Care Facility Cost Comparison by State — Home Care, Assisted Living & Nursing Home Rates
Care cost benchmarks last verified against Genworth & ACL sources in July 2026.
Quick Answer
National monthly median long-term care costs in 2026 are: Assisted Living (~$4,995/mo), Home Health Aide (~$5,400/mo), Memory Care (~$6,200/mo), and Nursing Home Semi-Private Room (~$8,669/mo). State rates vary dramatically (e.g. Texas nursing homes average ~$5,800/mo while New York averages ~$12,500/mo). Medicare does NOT pay for long-term custodial care.
| Care Type | California (Monthly) | California (Annual) | US National Median (Mo) |
|---|---|---|---|
| In-Home Health Aide (44 hrs/wk) | $6,768 | $81,216 | $5,720 |
| Assisted Living Facility | $5,750 | $69,000 | $4,995 |
| Memory Care Facility (Est.) | $7,000 | $84,000 | $6,160 |
| Nursing Home — Semi-Private Room | $10,372 | $124,464 | $8,669 |
| Nursing Home — Private Room | $11,040 | $132,480 | $9,733 |
Does Medicare Pay for Long-Term Care?
No. Original Medicare and Medicare Advantage do NOT cover custodial long-term care in assisted living or nursing homes. Medicare covers only short-term skilled nursing care (up to 100 days) following a qualifying 3-day inpatient hospital stay. Long-term care is paid out-of-pocket, via long-term care insurance, or by Medicaid once financial thresholds are met.
Source: Benchmarks based on Genworth 2023 Cost of Care Survey data. Verify actual local facility rates directly.
Long-term care is one of the largest unbudgeted expenses facing American families. Families often assume Medicare will cover assisted living or nursing home stays—only to discover Medicare pays zero for custodial care. State costs vary by over 100% depending on geographical labor costs, facility licensing laws, and occupancy rates. We built this tool to let you compare monthly and annual cost medians across all 50 states for every primary senior care option.
- Families evaluating whether an aging parent can afford assisted living or in-home care services long-term.
- Seniors planning ahead for retirement housing who want accurate state-level cost benchmarks.
- Caregivers exploring family financial assistance alongside our Family Caregiver Cost Calculator and Do I Need Care Options Wizard.
No Account. No Sign Up.
Use the tool instantly — no email, no password, nothing to create.
We Never Sell Your Data.
Your inputs are used only to generate your result. We do not share, store, or sell any information you enter.
Fully Independent.
Seniors Audit is not affiliated with any insurance company, government agency, or data broker. We have no financial interest in your coverage choices.
How to Use the Senior Care Facility Cost Comparison Tool
Selecting the right long-term care setting requires balancing clinical care needs with long-term financial sustainability. Follow these four steps to analyze state care benchmarks and build a realistic care budget.
- Step 1 — Select your state of residence. Select the state where care will be provided. Care costs depend heavily on regional cost-of-living index numbers and state-mandated staffing ratios for facilities.
- Step 2 — Compare monthly costs across four primary care settings. Review side-by-side medians for In-Home Care (Homemaker/Home Health Aide), Assisted Living Facilities, Memory Care Communities, and Skilled Nursing Facilities.
- Step 3 — Evaluate annual projected care expenditure. Examine the total 1-year and 3-year projected expenditure figures. The average length of stay in long-term care facilities is approximately 2.5 to 3 years.
- Step 4 — Cross-reference payment coverage rules. Review which care settings accept private pay, long-term care insurance (LTCI), Veterans Aid & Attendance, or Medicaid spend-down programs.
💡 Pro Tip for Medicare & Medicaid Planning
Medicare myth alert: Original Medicare (Parts A & B) pays only for up to 100 days of skilled nursing care following a 3-consecutive-day inpatient hospital stay. It covers $0 for ongoing assistance with Activities of Daily Living (ADLs) such as bathing, dressing, or eating. Medicaid pays for long-term nursing home custodial care, but only after an individual has spent down their countable assets to state threshold limits (typically $2,000 for a single person).
Senior Living & Care Facility Terminology Defined
Long-term care providers use specific industry and legal classifications to describe care levels. Review this reference table to understand what each term means.
| Term / Abbreviation | Full Official Name | Detailed Plain-English Definition |
|---|---|---|
| Assisted Living | Assisted Living Facility (ALF) | A residential housing facility for seniors who need help with daily activities (bathing, meals, medication management) but do not require 24/7 skilled nursing care. |
| Skilled Nursing (SNF) | Skilled Nursing Facility / Nursing Home | A licensed healthcare facility providing 24-hour medical supervision, physical therapy, and intensive nursing care administered by registered nurses (RNs). |
| Memory Care | Specialized Memory Care Unit | A secure, specialized residential unit within an ALF or nursing home designed specifically for individuals with Alzheimer's disease or vascular dementia. |
| ADLs | Activities of Daily Living | Six basic daily self-care tasks: bathing, dressing, eating, transferring (moving from bed to chair), toileting, and maintaining personal hygiene. |
| Custodial Care | Non-Medical Personal Care | Care that helps individuals with basic ADLs but does not require medical staff. Medicare does NOT cover custodial care in any setting. |
| Home Health Aide | Licensed Home Health Aide (HHA) | A trained professional who visits a senior's personal home to assist with personal care, vital sign monitoring, and light therapy exercises. |
| Respite Care | Short-Term Caregiver Relief Care | Temporary care provided in a facility or home to give primary family caregivers a break for several days or weeks. |
Real-Life Case Scenarios — Comparing Senior Care Costs
Arthur, age 81, was paying $4,200/month for 40 hours a week of home health aide assistance for his wife Helen, who has mobility challenges. Home upkeep and meals were becoming overwhelming.
