Hospice room and board typically costs between $315 and $355 per day at a nursing facility, based on 2025 national median rates. That works out to roughly $9,500 to $10,800 per month. The exact amount depends on where you live, the type of facility, and whether you choose a private or shared room. What surprises many families is that Medicare, which covers most hospice services, does not cover this particular cost.
What “Room and Board” Actually Means
When people talk about hospice costs, it helps to separate two things: hospice care and room and board. Hospice care includes nursing visits, pain management, medications related to the terminal illness, medical equipment, and emotional support. Room and board is the daily cost of living somewhere, including the bed, meals, housekeeping, and general supervision.
Medicare pays for the hospice care itself with little to no out-of-pocket cost to the patient. But if you’re living in a nursing home or a residential hospice facility, Medicare will not pay for your room and board. The logic is straightforward: you’d be paying for housing regardless of whether you were on hospice. That housing cost remains your responsibility.
How Much You’ll Pay by Setting
The national median cost for a semi-private room in a nursing facility is $315 per day, or about $114,975 annually, according to a 2025 cost-of-care survey. A private room runs $355 per day, totaling roughly $129,575 per year. These figures represent the midpoint, meaning half of facilities charge more and half charge less.
Residential hospice facilities, sometimes called hospice houses, vary even more in pricing. Some are run by nonprofits and use sliding-scale fees. Others operate as private-pay facilities with rates comparable to or higher than nursing homes. Costs can differ dramatically depending on your state and even your city. A nursing home room in rural Mississippi costs far less than one in the Boston metro area, and the same geographic variation applies to residential hospice centers.
If you or your loved one receives hospice care at home, room and board isn’t a separate charge. You’re already covering your own housing costs through rent or mortgage, so this issue primarily affects people in facilities.
When Medicare Does Cover Facility Stays
There is an important exception. Medicare covers short-term inpatient stays when the hospice team determines they’re medically necessary. This happens in two situations.
The first is called general inpatient care, which kicks in during a crisis. If pain or symptoms spiral out of control and can’t be managed at home, the hospice provider can arrange a stay in a hospital or skilled nursing facility for intensive symptom management. Medicare covers the full cost of that stay, including the room, because it’s considered part of the medical treatment.
The second is respite care, designed to give family caregivers a break. Medicare will cover up to five consecutive days in an inpatient facility so the person who provides day-to-day care at home can rest. Both of these are temporary by design and arranged through the hospice provider, not something families can request on their own terms.
How Medicaid Can Help
Medicaid is often the key to covering room and board for hospice patients in nursing facilities. If you qualify for Medicaid (based on income and asset limits, which vary by state), the program pays the nursing facility directly for room and board at 95% of the standard skilled nursing rate. The hospice patient may still owe a small portion based on their personal income, a calculation states call “post-eligibility treatment of income.” In practice, this means Medicaid looks at how much income you have and requires you to contribute what you can toward your own care, keeping only a small personal allowance.
Qualifying for Medicaid can be complex, especially for people who have savings or a home. Many families work with an elder law attorney or a Medicaid planning specialist to navigate the application process. Some states have longer processing times than others, so starting early matters.
Coverage for Veterans
Veterans enrolled in VA healthcare have access to hospice care as part of the standard medical benefits package, with no copays. This applies whether the VA provides the care directly or contracts with an outside hospice organization. For veterans in VA-contracted community nursing homes, the VA may cover the full cost of the stay. Eligibility depends on enrollment in VA healthcare and meeting the clinical criteria for hospice, but the financial benefit can be substantial for those who qualify.
Other Ways to Cover the Cost
Long-term care insurance is one of the most direct ways to pay for room and board, since these policies are specifically designed to cover nursing facility and residential care costs. If your loved one purchased a policy years ago, check whether it covers hospice residential settings. Many do, though the daily benefit amount and coverage period vary by plan.
Some nonprofit hospice organizations maintain charity care funds for patients who can’t afford room and board. Capital Caring Health, for example, provides more than $3 million in charity care annually to uninsured patients through its Patient Care Fund, supported by public donations. Not every hospice offers this, but it’s worth asking. Larger nonprofit hospices are more likely to have financial assistance programs, and social workers on the hospice team can usually point families toward local resources.
Choosing a semi-private room instead of a private one saves roughly $40 per day at the national median, which adds up to about $1,200 per month. Some families also consider moving a loved one home from a facility and providing care there with hospice support, which eliminates the room and board charge entirely, though it shifts the caregiving burden to the family.
What to Ask Before Choosing a Facility
When evaluating a nursing home or residential hospice, ask for a written breakdown of the daily rate and what it includes. Some facilities bundle extras like laundry, personal care supplies, and specialized diets into the room rate. Others charge separately for these items, and the bills can add up quickly.
Ask whether the facility accepts Medicaid, since not all do, and some only accept Medicaid for a limited number of beds. If your loved one might need to transition from private pay to Medicaid as savings run out, confirm that the facility will allow them to stay. Also ask the hospice provider’s social worker about any financial assistance programs, local grants, or community resources that could help offset costs. These conversations are a normal part of hospice planning, and the care team expects them.