not a long stay. Medicare Part A covers skilled nursing facility care only on a short-term basis after a hospital stay. To qualify, a person generally needs a qualifying inpatient hospital stay of at least three consecutive days, then enters a Medicare-certified facility for skilled care related to that stay. Medicare then covers up to 100 days per benefit period: days 1 through 20 at $0 a day once the Part A deductible is paid (usually already paid during the qualifying hospital stay), and days 21 through 100 with a daily coinsurance, after which coverage ends.3 The coinsurance amount changes each year, so confirm the current figure on Medicare's own coverage page before you count on a number. Medicare does not pay for long-term custodial care, the ongoing help with daily living that someone needs when skilled rehab is finished.3 That is the care most families worry about affording, and it's where Medicaid takes over.

Medicaid covers long-term nursing-facility care. New Hampshire Medicaid, administered by the Department of Health and Human Services, pays for nursing-home care for people who meet a nursing-facility level of care and the financial rules.4 Qualifying turns on two findings on separate tracks. The medical side is the level-of-care assessment. The money side, for a single applicant in 2026, sets the monthly income limit for institutional Medicaid at 300% of the SSI federal benefit rate, about $2,982, and the base countable-asset limit at $2,500, above the $2,000 federal SSI standard; since September 20, 2025, a disregard effectively raises that limit to $7,500 for adults applying for nursing-facility care. An applicant whose income is over the cap can still qualify as medically needy by spending down on care costs.4 A resident on Medicaid pays most of their monthly income toward the cost of care and keeps a personal needs allowance of about $93 a month for small personal expenses.4

A married couple is not held to the single-person numbers. When one spouse enters a nursing home and the other stays in the community, New Hampshire protects a separate resource allowance for that community spouse, up to $162,660 in 2026, so the at-home spouse is not left without savings.4 Two more rules shape long-term-care eligibility. New Hampshire applies a five-year, or 60-month, look-back to assets transferred for less than fair value, which can trigger a penalty period of ineligibility.4 And the state can recover Medicaid costs from a recipient's estate, but not when the recipient is survived by a spouse, a minor child, or a disabled child.4 If a nursing home isn't the right fit, New Hampshire also funds home and community-based care for older adults, mainly through the Choices for Independence waiver, for people who would otherwise need nursing-facility care.4 Because these rules are detailed and the dollar figures change, it's worth getting professional advice before assuming any outcome.

How to Vet a Facility

Quality varies widely from one nursing home to the next, and New Hampshire gives you several free tools to check a place before you commit. Use more than one, because each shows you something the others don't.

Start with the federal scorecard. On Medicare Care Compare, CMS rates every Medicare- and Medicaid-certified nursing home from one to five stars, combining an Overall rating with separate ratings for health inspections, staffing, and quality measures.2 Read the component ratings, not just the headline star count, because a strong Overall can hide a weak staffing or inspection score. The staffing numbers deserve a close look on their own, since how many nurses and aides a facility keeps per resident shapes day-to-day care more than almost anything else.

Then go to the source of those ratings. When you tour a facility, ask to see its most recent state survey results from the Health Facilities Administration, and watch for a pattern of repeat deficiencies rather than reacting to a single old citation.2 Finally, call the New Hampshire Long-Term Care Ombudsman before you sign anything. An advocate who visits facilities in your area regularly can give you an honest, on-the-ground read on a specific place that no rating captures.2

Learn More

Find personalized help comparing nursing homes in New Hampshire 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.