Nursing homes, like many other businesses, have to pay many things that you would never think about. One of the largest is having to pay doctors and registered nurses as well as dispensers for medications, their salaries. They also have to buy the medicines and other equipment they use. There is also the cost of insurance to cover them in case of accidents, which are far more devastating to elderly people. They also have to pay accountants, electric and water bills to keep everything running, etc. Then there is also the fact that the government often steps in to pay the cost for those who can’t afford it, and when that happens the state will take ownership of their property, private and personal, to sell at auction.