With over 30,000 senior living facilities dotting across the landscape of California, seniors in the Golden State have many options to consider. With a population of 6 million seniors – larger than almost anywhere else in the nation – the state is well equipped to address the needs of the aging population. This demographic is expected to grow rather than decline; the state estimates reaching a population of 9 million seniors by 2030, or twenty percent of the population.

However, as a state with a generally higher cost of living, California seniors can expect to pay slightly higher rates for care. However, there are ways to mitigate these costs. This guide explores the costs of care, financial resources, and local programs and agencies that help support seniors in need.

The Cost of Senior Living in California

Note: There currently isn’t authoritative data on the average cost of Independent Living Facilities nationwide, so instead, we use the cost of Assisted Living to estimate it. Since the cost of Independent Living is typically 30-40% lower than the cost of Assisted Living, the numbers below were calculated by subtracting 35% from the cost of Assisted Living.

Memory care is typically provided in communities licensed as assisted living facilities, and in general, costs 20-30% more than standard assisted living services. No authoritative cost data is available for this type of care, so we estimated memory care rates by adding 25% to assisted living fees in the Genworth 2021 Cost of Care Survey.

Senior living facilities provide health-appropriate levels of care to their residents. This greatly determines fees, as the following figures from the 2021 Genworth Cost of Care Survey confirm. Independent living facilities provide limited care for relatively healthy and mobile seniors, so their fees mostly represent the quality and scope of accommodations and amenities. Each facility offers different home styles, and all will have a clubhouse or central location where residents can socialize and participate in games and activities. Assisted living facilities also schedule activities appropriate for residents who require assistance with daily tasks, such as personal grooming. Accommodation will be a room within the facility.Most memory care units are within assisted living facilities but with comprehensive security systems for residents’ protection, such as keypad-entry doors and restricted access/exit points in outdoor areas. A typical community will have therapists or medical personnel delivering programs designed to mitigate dementia’s advance and staff skilled in supporting residents during memory loss episodes. Nursing homes offer hospital-like levels of care in residential settings. There will be at least one physician linked with the facility and a minimum of one skilled nurse on-site at all times. California law also dictates that nursing homes must provide residents with at least 3.5 hours of skilled nursing care per day.

The Cost of Assisted Living in California

Assisted living in California is more expensive than the national average and typically costlier than the states sharing its borders. At $5,250, average fees are higher than in Oregon, where the typical senior pays $5,045, and in Arizona, where the median is $4,000. Nevadans pay some of the lowest costs on the West Coast, at $3,750 per month.

The Cost of Nursing Home Care in California

At $9,794 for a semiprivate room, California’s nursing home fees are at the high end of the scale but not above Oregon’s, where families should budget for another $548 per month. Nevada’s average cost of $9,216 is below California’s, as is Arizona’s, at $6,540 — the lowest fee in the region and the only one of the four states below the national average.

Can You Use Medicaid to Pay for Senior Living in California?

The short answer is yes, but it won’t pay for every type of senior living facility, and strict rules govern what it will pay for and who qualifies. In California, Medicaid is officially known as the California Medical Assistance Program but is commonly known as Medi-Cal. It helps low-income seniors meet the costs of their long-term care in residential facilities or at home. It doesn’t cover any independent living costs, as seniors in those facilities don’t need regular health care.

Medi-Cal can help seniors best served in assisted living and memory care facilities. A Medi-Cal social worker develops a care plan in cooperation with the senior and sometimes their family. The plan will cover health care needs, such as medications, medical appointments and transportation for medical purposes.

Seniors who need nursing home care will also develop health care plans with their families and Medi-Cal social workers. Medical plans will be more in-depth than those for assisted living and memory care and will include other services, as nursing home residents also qualify for assistance with daily living tasks, such as bathing, toileting and eating.

	Medicaid Coverage Level	Type of Medicaid Coverage	Entitlement?*
Assisted Living	Partial	Medicaid Waiver
Independent Living	None	N/A	N/A
Memory Care	Partial	Medicaid Waiver
Nursing Home Care	Full	Medicaid

*Note: Entitlement programs mean that everyone who qualifies will receive coverage and be accepted into the programs. If the program is not “entitlement,” then participant caps could be in place, and there may be a waiting list.

