Skilled nursing in the home costs about $90 an hour, or $160 a visit, per the CareScout Cost of Care Survey 2025 published by Genworth. If you're weighing in-home nursing care for an aging parent, that number is your starting point — but the bigger question is what kind of care your parent actually needs, and how to get it without overpaying for hours you don't.
Here's the plain version. In-home nursing care brings a licensed nurse to your parent's house to do medical tasks — the kind that legally require training and a license. Think wound dressing changes after surgery, giving injections, managing a feeding tube, drawing blood, or setting up a complicated medication schedule. It's usually ordered by a doctor and delivered in scheduled visits, not around the clock.
What in-home nursing care actually covers
A registered nurse (RN) or licensed practical nurse (LPN) comes to the home and performs care that has to be done by a medical professional. This is not the same as someone who helps your dad get dressed and cooks lunch, though families often need both.
- Wound and incision care after a hospital stay or surgery
- Giving injections or IV medications
- Managing catheters, feeding tubes, or ostomy care
- Monitoring vital signs and chronic conditions like heart failure or diabetes
- Setting up and reviewing medications so they're taken correctly
- Teaching family caregivers how to handle a specific medical task
Nursing often comes bundled with home health — physical, occupational, or speech therapy — especially in the weeks after a hospital discharge. A nurse might visit twice a week to check a wound while a physical therapist works on getting your mom walking again.
What it costs and what drives the price
Skilled nursing in the home runs about $90 an hour, or $160 a visit, per the CareScout Cost of Care Survey 2025 published by Genworth. What you actually pay depends on where you live, how many visits your parent needs each week, and whether the work requires an RN or an LPN. Rural and urban rates differ. Overnight, weekend, or holiday care usually costs more.
The good news: skilled nursing is often intermittent. Unlike round-the-clock companion care, a nurse may only need to visit a few times a week for a set period — which keeps the total far below the cost of 24-hour care. And a big piece may be covered by insurance.
Who pays — and who qualifies
Medicare can cover skilled home health nursing, but with strict conditions. Your parent generally must be considered 'homebound,' a doctor must order the care and certify it's medically necessary, and it must come from a Medicare-certified agency. When it qualifies, coverage is for skilled care that's intermittent — not full-time and not indefinite. Personal care alone (bathing, meals, company) usually is not covered by Medicare.
- Medicare: covers skilled, intermittent nursing when a doctor orders it and your parent is homebound
- Medicaid: rules vary by state, but may cover more, including some long-term personal care
- Long-term care insurance: check the policy for home care benefits and daily limits
- Private pay: out of pocket, at the rates above, when insurance doesn't apply
- Veterans benefits: the VA may help eligible veterans with home-based care
Nursing care vs companion care — which does your parent need?
This is the confusion that costs families the most money. Many parents don't need a nurse every day — they need help with daily life plus a nurse a couple times a week. Matching the right care to the right need is how you avoid overpaying.
How to choose an agency and what to ask
Not all agencies are equal, and the wrong one causes turnover, missed visits, and stress. Do a little homework before you sign anything.
- 1Get a doctor's assessment of what medical care your parent actually needs
- 2Confirm whether Medicare, Medicaid, or long-term care insurance will cover it
- 3Get two or three quotes from licensed, Medicare-certified agencies
- 4Verify licensing, bonding, insurance, and how caregivers are screened
- 5Ask how they handle a missed visit, an emergency, or a schedule change
- 6Meet the nurse or care team before care starts, and set a clear care plan
- Is your agency Medicare-certified, licensed in this state, bonded, and insured?
- Are your nurses employees or contractors, and how do you background-check them?
- Will my parent see the same nurse, or a rotating team?
- What happens if a nurse calls out sick — is there a backup?
- Who do I call after hours with a question or a problem?
- How do you communicate updates to me as the family?
Warning signs and common mistakes
A few red flags: an agency that can't produce proof of licensing, vague answers about who shows up, pressure to sign a long contract fast, or no clear plan for missed visits. The most common mistake families make is buying more care than they need — paying nurse rates for tasks an aide could do — or paying privately for care Medicare would have covered.
The other quiet gap: the hours between visits. A nurse comes twice a week, an aide comes for a few hours, and then your mom Margaret is alone the rest of the day. Medical care is handled; the loneliness and the small daily 'is she okay?' worries are not.
How nursing care fits with keeping a parent safe at home
In-home nursing is one piece of a plan, not the whole thing. Most families end up layering: a nurse for the medical work, an aide for daily help, a medical alert device for emergencies, and something to bridge the quiet hours. The goal is a parent who stays in their own home, safely and connected.
That last piece is where a daily check-in call helps. Call Mabel is a warm phone companion your parent talks to every day on their regular phone — a real conversation that notices when something seems off and keeps you in the loop between nurse visits. It's a complement to nursing and caregivers, not a replacement, and it's not medical or emergency monitoring. Compared with home care at $5,000+ a month, it's a small way to fill the gap when no one's in the house.
- ✓Start with your parent's doctor — a home health order may unlock Medicare coverage.
- ✓Match the care to the need: nurses for medical tasks, aides for daily help.
- ✓Get two or three quotes from licensed, Medicare-certified agencies and check credentials.
- ✓Meet the care team and set a clear plan before care begins.
- ✓Plan for the quiet hours between visits, not just the visits themselves.