Nursing homes and assisted living in Vermont

In Vermont, most residences for older adults are Residential Care Homes of different levels. Understanding those levels will help you find the place that best fits your loved one.

What care settings are called here

The Division of Licensing and Protection, part of the Department of Disabilities, Aging and Independent Living (DAIL), licenses these places. Its phone number is (802) 241-0344.

• Residential Care Home Level III: help with personal care and managing medicines, with nursing supervision, but without full-time nursing care.
• Residential Care Home Level IV: help with personal care and medicines, with no other nursing services.
• Assisted Living Residence: this is assisted living. It combines housing, health services and support, with a private room and bathroom.
• Nursing Home: a nursing home, with nursing care 24 hours a day.

The Division of Licensing and Protection website has directories by facility type and inspection results. These are useful tools for comparing at your own pace.

How Medicaid helps in Vermont

The main long-term care program is called Choices for Care. It's for people 18 and older who need the level of care a nursing home provides. It can pay for care in different settings:

• In the person's own home.
• In an adult family home (Adult Family Care).
• In a nursing home.
• Through Enhanced Residential Care (ERC), which pays for 24-hour services in approved Level III Residential Care Homes or Assisted Living Residences. The person pays for room and board.

There is also ACCS (Assistive Community Care Services), a Medicaid benefit that pays for services in participating Level III homes and Assisted Living Residences. Here, too, the resident pays for room and board.

Where to apply: you apply for Medicaid through the Department of Vermont Health Access (DVHA).

• Customer Support: 1-802-476-0100.
• Help in other languages: 1-855-899-9600.

How much care costs in Vermont

These are the state medians from CareScout's Cost of Care Survey 2025 (data from July to November 2025):

• Assisted living (private room, one bedroom): $8,597 a month.
• Nursing home, semi-private room: $464 a day (about $14,113 a month).
• Nursing home, private room: $511 a day.
• In-home caregiver (non-medical): $45 an hour.

CareScout did not publish a median for adult day centers in Vermont.

Who to call

• Long-Term Care Ombudsman (a free advocate for residents, run by Vermont Legal Aid): 1-800-889-2047.
• Senior HelpLine (connects you with your local agency on aging): 1-800-642-5119.
• Eldercare Locator (national line): 1-800-677-1116.

Tips for your family

• Ask about the home's level. A Level III home can offer more health-related help than a Level IV home.
• Ask whether the home takes part in ERC or ACCS. If your loved one is going to need Medicaid, ask before they move in.
• Call the Senior HelpLine. It can help you find a home with ACCS and apply for Medicaid.
• Learn about certified adult day centers. There are 11 state-certified providers, and Choices for Care can help pay for them.
• If needs are moderate, ask about the Moderate Needs Group. It offers help at home and adult day services with limited funding, and you don't need to have Medicaid.

This is general information and does not replace medical or legal advice.