Medicaid’s Coverage of Assisted Living & Memory Care in California

Seniors in need of nursing home levels of care that can be satisfied in assisted living and memory care settings may be eligible for the assisted living waiver. 

Assisted Living Waiver

The purpose of the assisted living waiver is to help seniors in need of nursing home care avoid entering an institution for as long as possible. Nursing home residents who can rejoin their communities in an assisted living setting may also qualify. The waiver can pay health care costs in assisted living and memory care communities but can’t cover room and board expenses. It’s also only available in 15 counties, so seniors elsewhere in the state will need to move to a licensed and approved facility in an applicable territory.

Medicaid’s Coverage of Nursing Home Care in California

Medi-Cal will pay for all nursing home services deemed medically necessary. These include prescription costs not already covered by the resident’s Medicare Part D plan, visits from physicians, ambulance services and x-ray and laboratory costs. It will also cover costs for instruments that offset age-related deterioration, such as eyeglasses, hearing aids, orthopedic devices and some dental work. Nonmedical costs, such as accommodation, meals and mobility assistance also fall within Medi-Cal’s scope. 

Eligibility for Medicaid in California

As of 2022, seniors with incomes at or below 138% of the Federal Poverty Level are likely to be eligible for Nursing Home Medicaid. Supplemental Security Income recipients automatically qualify for full coverage. Those who do not qualify may still be eligible for support via a Covered California health plan, which can lower deductibles, co-pays and some directly paid costs. 

2022 California Medicaid Income Limits

	Income Limits*	Asset Limits
Single Person	No income limit** (Nursing Home care)$18,075 (Medicaid Waiver)	$2,000
Two-Person Household (Only One Applicant)	No income limit** (Nursing Home care)$18,075 (Medicaid Waiver) for applicant	$2,000 for applicant and $137,400 for non-applicant
Two-Person Household (Two Applicants)	$24,353 (Medicaid Waiver)	$3,000

*Per year
**All the applicant’s qualifying income must contribute towards nursing home costs. Medicare premiums and a spouse’s income allowance don’t qualify. The Medicaid beneficiary also retains a personal needs allowance of $35 per month.

In addition to meeting the program’s income and asset restrictions, seniors will need to satisfy some other requirements. These include:

• Being a U.S. citizen or legal resident
• Aged 65 or older
• Having a medical condition within the program’s scope

Applying for Medicaid in California

There are several ways seniors can get more information and apply for Medicaid in California. They include visiting the local Department of Social Services office, going online to Covered California and calling (800) 300-1506 to speak to an advisor.

Before You Apply

Seniors should collect all the documentation they need to support their application prior to applying, as information gaps will inevitably extend processing times. These documents should include:

• Social Security number
• Proof of identity, such as a driver’s license or voter’s registration card
• Proof of citizenship or U.S. national status
• Proof of immigration status or lawful presence
• Proof of earned and unearned income, such as pay stubs and annuity statements
• Proof of non-incarceration status, which can be parole papers or a completed non-incarceration attestation form
• Proof that no other form of coverage exists, which could be a letter from a previous insurer confirming a policy’s end date
• Proof of status if an American Indian or Native Alaskan

How To Get Help

Seniors who need information and assistance prior to applying for Medicaid in California have several resources in the state that provide support for free. The following list includes contact details and a short description for three of them.

Resource	Contact	What You Should Know
American Council on Aging	Online Only	The American Council on Aging is a nonprofit organization that operates entirely online. Its website provides a wealth of support and information for seniors. These include a Medicaid eligibility test, which can help seniors determine if they qualify for Medi-Cal. The site includes detailed information on Medicaid eligibility by care type, including assisted living and nursing home care. There’s also a spend-down calculator that can indicate how much of a potential applicant’s wealth must be spent down for them to become eligible for Medicaid.
Medi-Cal	(888) 452-8609	Contacting Medi-Cal directly through its website or phone number can help seniors and their families get authoritative answers to questions quickly. The site also includes FAQs where visitors can get answers to the most commonly asked questions, including those relating to financial assistance, citizenship and coverage.
LawHelpCA.org	Multiple Contacts	LawHelpCA.org is a website funded by the State Bar of California, LSC and the Legal Aid Association of California. It provides contact details for attorneys across the state who provide advice and representation on Medi-Cal matters for little or no cost. It also provides information about Medi-Cal as it relates to the law for seniors who prefer to conduct their own research.

