No, not all nursing homes accept Medicaid. Only nursing homes that are officially Medicaid-certified can accept Medicaid as payment, and even among those, many limit how many “Medicaid beds” they offer at any given time. An estimated 80–90% of U.S. nursing homes accept Medicaid in some capacity, but acceptance and actual availability are two different things.
If you’re asking “do all nursing homes take Medicaid” or “do all nursing homes accept Medicaid,” the answer is the same either way no, and the difference between a facility that’s Medicaid-certified and one that actually has an open Medicaid bed matters more than the yes/no answer itself.
If you’re helping a parent or spouse plan for nursing home care and Medicaid is part of the financial picture, this distinction matters more than almost anything else in the search process. A facility can be fully licensed, well-reviewed, and technically “Medicaid-certified”, and still have no Medicaid bed open the day you call.
Medicaid & Senior Care Information Reviewed By: New Day Lifestyle for Seniors Editorial Team | Last Updated: 2026
Do All Nursing Homes Accept Medicaid?
No. Whether you phrase it as “do all nursing homes take Medicaid” or “do all nursing homes accept Medicaid,” the answer is the same: nursing homes are not required by law to accept Medicaid residents, and a meaningful share choose not to participate in the Medicaid program at all. Among those that do accept Medicaid, participation isn’t unlimited, most facilities designate only a portion of their beds as “Medicaid beds,” reserving the rest for private-pay or Medicare residents, who are typically reimbursed at a higher rate.
That means there are really three different categories of nursing homes families run into:
- Medicaid-certified facilities with open Medicaid beds able to admit a Medicaid-eligible resident right away.
- Medicaid-certified facilities with no current Medicaid bed availability technically accept Medicaid, but there may be a waitlist.
- Facilities that don’t participate in Medicaid at all, private-pay or Medicare-only, regardless of eligibility or need.
Knowing which category a facility falls into, before you fall in love with it, saves families real time and heartbreak.
Why Some Nursing Homes Don’t Accept Medicaid
It comes down to reimbursement. Medicaid pays nursing homes a state-set daily rate for covered residents, which is generally lower than what private-pay residents or Medicare (for short-term skilled care) pay for the same room and services. Because of that reimbursement gap, some facilities choose to:
- Not participate in the Medicaid program at all
- Participate, but cap the number of Medicaid-designated beds
- Prioritize filling openings with private-pay or Medicare residents before turning to a Medicaid waitlist
None of this is about whether a resident “deserves” care, it’s a financial and operational decision each facility makes independently, within the rules of its state’s Medicaid program.
What Does “Medicaid-Certified” Actually Mean?
A nursing home can only accept Medicaid as payment if it’s officially certified as a Medicaid Nursing Facility (NF), a status separate from simply being licensed to operate. Medicaid-certified facilities must:
- Be surveyed and certified by the state, subject to federal (CMS) requirements
- Deliver specific nursing, medical, and rehabilitative services that meet Medicaid coverage standards
- Undergo regular inspections for health, safety, and quality of care
- Maintain compliance with federal nursing home participation requirements
Many nursing homes are certified for both Medicare (as a skilled nursing facility, for short-term rehab) and Medicaid (as a long-term nursing facility), which is actually the most common and convenient scenario for families, because it often means a resident can transition from Medicare-covered rehab into Medicaid-covered long-term care in the same building, without having to move.
What Is a “Medicaid Bed”, and Why It Matters
A “Medicaid bed” refers to a room or bed a facility has specifically designated for residents whose stay will be paid for by Medicaid. Here’s the part that surprises most families:
Being Medicaid-certified does not guarantee an open Medicaid bed.
A facility might be fully certified to accept Medicaid and still have zero Medicaid beds available on the day you need one, either because all of them are currently occupied, or because the facility has intentionally limited how many it offers. This is why two families calling the same nursing home in the same month can get completely different answers about whether “they take Medicaid.”
Practical takeaway: always ask specifically about current Medicaid bed availability, not just whether the facility “accepts Medicaid” in general.
Medicaid-Certified vs. Actually Admitting You: The Real Difference
Even with an available Medicaid bed, admission isn’t automatic. Facilities typically also require:
- Confirmed Medicaid eligibility : The applicant must already be approved, or very close to approved, for their state’s Nursing Home Medicaid program.
