Nursing home, semi-private room costs in North Carolina
Here is the middle of the price range in North Carolina, and then — because it is the question that actually follows — who pays for it. The short answer on that second one surprises most people: Medicare does not.
The North Carolina median
$9,733 a month
- Works out to, monthly
- $9,733
- Works out to, yearly
- $116,796
That is about 2% higher than the national median of $9,581 a month. Within North Carolina the spread is usually wider still: a city costs more than a rural county, often by a great deal.
A room shared with one other resident in a licensed nursing facility, with round-the-clock nursing supervision, meals, laundry and basic supplies included in the room charge.
What this number is, and what it is not.
It comes from an industry cost-of-care survey — providers reporting their prices — not from a government rate table. There is no federal agency that publishes what assisted living costs, which is why the survey is the source of record here and why we label it plainly rather than dressing it up as official.
A median means half charged more and half charged less. It is not a quote for any particular home, agency or facility, and no provider is bound by it. Prices collected for the 2025 survey.
Where North Carolina sits
$9,733 a month ranks North Carolina 28th of the 50 states priced for nursing home, semi-private room: 27 charge more, 22 charge less.
Wyoming is the next state up, at $9,916; Kentucky the next down, at $9,718.
The national median is $9,581, so North Carolina runs $152 above it — 2% more, or $1,824 a year ($152 × 12 months).
The column runs $5,627 (Texas) to $27,831 (Alaska). North Carolina sits 18% up it, 1.73× the lowest, with 18 other within a tenth of it.
Of the 6 kinds of care North Carolina was priced for, this is its 3rd dearest standing: at best 9th of 46 for skilled nursing at home (private duty nurse), at worst 43rd of 50 for in-home care (non-medical caregiver).
What $9,733 a month becomes
Our multiplication, holding the North Carolina median flat — no real bill does — with the same span of the state's least costly priced care beside it:
Six months
$58,398
$11,050 of adult day health care
One year
$116,796
$22,100 of adult day health care
Two years
$233,592
$44,200 of adult day health care
Three years
$350,388
$66,300 of adult day health care
Five years
$583,980
$110,500 of adult day health care
Care is bought in years, not months, and $9,733 a month is $116,796 a year.
Five years at the national median would be $574,860: $9,120 less than five years in North Carolina.
Inside North Carolina, five years of adult day health care runs $110,500 and five of skilled nursing at home (private duty nurse) $1,487,200; this page's $583,980 sits 34% between them. Most families pay for more than one of these in sequence.
Against other care in North Carolina
Converted to a month on our schedule, set beside this page's $9,733:
Skilled nursing at home (private duty nurse)
$24,787 a month
$15,054 a month more, $180,644 a year, 2.55× this page. North Carolina places 9th of 46 for it, 19 above its 28th here.
Nursing home, private room
$10,798 a month
$1,065 a month more, $12,780 a year, 1.11× this page. North Carolina places 29th of 49 for it, 1 below its 28th here.
Assisted living community
$6,496 a month
$3,237 a month less, $38,844 a year, 0.67× this page. North Carolina places 20th of 50 for it, 8 above its 28th here.
In-home care (non-medical caregiver)
$5,720 a month
$4,013 a month less, $48,156 a year, 0.59× this page. North Carolina places 43rd of 50 for it, 15 below its 28th here.
Adult day health care
$1,842 a month
$7,891 a month less, $94,696 a year, 0.19× this page. North Carolina places 33rd of 45 for it, 5 below its 28th here.
On the same monthly footing, nursing home, semi-private room is the 3rd costliest of the 6 kinds of care priced in North Carolina, at $9,733. The conversions are ours; the medians are the survey's.
44 hours a week of in-home care in North Carolina is $5,720 a month against $6,496 for assisted living — 14% more. The first buys 44 hours and nothing else; the second includes the room, the meals, and someone awake overnight.
Who actually pays for this
This is the part most cost pages leave out, and it is the part that changes what a family does next.
