Updated August 27, 2026. Quick answer: Delaware publishes two figures every year and its manual uses them in two different places. Effective January 1, 2026 the average daily cost is $439.84 and the average monthly cost is $13,378.33. For assets transferred on or after 2/8/06, the manual’s penalty section divides by the DAILY figure and the answer comes out in days.
What Delaware publishes
| What the state lists | Figure |
|---|---|
| Average daily cost to a private pay patient, effective 1/1/2026 | $439.84 |
| Average monthly cost to a private pay patient, effective 1/1/2026 | $13,378.33 |
| Prior year, effective 1/1/2025 – daily | $405.83 |
| Prior year, effective 1/1/2025 – monthly | $12,377.88 |
| Effective 1/1/2024 – daily | $390.93 |
| Effective 1/1/2024 – monthly | $11,890.77 |
| Days per month the manual uses to convert between them | 30.42 |
| The notice that publishes the 2026 figures, and its date | A-15-2025 |
| What the manual says the figure is not | This is not the average Medicaid per diem rate. |
How the penalty period is calculated
- DSSM 20350.1.10 defines the average monthly cost as “the average cost to a private patient for a month of nursing facility services in Delaware at the time of application”, and says the monthly rate is determined based on “365 days divided by 12 months or 30.42 days per month”.
- DSSM 20350.3 states the penalty period as the total, cumulative uncompensated value of all assets transferred on or after the look-back date divided by the average monthly cost to a private patient for nursing facility services at the time of application, and says the resulting figure is the number of months of ineligibility.
- DSSM 20350.3.1, the section covering assets transferred on or after 2/8/06, states it differently: the penalty period continues to run for the number of DAYS determined by dividing the total value of assets transferred within the look-back period by the State’s average daily cost to a private patient.
- Counting rules in the monthly section round a partial month DOWN – from a September 28 transfer, round down to make August the last month in the period – and a full month is counted at the beginning of a period of ineligibility.
- Once the penalty period is imposed it will not be interrupted, and continues to run even if the individual stops receiving an institutional level of care.
- For a person who is not institutionalized, the penalty date does not begin until the individual is receiving an institutional level of care.
- The annual notice sets out how the pair is built: the daily average usual and customary nursing facility charge for a private pay patient is calculated annually, rounded, and a monthly rate is obtained by multiplying the rounded daily rate by 30.42 days.
Once you have the figure above, the Medicaid penalty period calculator does the arithmetic. This page is the Delaware rate record; the calculator is the class parent.
What this page does not settle
- The two published figures do not reproduce each other by the method the notice describes. Multiplying the rounded daily rate of $439.84 by 30.42 gives $13,379.93, and the notice prints $13,378.33 – about $1.60 apart. Dividing the printed monthly figure by 30.42 runs the other way and gives about $439.79. A penalty worked from the daily figure and one worked from the monthly figure will therefore not land in exactly the same place. That arithmetic is done here, not by the state.
- The manual carries a monthly divisor and a daily divisor in adjacent sections – 20350.3 and 20350.3.1 – and the second is scoped to assets transferred on or after 2/8/06. This page reports both as the manual words them and does not decide which governs a particular file.
- The daily route and the monthly route also round differently: the monthly section rounds a partial month down to the preceding month, while a figure expressed in days has no partial month to round.
- The figures are recalculated annually and each notice replaces the last, so a Delaware calculation depends on which year’s notice applies to the application date.
- The notice states in terms that this is not the average Medicaid per diem rate, which means the number a facility is paid by Medicaid is not the number the penalty uses.
Eligibility is decided by the state agency on the whole file, not by this one number. Nothing here is legal advice, and no one should transfer, retitle or give away property on the strength of a worksheet.
Sources
- Delaware DMMA Administrative Notice A-15-2025, 2026 Nursing Home Private Pay Rate (the 2026 figures)
- Delaware DMMA, 2025 Nursing Home Private Pay Rate (the prior year)
- Delaware DMMA, 2024 Nursing Home Private Pay Rate
- 16 Del. Admin. Code, Division of Social Services Manual 20000, including 20350 Transfer of Assets and 20350.1.10 Average Monthly Cost (the method)
Each source above was retrieved and read against the state text on August 27, 2026. Every figure on this page was checked against those bytes.
A transfer penalty is a separate test from the income standard that decides eligibility in the first place. For what Delaware uses as that standard, and the state document it comes from, see Medicaid nursing home income limit in Delaware ($2,485/Month).
Related: Delaware’s Medicaid home equity limit for a single applicant with no spouse or dependent child at home.
Related: Delaware’s Medicaid Personal Needs Allowance; the amount a nursing-facility resident keeps from their own income each month.