Costs & Funding · 6 min read
How Much Does a Nurse Call System Cost? A Straight Answer for Senior Housing
Rewiring a hardwired nurse call system runs about $1,000 or more per unit. Wireless monitored call-for-aid is $15 per unit per month on a 60-month term, plus $25 per unit to install — with the old system removed free. Here is the full cost picture.
Short answer: replacing a legacy pull-cord or nurse call system with wireless, 24/7 monitored call-for-aid costs $15 per unit per month on a 60-month term, plus a one-time $25 per unit installation. Removal of the old system is free. Rewiring the existing hardwired system instead typically costs about $1,000 or more per unit — and still leaves you with an alarm that only works if someone is on site to hear it.
The three options, side by side
- Rewire the hardwired system: about $1,000+ per unit, weeks of in-unit construction, and alerts still sound at a panel someone must be present to hear.
- Remove the system entirely: labor in every unit, wall repair and finishes, and residents left with no way to call for help. HUD's H 2026-06 notice now permits this at covered properties, with tenant notice — but it removes a safety feature residents rely on.
- Replace with wireless monitored call-for-aid: $25 per unit to install, $15 per unit per month, about a day per building, old equipment removed free, and every call answered by a live person around the clock.
What the $15 per unit per month includes
- Wireless wall buttons and wearable pendants in every unit.
- 24/7 live monitoring — a person answers every call, day and night.
- A time-stamped record of every call and response, useful for NSPIRE inspections and liability defense.
- Maintenance of the system over the 60-month term.
- Free removal of the legacy pull-cord system at installation.
What a 60-unit building actually pays
For a 60-unit building: $1,500 one-time installation (60 × $25), then $900 per month (60 × $15). Over the 60-month term that is $55,500 all-in — compared with roughly $60,000 or more to rewire the old hardwired system, before any monitoring cost, and with weeks of construction disruption.
How HUD properties pay for it without touching reserves
Monitored call-for-aid runs $15 per unit per month on a 60-month term, plus $25 per unit for installation. For HUD properties, the subscription becomes a line item in the property's annual HUD budget submission, and HUD's rent-setting process authorizes a commensurate rent adjustment to cover it — $0 out-of-pocket to the property, with Reserve for Replacement funds left untouched.
Using Reserve for Replacement instead typically means fronting a $50,000–$70,000 capital replacement and waiting for reimbursement. The budget-line approach avoids that.
The cost of doing nothing
A non-functioning call-for-aid system is a Life-Threatening NSPIRE deficiency with a 24-hour correction requirement. Beyond inspection findings, an unanswered call can become a fall left undiscovered, an emergency that escalates, or a liability claim — the average fall-related liability claim runs about $49,000. The ROI Calculator models these numbers for your unit count.
Get a number for your building
Every building is different. Schedule a free virtual inspection and we will count your devices, check your system against HUD's NSPIRE rules, and give you a written fix-and-funding plan with exact pricing for your property.