Medicare does not pay for long-term care
Medicare pays for short stretches of skilled care — a limited stay in a skilled nursing facility after a qualifying hospital admission, or skilled home health under specific conditions. It does not pay for custodial care: help with bathing, dressing, meals, medication reminders and supervision. That is what most people need, and for years at a time.
Medicare's own page on long-term care ↗ says the same thing in its own words. It is worth reading once, because almost everyone assumes the opposite.
Medicaid may pay — after a spend-down
Medicaid is the largest payer of long-term care in the country, but it is needs-based: it begins once income and countable savings are inside the limits North Carolina sets. Getting there by spending savings on care is what people mean by a spend-down. There is also a look-back period, so gifts and transfers made in the years beforehand matter.
Veterans: Aid and Attendance may help
A wartime veteran, or a surviving spouse, who needs help with daily activities may qualify for an addition to the VA pension called Aid and Attendance. It is an income-and-net-worth benefit, it is paid monthly, and a great many families who qualify have never heard of it. Accredited veterans service organizations help with the claim for free.
Otherwise: savings, family, and long-term care insurance
Most families pay out of pocket first — from savings, a pension, the sale of a house, or several relatives contributing. A long-term care insurance policy bought years ago pays a daily or monthly amount if the policy's conditions are met; if there is a policy in the family, find it and read what triggers it before you need it.
Working out which of these applies to one particular family is exactly what a free North Carolina counselor does all day. They are paid by a federal grant, not by commission, and they have nothing to sell you. The Eldercare Locator (ACL): 1-800-677-1116 ↗ will connect you to the area agency on aging for your county.
Who to ask in North Carolina
North Carolina's free counseling program is Seniors’ Health Insurance Information Program (SHIIP), on 1-855-408-1212. It is grant-funded and sells nothing.
North Carolina Medicaid decides Medicaid long-term care here — not a facility, and not us. North Carolina runs it as Nursing facility (institutional) Medicaid, Community Alternatives Program waiver (CAP/DA) and Regular Medicaid for the aged, blind and disabled, with a 60-month look-back on gifts and transfers.
Beside $9,733 a month — our comparison, its limits — that is what "spend-down" means: countable assets may not top $2,000, or about 6 days of nursing home, semi-private room at this rate.
Verified 2026-08-02 against CareScout (formerly Genworth) Cost of Care Survey 2025, fielded July-November 2025 (effective 2026-01-01)— an industry survey, not a government figure. Why we use it.
Verified 2026-08-02 against SHIP National Technical Assistance Center (effective 2026-01-01)— an industry survey, not a government figure. Why we use it.
Verified 2026-08-02 against North Carolina Department of Health and Human Services, Aged, Blind and Disabled Medicaid Manual MA-2230 Financial Resources, with MA-2940 the 2026 cost-of-living adjustment and MA-3260 the Community Alternatives Program (effective 2026-01-01)
Common questions
- Does Medicare pay for nursing home, semi-private room in North Carolina?
- No. Medicare pays for short stretches of skilled care after a qualifying hospital stay, and for skilled home health in limited circumstances. It does not pay for long-term custodial care — help with bathing, dressing, meals and supervision — which is what most families are actually paying for.
- Is nursing home, semi-private room dearer in North Carolina than in other states?
- $9,733 a month places North Carolina 28th of the 50 states the survey priced for it: 27 charge more and 22 charge less. The national median is $9,581. That ranking is our arithmetic on the survey's published medians, not a ranking the survey itself publishes.
- Is this the price I will be quoted in North Carolina?
- No. It is the middle of a range from an industry cost-of-care survey: half of the providers surveyed charged more, half charged less. Prices vary a great deal between a city and a rural county in the same state, and no facility is bound by this figure.
- Who can help me work out how to pay for it?
- North Carolina runs its free counseling program as Seniors’ Health Insurance Information Program (SHIIP), on 1-855-408-1212. It is paid for by a federal grant, sells nothing, and the Eldercare Locator (1-800-677-1116) will connect you to the area agency on aging that covers your county.