| Cost Factor | Details & Monthly Expenditure |
|---|---|
| Home Health Care Cost | $4,200/mo ($26/hr × 40 hrs/wk) + $1,500/mo home utilities/taxes |
| Assisted Living Quote (Ohio) | $4,800/mo (Includes private 1-bedroom apartment, 3 daily meals, housekeeping & meds) |
| Financial Result | ✅ Assisted living saved $900/mo total combined living costs |
| Care Outcome | ✅ 24/7 staff availability & reduced caregiver burnout for Arthur |
Takeaway: Always calculate total home maintenance costs alongside home care fees when comparing against assisted living quotes. Evaluate family caregiver costs with our Family Caregiver Cost Calculator.
Grace, age 85, required skilled nursing care following a severe hip fracture. Her private savings were $45,000, and private-pay nursing home rates in Florida averaged $8,500/month.
| Planning Factor | Details & Spend-Down Timeline |
|---|---|
| Monthly Nursing Home Rate | $8,500/month (Private Pay) |
| Private Savings Remaining | $45,000 |
| Spend-Down Horizon | 5.2 months until reaching Florida's $2,000 Medicaid asset limit |
| Medicaid Transition | ✅ Applied for Florida Institutional Care Program (ICP) Medicaid at month 4 |
Takeaway: Plan for Medicaid spend-down well in advance of private asset exhaustion.
Representative care cost benchmarks based on official 2026 Genworth and Administration for Community Living survey data.
Common Care Cost Mistakes — And How to Avoid Them
Assuming Medicare Will Pay for Long-Term Assisted Living
Over 60% of families mistakenly believe Medicare pays for assisted living or extended nursing home stays. Medicare only covers short-term skilled rehab following an inpatient hospital stay.
The fix is to build your care budget around private funds, long-term care insurance, or state Medicaid programs.
Not Factoring in Extra Care Tier Add-Ons in Assisted Living
Assisted living facilities quote a base rent, but charge tiered monthly add-ons ($300 to $1,500/mo extra) for medication management, bathing help, or incontinence care.
The fix is to ask for a written "Care Level Point Assessment" before signing any facility lease contract.
Official Government & Industry Sources
| Source Name | What We Used It For | Direct Link |
|---|---|---|
| Genworth Cost of Care Survey | National and state median cost benchmarks across home care, assisted living, and nursing home options | Genworth Cost of Care Survey |
| ACL — Administration for Community Living (LongTermCare.gov) | Federal long-term care statistics, Medicaid rules, and eldercare planning guides | ACL LongTermCare.gov |
| Eldercare Locator (U.S. Administration on Aging) | Federal agency directory linking seniors to local Area Agencies on Aging (AAA) | Eldercare Locator |
Seniors Audit is an independent educational platform. We do not accept referral fees or commissions from care facilities.
Frequently Asked Questions About Care Facility Costs
What is the average cost of assisted living in the United States?
The national median cost for assisted living is approximately $4,995 per month ($59,940 per year), though rates vary widely by state and city.
What is the average cost of a nursing home?
Nationally, a semi-private room in a nursing home averages $8,669 per month ($104,028 per year), while a private room averages $9,733 per month ($116,796 per year).
Does Medicare pay for assisted living or nursing home care?
Medicare does NOT pay for long-term custodial care in assisted living or nursing homes. It pays up to 100 days of medically necessary skilled nursing care after a 3-day inpatient hospital stay.
When does Medicaid start paying for nursing home care?
Medicaid pays for nursing home care once a senior meets state-defined clinical criteria and spends down countable assets to state income/asset limits (typically $2,000 for an individual).
What is the difference between assisted living and a skilled nursing facility?
Assisted living provides assistance with daily living (meals, bathing, meds) in an apartment setting. Skilled nursing facilities provide round-the-clock clinical medical and nursing care.
Are memory care facilities more expensive than regular assisted living?
Yes. Memory care typically costs 20% to 30% more than standard assisted living due to specialized staffing ratios, secure building features, and cognitive programming.
How do I find care facilities in my area and compare their actual rates?
Use the official federal Long-Term Care website (longtermcare.acl.gov) or contact your local Area Agency on Aging via eldercare.acl.gov.
What is the Genworth Cost of Care Survey?
The Genworth Cost of Care Survey is a long-running industry benchmark measuring monthly and annual long-term care costs across all 50 states and metro areas.
Other Free Senior Living & Caregiving Tools
About This Educational Estimate: This tool is for educational purposes only. Seniors Audit uses the official formulas published by Administration for Community Living (ACL) & Genworth, but results are estimates based on the information you entered. Rules, rates, and eligibility thresholds change annually and vary by individual circumstance.
Always verify your specific result directly with Administration for Community Living (ACL) & Genworth at 1-800-677-1116 or at longtermcare.acl.gov before making enrollment, coverage, or financial decisions.
If you have Medicare questions, a free SHIP counselor in your state can review your specific situation at no cost — find yours at shiphelp.org.
Seniors Audit is independent and not affiliated with any government agency or insurance company. We are not affiliated with, endorsed by, or connected to any government agency, insurance company, or financial services firm. All calculations use the official formulas and current figures published by the agencies listed above. We do not receive payment for referrals, leads, or any action taken by visitors to this site. Last reviewed: July 2026.