Colorado Nursing Home Medicaid

Last updated: August 21, 2026 Jurisdiction: Colorado

Colorado nursing-facility coverage sits within LTSS

Health First Colorado pays for nursing-facility services through its Long-Term Services and Supports system when the person satisfies the applicable financial and functional requirements. HCPF treats nursing facilities as a distinct provider setting and uses LTSS functional-eligibility tools, so admission to a facility is not by itself a Medicaid eligibility approval. Families should coordinate the facility, the assessment process, and the financial application rather than wait for one to replace the other (HCPF Nursing Facilities Topics; HCPF case-management tools).

The published Long-Term Care Level of Care Eligibility Assessment says that, to qualify for Medicaid long-term-care services, the applicant generally must have deficits in two of six activities of daily living or a qualifying moderate-or-greater supervision need in behavior or memory/cognition. HCPF describes this as a functional eligibility assessment, which means the team should document bathing, dressing, eating, toileting, transfers, mobility, supervision, and relevant medical information rather than rely only on a diagnostic label (Colorado LTSS eligibility assessment).

The 2026 personal-needs allowance

For a Medicaid resident of a nursing or intermediate-care facility, HCPF’s 2026 COLA memo sets the personal-needs allowance at $110.36 per month effective January 1, 2026. The memo labels this the Nursing and Intermediate Care Facility PNA and shows that it is updated through the annual adjustment process. It is the amount reserved for the resident’s personal needs before the facility patient-payment calculation uses remaining income, not a separate monthly income-limit test (HCPF 2026 COLA memo).

HCPF’s nursing-facility materials call attention to the resident personal-needs account and its required surety-bond rules. The facility and eligibility calculation should therefore identify the resident’s PNA, patient payment, and any permitted deductions clearly. A family should not assume that “Medicaid pays” means every source of the resident’s monthly income is available for household spending; the patient-payment calculation remains part of the long-term-care case (HCPF Nursing Facilities Topics; HCPF long-term-care eligibility rule).

Income trusts can be part of the facility path

Colorado’s 300%-of-SSI limit is $2,982 per month in 2026. HCPF’s income-trust instructions say an applicant above that level but below the relevant regional private-pay nursing-facility rate can use the income trust to establish and maintain eligibility for long-term-care institution care. Because the applicable private-pay rate differs by Colorado region, use the current regional chart rather than an old statewide number (HCPF 2026 COLA memo; HCPF Income Trust instructions).

2026 Colorado nursing-facility PNA: $110.36 per month. The applicant also needs the appropriate LTSS functional review and long-term-care financial eligibility determination (HCPF 2026 COLA memo).

For the larger funding framework, see Medicaid (Baseline). A facility social worker, case manager, or Colorado benefits professional can help reconcile the admission date, functional assessment, income, resources, and patient-payment notice.

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Colorado nursing-facility coverage sits within LTSS

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