Can You Use Medicare to Pay for Senior Living in California?

Unfortunately, Medicare does not cover the cost of assisted living, independent living, or memory care. Unlike nursing homes, these care types are not considered to be “clinical settings” and so are not eligible for Medicare coverage. That being said, those who live in these communities can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.

When it comes to nursing home care, it gets much more complicated. Medicare does provide limited coverage for a qualified stay in a nursing home,but there are strict rules and requirements of which you should be aware. This benefit is available to seniors who have been hospitalized for at least three days, excluding the date of discharge.

Once you’ve met the hospitalization requirement, Medicare will pay for up to 100 days in a skilled nursing facility (per benefit period). While the first 20 days are covered in full, there is a daily coinsurance rate that must be paid starting on day 21. After day 100, seniors are responsible for the entire cost.

	Medicare Coverage	Medicare Coverage Duration	Coinsurance Requirement?
Assisted Living	None	N/A	N/A
Independent Living	None	N/A	N/A
Memory Care	None	N/A	N/A
Nursing Home Care	Limited	100 Days Per Benefit Period	Yes – After 20 Days

What Nursing Home Care Services Does Medicare Cover?

Medicare covers a number of specific services, including:

• Meals
• A semiprivate room
• Medications
• Skilled nursing services
• Physical therapy
• Occupational therapy
• Speech therapy
• Audiologist care
• Medical supplies
• Medical social services
• Nutritional counseling
• Ambulance transportation

What Nursing Home Care Services Aren’t Covered by Medicare?

Medicare does not cover long-term custodial care that addresses seniors’ day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.

Medicare Support & Resources in California

Understanding Medicare can be difficult for some seniors. However, there are plenty of free resources in California that can inform, advise and support individuals eligible for Medicare and those who have already joined a plan. These resources can also help seniors denied Medicare and those concerned about being victims to fraudsters.

Resource	Contact	What You Should Know
Health Insurance Counseling and Advocacy Program (HICAP)	(800) 434-0222	HICAP is a free state-funded program staffed by trained volunteers who help seniors with Medicare, and those eligible to join, get the information and support they need. The counselors provide confidential one-on-one assistance, which includes helping the senior understand the different Medicare plans and options for additional coverage. Seniors needn’t be concerned about being sold insurance as the counselors are impartial and focused only on helping clients get the most from Medicare. They can also refer seniors to legal advisors who specialize in issues related to Medicare and long-term care insurance.
Senior Medicare Patrol	(855) 613-7080	The purpose of Senior Medicare Patrol is to prevent Medicare beneficiaries from being victims of fraud. The program’s volunteers are typically seniors with Medicare who can help their peers understand how scammers operate. Scams often involve duping the senior into revealing their Medicare identification number, which the scammer then uses to bill for nonexistent services and supplies. The volunteers can help seniors recognize and prevent potential fraud.
Medicare.gov	(800) 633-4227	Medicare.gov is the official U.S. government site for Medicare beneficiaries. It provides information on how Medicare works, what the general costs are and how the plans apply if a senior continues to work beyond 65 years of age. Seniors can sign up for Medicare on the site and review ways of getting more coverage, including Medigap plans specific to California. The site also has a live chat function where visitors can ask questions any time of the day or night.

Are There Other Financial Assistance Options for Senior Living in California?

Depending on your unique situation, there may be other financial assistance options to partially or fully cover the cost of senior living in California. Below, we cover some of the common ways that seniors can make senior living options such as assisted living or memory care more affordable.

	How to Get Started	What You Should Know
Aid and Attendance	Apply online at va.gov.	If you are a veteran and you receive a VA pension, you may also be eligible for the Aid and Attendance benefit. This benefit takes the form of a monthly cash allowance that you receive in addition to your standard pension. This benefit is used by veterans who need long-term care services, including care received at an assisted living facility.
Reverse Mortgages	Research and learn about the different types at ftc.gov.	If you own a home, you may be able to use a reverse mortgage to access some of the equity in your home. Like traditional loans, reverse mortgages do need to be repaid with interest, typically within 12 months, so seniors should carefully weigh this option alongside other financing methods.
Long-Term Care (LTC) Insurance	Learn about how to receive LTC insurance benefits at acl.gov.	While those who currently need assisted living will typically not be eligible, if you purchased an LTC insurance policy in the past, you may be able to use it to help pay for assisted living. While most policies cover at least a portion of the cost, you still need to check the specific terms of your policy.

