Skilled nursing Medicaid rates in Arkansas sit at the bottom of the national ranking. Arkansas Medicaid lists $70.00 a day for a nursing home stay, effective July 1, 2025. That ranks 21st of 21 ranked states and is 75.2% below the national median of $282.59.
Unlike the other low-ranked states, Arkansas's figure is a plain daily amount with no billing code attached. That makes it the most direct low comparison in the country, and it is worth reading carefully alongside a facility's own rate notice before drawing conclusions about what an Arkansas building receives.
A daily figure has to be read against how nursing facility payment works. Many states pay a per diem built from several components: direct care tied to resident acuity, indirect and administrative costs, capital, and add-ons. A published statewide figure is one point of comparison; a facility's own rate letter is the figure it is paid.
The Arkansas Medicaid rates page shows the published rate alongside its source document. An operator should open that document to see what the $70.00 covers before using it in a budget or a market comparison.
What the ranking does say with confidence: of the 21 states where a single statewide daily figure can be compared, Arkansas's published figure is the lowest.
It helps to separate the ranking from a facility's own rate notice. The ranking compares one published statewide figure per state. A facility's actual per diem can differ because of resident acuity, size, ownership and cost history, so two Arkansas buildings may be paid quite differently.
How components build a per diem
In a component system, each part of the rate answers a different cost:
- Direct care follows the nursing needs of the residents, often measured by an acuity score.
- Indirect care and administration cover dietary, housekeeping, laundry and the front office.
- Capital pays for the building and equipment.
- Add-ons recognize specific costs or programs.
Why it matters for comparisons
The national median of $282.59 is a reference point for the market, not a target any single facility is paid against. When an Arkansas operator compares itself with a facility in another state, the useful comparison is per diem to per diem, using each facility's own rate letter.
The spread between Arkansas and the top of the ranking is wide.
| State | Daily rate |
|---|---|
| New Mexico | $826.00 |
| Colorado | $419.22 |
| Kentucky | $365.78 |
| National median | $282.59 |
| Michigan | $99.90 |
| Arkansas | $70.00 |
Kentucky is a useful contrast: a plain daily figure, like Arkansas's, ranked fifth at $365.78. The Michigan figure is attached to code G9685, and Connecticut's $107.21 to code 1293Z. Arkansas has no code attached, which is why it anchors the bottom of the comparison.
Arkansas sits between several large Medicaid programs. The Texas skilled nursing page, the Oklahoma skilled nursing page and the Louisiana Medicaid rates page cover the surrounding states.
For operators with buildings on both sides of a state line, these comparisons matter in practice. Staff can move between markets, residents and families sometimes choose facilities across the border, and a chain's regional budget has to blend very different Medicaid revenue per day. Reading each state's rate in its own terms, and against its own wage level, gives a fairer picture than the headline figures alone.
Arkansas facilities do have one cost advantage: nursing wages are lower than the national median at every licensure level, according to May 2025 federal occupational data.
| Role | Arkansas | US median |
|---|---|---|
| Registered nurse | $37.95 | $46.90 |
| Licensed practical nurse | $27.22 | $30.96 |
| Nursing assistant (CNA) | $16.55 | $20.32 |
Nursing assistants provide most hands-on care, and the Arkansas CNA wage of $16.55 an hour is the figure that most shapes direct care budgets. Registered nurse coverage at $37.95 is the most expensive hour on the schedule. Licensed practical nurses at $27.22 often handle medication passes and treatments.
Lower wages narrow the gap but do not close it. A facility still has to staff around the clock, and the daily payment has to stretch across every nursing hour a resident needs plus dietary, housekeeping, activities, administration and the building.
Three levers matter most in Arkansas:
- Payer mix. Medicare skilled days and private-pay days carry a larger share of cost in a low-rate state, so admissions strategy is a financial decision.
- Retention. Turnover adds recruiting, orientation and agency staffing costs on top of wages. Keeping CNAs is often the single biggest controllable cost.
- Licensure mix. Matching RN, LPN and CNA hours to the tasks each is trained for keeps the most expensive hours where they are required.
Most nursing homes serve three kinds of resident days, and each is paid differently.