- A nursing facility level of care (NFLOC) determination : A state assessment confirming the person’s medical and functional needs meet the threshold for nursing home care, not just assisted living or home care.
- A pre-admission screening : Many states require this before Medicaid will pay for a nursing home placement.
This combination, certification, bed availability, financial eligibility, and level-of-care approval, is why “does this nursing home accept Medicaid” is rarely a simple yes/no question in practice, even though it’s often asked that way.
How to Find a Nursing Home That Accepts Medicaid
- Start with Medicare’s Care Compare tool (medicare.gov/care-compare) it lists every Medicare- and Medicaid-certified nursing home in the country, searchable by location, with CMS quality star ratings for health inspections, staffing, and quality measures.
- Confirm current Medicaid bed availability directly with the facility : Call the admissions office and ask specifically (see the questions in the next section).
- Check with your state Medicaid office : Many states maintain their own list of Medicaid-participating nursing facilities, which can be a useful cross-reference against Care Compare.
- Ask about waitlists : If a facility has no open Medicaid bed today, ask how long the typical wait runs and whether you can be added to a list now.
- Get eligibility moving in parallel : Medicaid nursing home eligibility (income, asset, and level-of-care requirements) can take time to process, so starting that application doesn’t need to wait until a bed is confirmed.
What If You Start as Private Pay and Later Need Medicaid?
This is one of the most common real-world paths families take, and it’s worth understanding ahead of time. It often looks like this:
A person is hospitalized, then transitions to a nursing home for Medicare-covered short-term skilled nursing rehabilitation (see our related guide on what Medicare pays for in a nursing home). If ongoing nursing home care is still needed after Medicare coverage ends, the person (or family) typically pays privately, sometimes using long-term care insurance, until their assets are spent down to their state’s Medicaid eligibility threshold.
If the nursing home is Medicaid-certified, the resident can often convert from private pay to Medicaid coverage without changing facilities, continuing to live in the same room. This is one of the strongest reasons to specifically ask about Medicaid certification and bed conversion policy before choosing a facility, even if Medicaid isn’t needed on day one.
If the facility is not Medicaid-certified, a resident who exhausts their private funds may need to relocate to a Medicaid-certified facility, which is a difficult transition to make during an already stressful time.
Questions to Ask a Nursing Home About Medicaid Before You Choose
- Are you currently certified to accept Medicaid, in addition to Medicare and private pay?
- Do you have any Medicaid beds open right now?
- Is there a waitlist for Medicaid residents, and roughly how long is it?
- If someone is admitted as private pay, can they convert to Medicaid later without moving rooms or facilities?
- Is there a limit on how many residents can be on Medicaid at one time?
- What is the process and timeline for a Medicaid eligibility and level-of-care determination?
Asking these questions during the initial tour or phone call, rather than assuming the answer, is the single best way to avoid a surprise later.
Does Accepting Medicaid Affect the Quality of Care?
Not by law. Medicaid-certified nursing homes must meet the same federal health, safety, and staffing standards as any Medicare-certified facility, and all certified facilities are subject to the same CMS inspection and quality-rating system on Medicare’s Care Compare tool. A facility’s Medicaid participation status is not, by itself, an indicator of care quality, the CMS star ratings (health inspections, staffing, and quality measures) are a more reliable way to evaluate a specific facility, regardless of payer mix.
State-by-State Differences in Medicaid Nursing Home Acceptance
Because Medicaid is jointly funded and administered by each state within federal guidelines, both reimbursement rates and eligibility thresholds vary meaningfully by state, which indirectly affects how many nursing homes in a given state choose to offer Medicaid beds, and how many they’re willing to offer. Two practical implications for families:
- Financial eligibility limits differ by state. Income and asset limits for Nursing Home Medicaid are set at the state level and are updated periodically.
- Verify directly with your state’s Medicaid program. Because rules and participating facility lists change, your state Medicaid office is the authoritative source, not a national estimate or a third-party website.
How New Day Lifestyle for Seniors Can Help
Sorting through Medicaid certification, bed availability, waitlists, and eligibility timelines on top of an already emotional decision is a lot to carry alone, and it’s exactly the kind of research that’s easy to get wrong under time pressure.