Free Senior Living Resources for Seniors in California

California’s elder community can access many free resources provided by nonprofit organizations and government agencies dedicated to supporting them in times of need. Those listed here can help with accessing transportation, filing taxes, applying for benefits and getting help if memory loss becomes a concern.

Resource	Contact	What You Should Know
Area Agencies on Aging	(800) 510-2020	There are 33 Area Agencies on Aging in California, all funded by the state to help seniors with age-related needs. Most of their work concerns seniors living at home, but they also assist Californians in senior living facilities. The agencies can arrange free legal advice and representation for matters relating to civil law and provide transportation for seniors who would otherwise struggle to make appointments or visit loved ones.
AmeriCorps RSVP California	(800) 942-2677	Older Californians who want to volunteer their time to help others can contact their nearest RSVP center, which will connect them with the most appropriate nonprofit in the area. Voluntary work covers a wide range of needs, such as helping homebound seniors, mentoring younger members of the community and doing clerical work for state agencies. RSVP covers the costs of accident and liability insurance while the senior is working.
California Department of Veterans Affairs	(800) 952-5626	The California Department of Veterans Affairs can help U.S. military vets and their dependents obtain the local, state and federal benefits they’re entitled to. It can also refer vets to nonmedical VA clinics that specialize in treating psychological conditions, such as PTSD and depression. Although the department doesn’t deal directly with medical issues, it can refer vets and their family members to the nearest hospital within their VA health care system.
VITA and TCE Programs	Multiple Locations	Volunteer Income Tax Assistance (VITA) and Tax Counseling for the Elderly (TCE) are IRS programs that provide free tax return assistance to seniors, the disabled and other qualifying citizens. They are administered locally by trained volunteers working in community centers, libraries and offices of nonprofits across the state. The program’s local representatives make every attempt to provide seniors with assistance in their native languages.
Alzheimer’s Association	(800) 272-3900	The Alzheimer’s Association serves Californians through its Southland and Northern California and Northern Nevada chapters. Both branches deliver local support in the form of one-on-one counseling sessions, group meetings and the supply of educational material. They support seniors with early to mid-stage Alzheimer’s and family members who want to learn how to help loved ones on their journey. There’s also online support for seniors and others who can’t attend face-to-face sessions.

COVID-19 Rules and Restrictions for California Senior Living Facilities

The following information is based on research done on several government websites, including cdph.ca.gov and caassistedliving.org. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 2/2/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visiting Loved Ones

Can I visit my relative in person if he/she wants emotional support from me?	Yes (Conditions Apply)
Can I visit my relative in person for end-of-life compassion care?	Yes
Will my loved one be required to self-quarantine after I visit him or her?	No (Conditions Apply)
Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?	Yes
Are Hairdressers and other non-medical contractors still allowed in senior living facilities?	Yes (Conditions Apply)
Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?	Yes
Are visitors being screened for elevated temperatures?	Yes
Are visitors being asked questions about health, travel, and potential virus contact?	Yes

Outings and Group Activities

Are residents allowed to leave the facility for non-medical reasons?	Yes
Are residents of senior living facilities who leave and return required to self-quarantine?	No (Conditions Apply)
Are senior living facilities required to cancel all group outings?	Not Available*
Are residents still eating together in the dining hall?	Yes (Conditions Apply)
Are facilities still allowed to host group activities within the community?	Yes (Conditions Apply)

*NOTE: This information was not available for this state, contact your local area agency on aging or senior living facility for more information.

Safety Measures for Staff & Contractors

Are staff members and contractors being screened for elevated temperatures?	Yes
Are staff members and contractors being tested for Coronavirus?	Yes
Are staff members and contractors being asked questions about health, travel, and potential virus contact?	Yes

Safety Measures for Residents

Are staff members required to regularly screen residents for coronavirus symptoms?	Yes
Are residents relied on to screen themselves and self-report potential coronavirus symptoms?	No
Are staff members required to take residents’ temperatures?	Yes
Are residents being tested for coronavirus?	Yes (Conditions Apply)

Senior Living Laws and Regulations in California

Note: All these rules typically apply to non-clinical senior living facilities, such as independent living, assisted living, and memory care facilities. Nursing homes and other senior living facilities with a clinical setting may have additional or slightly different requirements and regulations.

