Finding a nursing home that accepts Medicaid starts with one free tool: the Medicare Care Compare website at medicare.gov/care-compare. You can search by zip code, filter for Medicaid-certified facilities, and compare quality ratings side by side. But the search goes beyond just finding a facility with a Medicaid certification. You also need to confirm the home has available Medicaid beds, understand the financial eligibility requirements, and evaluate quality before committing.
Start With Medicare Care Compare
The federal Care Compare tool, run by the Centers for Medicare and Medicaid Services, is the most comprehensive directory of nursing homes in the country. Every facility that participates in Medicare or Medicaid is listed. You can search by location, then look at each facility’s profile to confirm it accepts Medicaid payments for long-term stays. Each listing includes an overall five-star quality rating based on three separate categories: health inspections, staffing levels, and quality measures like how often residents develop pressure sores or lose mobility. A facility with strong marks across all three is more reliable than one with a high overall score driven by just one category.
Write down every Medicaid-certified facility within your preferred radius. This becomes your working list. From here, you’ll narrow it down by calling each one directly.
Call Facilities to Ask About Medicaid Bed Availability
Medicaid certification does not guarantee a facility will have a spot for you. Nursing homes receive significantly less reimbursement for Medicaid residents than they do for private-pay or Medicare residents. About 70 percent of long-term care residents in some states are funded at least partly by Medicaid, but many facilities still prefer to fill beds with higher-paying residents first. This creates a reality where Medicaid-eligible residents can face waitlists even at certified homes.
When you call, ask the admissions office these specific questions:
- Do you currently have Medicaid beds available? Some homes distinguish between Medicaid-certified beds and private-pay beds.
- Is there a waitlist for Medicaid residents, and how long is it typically?
- If I enter as a private-pay resident and later transition to Medicaid, will I be able to stay? Some facilities accept Medicaid conversions; others may pressure residents to leave.
- Are there any services not covered by Medicaid that I’d need to pay for out of pocket? Things like beauty shop visits, phone service, or internet access often carry extra charges.
Get answers in writing whenever possible. Facilities are required to disclose their services, charges, and fees before admission.
Use Your Area Agency on Aging
Every region of the country has an Area Agency on Aging (AAA) that provides free guidance on long-term care placement. These agencies help hundreds of thousands of people each year connect with resources, including identifying Medicaid-accepting nursing homes in your area. They also offer free long-term care consultations that can walk you through Medicaid eligibility, local facility options, and alternatives like home-based care.
To find your local AAA, call the Eldercare Locator at 1-800-677-1116 or visit eldercare.acl.gov. In Ohio, for example, you can reach the aging network at 1-866-243-5678. Every state has an equivalent contact point. These offices often know which facilities in your area have current Medicaid openings, saving you dozens of phone calls.
Contact Your State’s Long-Term Care Ombudsman
The Long-Term Care Ombudsman Program is a federally mandated advocacy service that exists in every state. Ombudsmen investigate complaints, represent residents’ interests before government agencies, and provide information about long-term care services. They handled over 500,000 instances of information and assistance in a recent reporting period. While they don’t place residents into facilities directly, they can tell you which homes in your area have a strong track record and which ones have a pattern of complaints. This is insider knowledge you won’t find on a website.
You can find your state ombudsman through the Administration for Community Living at acl.gov or through the Eldercare Locator. If you’re already dealing with a facility that’s being uncooperative about accepting Medicaid, the ombudsman can intervene on your behalf.
Understand the Financial Requirements
Medicaid for nursing home care has strict financial limits. While exact thresholds vary by state, they follow a general pattern. In Texas, for example, an individual can have no more than $2,000 in countable assets and a maximum gross monthly income of $2,982. For a couple, the asset limit is $3,000 with a monthly income cap of $5,964.
If one spouse enters a nursing home while the other stays at home, the spouse in the community is allowed to keep a protected amount of resources, ranging from roughly $32,500 to $162,700 depending on the state. This protected amount excludes the home’s value, household goods, one car, and burial funds. The goal is to prevent the healthy spouse from being impoverished.
If your income or assets exceed these limits, you may still qualify through what’s called a “spend-down.” This works like a deductible: you’re responsible for medical costs up to a certain monthly amount, and once your remaining expenses exceed that threshold, Medicaid kicks in. Your spend-down amount then becomes part of your contribution toward the cost of care. States also impose a look-back period on asset transfers, meaning you can’t give away money or property to qualify faster. The look-back is typically five years in most states, and transfers made during that window can trigger a penalty period where Medicaid won’t cover your care.
Your state Medicaid office or AAA can walk you through the specific numbers that apply where you live. An elder law attorney is worth consulting if your financial situation is complicated, particularly if you own a home, have retirement accounts, or have a spouse who needs to maintain their standard of living.
Visit Before You Decide
Once you’ve identified facilities with Medicaid availability and confirmed you’ll meet the financial requirements, visit in person. Drop by unannounced if possible, ideally during a meal or an activity period when you can see how staff interact with residents in real time.
Pay attention to the basics: Does the facility smell clean? Are residents dressed and groomed? Do staff respond quickly when someone calls for help? Then ask pointed questions about what life looks like for Medicaid residents specifically:
- Room assignments: Will you have a private room, or will it be shared? If you start private-pay and later switch to Medicaid, can you keep a private room?
- Therapy access: Will you receive preventive care, and can you see specialists like eye doctors, podiatrists, or mental health professionals?
- Oral care: How does the facility handle dental needs?
- Personal belongings: How much furniture and personal items can you bring? Is there closet and drawer space?
- Daily life: Will you have access to a phone, television, and internet? Can you choose your roommate?
The key concern is whether Medicaid residents receive the same quality of care and access to services as private-pay residents. Legally, they should. In practice, it varies. Visiting gives you the best read on this.
Apply for Medicaid Before You Need It
Medicaid applications for long-term care take time, often several weeks to several months depending on your state and the complexity of your finances. Start the process as early as possible, even before you’ve selected a specific facility. Your state Medicaid office handles applications, and many states allow you to apply online. The AAA or a social worker at a hospital can also help you start the paperwork if you’re dealing with a sudden health crisis and need placement quickly.
If you’re admitted to a nursing home before Medicaid approval comes through, many facilities will accept you with a pending application, but confirm this upfront. Some will require you to pay privately until approval, then retroactively bill Medicaid. Others won’t admit you until the approval is finalized. Knowing a facility’s policy on pending applications can save you from a financial gap you weren’t expecting.