At New Day Lifestyle for Seniors, we help families throughout McKinney, Texas, and the greater Dallas–Fort Worth area sort through senior care options, including narrowing down which local nursing homes and residential care homes currently have availability that fits a family’s care needs and payment situation, Medicaid, Medicare, private pay, or a combination. Our guidance is free to families, and we don’t determine Medicaid eligibility ourselves, for that, your state Medicaid office is the right resource, but we can help you ask the right questions and avoid facilities that look right on paper but won’t actually have a bed available when you need one.
Frequently Asked Questions
1. Do all nursing homes accept Medicaid?
No. Nursing homes aren’t required to accept Medicaid, and only facilities that are officially Medicaid-certified can do so. Even certified facilities often limit the number of “Medicaid beds” they offer, so acceptance and actual availability aren’t the same thing.
2. What percentage of nursing homes accept Medicaid?
Estimates generally put Medicaid acceptance at around 80–90% of U.S. nursing homes, but this figure can be misleading, many of those facilities have only a limited number of Medicaid beds, which may not be currently available.
3. What is a “Medicaid bed”?
A Medicaid bed is a room or bed a nursing home has specifically designated for residents whose care will be paid for by Medicaid. A facility can be Medicaid-certified overall while having zero Medicaid beds open at a given time.
4. Can a nursing home refuse to accept a Medicaid resident?
A facility that isn’t Medicaid-certified can decline Medicaid patients entirely. A Medicaid-certified facility with no current Medicaid bed availability can also decline admission until a bed opens, though it may offer a waitlist.
5. If I start paying privately, can I switch to Medicaid later at the same nursing home?
Often, yes, if the facility is Medicaid-certified, many residents can convert from private pay to Medicaid coverage without changing rooms or facilities once they become financially eligible. This isn’t guaranteed at every facility, so it’s worth confirming the policy before admission.
6. How do I find a nursing home that accepts Medicaid near me?
Start with Medicare’s Care Compare tool (medicare.gov/care-compare), which lists every Medicare- and Medicaid-certified nursing home with quality ratings. Then call each facility directly to confirm current Medicaid bed availability, since certification alone doesn’t guarantee an open bed.
7. Does accepting Medicaid mean lower-quality care?
No. Medicaid-certified facilities must meet the same federal health, safety, and staffing standards as any certified nursing home, and quality is independently rated through CMS’s star rating system, not determined by a facility’s payer mix.
8. Is it the same to ask “does Medicare cover nursing homes” and “do nursing homes accept Medicaid”?
No, these are different questions about different programs. Medicare coverage relates to whether Medicare will pay for short-term skilled nursing care after a hospital stay; Medicaid acceptance relates to whether a specific facility will take Medicaid as long-term payment. See our related guide on what Medicare pays for in a nursing home for the coverage-specific rules.
9. What happens if a nursing home has no Medicaid beds available?
Many facilities offer a waitlist for Medicaid beds. Families often need to consider private pay in the interim, look at other Medicaid-certified facilities with current openings, or begin the Medicaid eligibility process while waiting for a bed to open.
10. Do all nursing homes take Medicaid, or just some of them?
Just some of them. “Do all nursing homes take Medicaid” and “do all nursing homes accept Medicaid” describe the same reality: only facilities that are officially Medicaid-certified can take Medicaid as payment, and even certified facilities often cap the number of Medicaid beds they offer, so a “yes” answer from one facility doesn’t apply to every nursing home in your area.
11. Does Medicaid pay the same amount to every nursing home?
No. Medicaid reimbursement rates are set at the state level and are generally lower than private-pay or Medicare rates, which is one of the main reasons some facilities limit or decline Medicaid participation.
Official Sources & References
- Medicaid.gov | Nursing Facilities : Official explanation of Medicaid Nursing Facility (NF) services, certification, and the transition from private pay to Medicaid.
- CMS.gov | Nursing Homes (Certification & Compliance) : Official source for how facilities become Medicare/Medicaid-certified and how the survey and compliance process works.
- Medicare.gov | Care Compare : Official Medicare tool for finding and comparing Medicare- and Medicaid-certified nursing homes, including CMS quality star ratings.
- Your State’s Medicaid Agency Website : Use your state’s official Medicaid website to verify current income and asset eligibility limits and identify participating nursing facilities. State rules vary, so readers should check their state’s Medicaid agency for the most current requirements.