In order to best provide for those in need, senior living facilities in California must abide by state rules and policies. These are some of the laws and regulations seniors and the family members should know about.

Admissions Requirements

Due to the nature of senior living facilities, California seniors will need to meet certain abilities or expectations to ensure a safe and comfortable way of living. Assisted living facilities are permitted to admit seniors who:

• Are able to administer their own medications or who may need assistance or reminders due to mental or physical limitations
• May require medical treatment off-site or by a visiting professional
• Have any mild form of dementia or who experience distress due to life changes or personal losses
• Have cognitive impairments that are mild in nature

However, not all seniors will find senior living facilities to be the right fit. Anyone who requires 24 hour care, needs specific medical treatments like nasogastric tubes, has a serious infection, needs assistance in all daily tasks, or has severe mental conditions that could result in harm to other residents are not eligible for senior living care.

Medication Management

Only certified medical professionals are permitted to provide medications to residents in California. Staff members without training and licensing can only assist in self-administration in specific circumstances, including minor illness, hand tremors, or any non-cognitive issue that may prevent a resident from taking medication independently. Self-administration by non-certified staff does not include any measures that could stand in the way of a resident’s right to refuse treatment.

Memory Care Regulation

Staff who work with memory care facilities are required to have at least 12 hours of preliminary memory care training before hiring and eight hours of dementia care training annually, in addition to other training requirements in the state. This education must include hydration, skin care, therapeutic activities, behavioral indicators, daily care requirements, and common medical problems.

Memory care facilities must implement state-supported safety requirements to prevent resident injury. Family members must be notified when needs, behaviour, or condition changes.

Staffing Requirements

Assisted living facilities in California must have a certified administrator that manages the property; when this person is not present, someone must be appointed as an interim manager. Staffing in senior living facilities depends on size. Those with up to 100 residents must have one awake staff member at all times. Those with between 100 and 200 residents must have one on-call and one awake staff member. Above this size, an additional awake staff member is required for every 100 residents.

Caregivers working in a senior living facility must have knowledge of first aid and complete both 40 hours of onboarding training and 20 hours of continuing education training every year. Topics to be studied include personal care duties, resident rights, emergency training, community rules, sanitation, medication management, and how to identify potential serious medical challenges. An FBI background check is required for all employees and licensed workers within a facility.

Frequently Asked Questions

How much does assisted living cost in California?

On average, assisted living in California costs around $4,500 per month. However, this can vary regionally significantly. San Jose, for example, is far more expensive, averaging $5,853 per month, while Fresno costs just $3,861 per month.

Are there financial assistance programs for assisted living in California?

Yes. For seniors who require financial assistance, there are options available in California. Medi-Cal, California, Medicaid program, can be especially beneficial; the Assisted Living Waiver Program offers a way for seniors who meet the eligibility criteria to save money on costs of care.

What are “Activities of Daily Living”?

Activities of Daily Living, or ADL, refers to normal tasks required to live on a day to day basis, including bathing, eating, cleaning, dressing, and using the bathroom. Helping seniors with ADL is a common service offered in assisted living communities.

What types of amenities are commonly in Assisted Living Communities?

Amenities can be a major part of nursing home care as the services offered can contribute significantly to qualify of life. In addition to caregiver support with activities of daily living and medication management, many assisted living programs offer options like social gatherings, spiritual programming, exercise activities, arts and crafts, and entertainment options.

What is the difference between assisted living and nursing homes?

The primary difference between assisted living facilities and nursing homes relates to the extent of medical care provided. While residents in an assisted living facility can live somewhat independently in their own apartments or suites, patients in a nursing home often require around-the-clock medical support or monitoring.

Learn More About Senior Living in California

For more information about specific types of senior living in California read our Guide to Assisted Living and Independent Living.

The Top Cities for Senior Living in California

Learn more about the cost of senior living in the top California cities. Additionally, find reviews and information about assisted living facilities and other senior living communities across the state.