Quality Reality Check
Navigating nursing home options can feel overwhelming, but understanding the quality landscape in Delaware can help you make an informed decision. With 44 facilities and 4,709 beds across the state, Delaware's nursing homes have an average quality rating of 3.3 out of 5 stars. When looking at the lower end, about 31.8% of Delaware's nursing homes are rated as 1 or 2 stars (4 facilities with 1-star and 10 facilities with 2-stars). Nationally, more than one-third of nursing homes carry these lower 1 or 2-star ratings. On a positive note, 43.2% of Delaware facilities achieve a higher 4 or 5-star rating, which compares favorably to the national average of 31.1% of beds rated four or five stars. A crucial indicator to watch is staffing: Delaware's nursing homes average 1.03 RN hours per resident per day. Always look for facilities with adequate staffing, as low levels can lead to compromised care, and watch out for recurring or serious violations on inspection reports, which are red flags.
Will Medicaid Cover It?
For many families, Medicaid is a lifeline for nursing home care. In Delaware, if your parent needs nursing home care, Medicaid can cover costs, but there are specific financial requirements. For a single applicant in 2026, income must be under $2,485 per month and countable assets under $2,000. If both spouses are applying, their combined assets must be under $3,000, with each spouse's income under $2,485 per month. If only one spouse needs care, the applicant's assets are capped at $2,000, but the non-applicant spouse can keep up to $162,660 in assets.
Delaware is an "income cap state," meaning if income exceeds the limit, a Qualified Income Trust (also known as a Miller Trust) can be used to become income-eligible. For assets, "spending down" means using excess funds on non-countable items like home modifications, paying off debts, or prepaying funeral expenses. Be aware of the 60-month (5-year) look-back period for asset transfers, as gifting assets can result in a penalty period. Once approved, most of the Medicaid beneficiary's income, minus a $75 monthly personal needs allowance and Medicare premiums, will go towards the nursing home costs. To apply, you'll need a medical eligibility determination by a Division of Medicaid and Medical Assistance (DMMA) nurse and a financial review by a social worker. You can start the process online via Delaware ASSIST or by calling the DMMA Central Intake Unit at 1-866-940-8963 for long-term care applications.
Finding the Right Facility
Finding the right nursing home for your parent begins with research. Medicare's Care Compare tool is an excellent starting point, allowing you to compare Delaware facilities based on their 1 to 5-star quality ratings. While national staffing shortages are a concern, Delaware's counties are projected to have a nursing home bed surplus through 2029, suggesting that availability may not be a widespread issue. Occupancy rates in 2023 were 67.9% in New Castle County, 63.2% in Kent County, and 60.2% in Sussex County. When reviewing a facility's inspection report, pay close attention to any recurring deficiencies, serious violations that could immediately threaten residents' safety, and the overall quantity of citations. These reports detail everything from cleanliness and safety measures to staff qualifications and whether care plans are properly followed. Remember, the goal is to find a place where your parent will be safe, respected, and receive high-quality care.
Last updated: April 23, 2026. Sources: Genworth 2024 Cost of Care Survey, CMS Nursing Home Compare, Delaware Division of Medicaid and Medical Assistance.
Last updated: May 3, 2026. Sources: Genworth 2024 Cost of Care Survey, CMS Nursing Home Compare, Delaware Division of Medicaid and Medical Assistance.
Last updated: May 3, 2026. Sources: Genworth 2024 Cost of Care Survey, CMS Nursing Home Compare, Delaware Division of Medicaid and Medical Assistance.