Medicare skilled days
Medicare covers short skilled stays after a qualifying hospital admission, usually for rehabilitation. These days are paid at Medicare's own rates, which are set nationally and adjusted for local costs and the resident's clinical profile. They are typically the highest-paying days in the building.
Medicaid long-stay days
Medicaid pays for residents who need ongoing care and meet the program's financial and functional rules. These are usually the majority of days in a facility, and they are paid at the state's rate, the figure this page is about.
Private-pay days
Residents who pay from their own funds, or through long-term care insurance, pay the facility's private rate. Many private-pay residents later spend down their savings and convert to Medicaid.
In a state where the Medicaid figure sits at the bottom of the national ranking, the balance among these three matters more than anywhere else. A facility that tracks its mix each month, and understands how quickly private-pay residents convert to Medicaid, can see a budget problem coming months before it shows up in cash flow.
Before using any published figure in a budget, an operator should be able to answer a few questions from the source document and the facility's own rate notice:
- What period does the rate cover? The current statewide figure dates from July 1, 2025.
- Which costs are included? Confirm whether the figure covers the full stay or a defined part of it.
- Is there an acuity adjustment? If the rate varies with resident needs, the facility's case mix drives revenue.
- Are there add-ons? Quality or program payments can sit outside the base figure.
- How are leave and hospital days handled? These rules decide whether a bed-hold day is paid.
Clear answers to these questions turn a published number into a usable forecast.
Our data counts 16 plans in Arkansas Medicaid, including Arkansas Total Care, CareSource PASSE and Summit Community Care. For nursing facilities, the rule is that services are paid directly by the state, outside managed care. The same rule applies to home and community-based services, personal care and IDD services.
For a nursing facility, that means one payer and one schedule. There is no plan contract to negotiate on the daily rate, and any state rate change applies to every Medicaid resident at once. The Arkansas managed care page tracks the plans and rules that are classified.
Arkansas PASSE (Provider-led Arkansas Shared Savings Entity) operates as risk-based managed care for members with behavioral-health or intellectual and developmental disability needs. A PASSE 1915(b) waiver renewal, effective January 1, 2027, went to hearing in October 2026. Facilities with residents enrolled in a PASSE should confirm how those members' other services are coordinated.
The ARChoices in Homecare waiver and the Living Choices Assisted Living waiver pay for care at home and in assisted living, the main alternatives to a nursing home stay for older adults and people with physical disabilities.
For a nursing facility, those programs shape census. When home and assisted-living options are funded, the residents who remain in nursing homes tend to have higher care needs, which raises cost per day while the published daily figure stays where it is.
A 2025 Living Choices Assisted Living Waiver Rate Study Report was published in August 2026. Its outcome matters to nursing facilities indirectly: assisted-living rates influence how many lower-acuity residents choose assisted living over a nursing home. The Arkansas home care rates page covers the in-home side.
No recent changes specific to Arkansas nursing facility rates are recorded, and no coverage rules or prior authorization limits apply to the daily rate. The current figure has been effective since July 1, 2025, so the next rate year would be the first signal of a change.
Other notices are worth following. A proposed PASSE HCBS minimum fee schedule effective January 1, 2027 is pending CMS approval, and the assisted-living rate study may lead to new waiver rates. Watch the Arkansas Medicaid rates page for an update to the nursing facility effective date.
- Treat the $70.00 as a reference point, not a forecast for any one building, and compare it with the per diem your facility is actually paid.
- Budget on cost per resident day, since a low rate leaves little room for unplanned costs.
- Use wage data in planning. Below-median wages are the main cost offset, so track local wage movement closely.
- Use the high end of the ranking for perspective on how far apart state payment systems can be, especially in rate discussions with the state.
All 58,270 current Arkansas Medicaid rates are available with a MedicaidRate plan.
Rates on this page are compiled from official state Medicaid publications from Arkansas Medicaid, and each rate links to its source document. Arkansas records go back to 1996. Wages are May 2025 federal occupational medians. The national skilled nursing overview shows all states, and the methodology explains why only 21 of the 44 states with a published rate can be ranked.