Guide
Elder Care Costs by State: 2025 Data
Elder care is one of the largest financial commitments American families face — and costs vary by a factor of two or more between states. Here is what the 2025 CareScout data shows across all six major care types.
Key Takeaway
A semi-private nursing home room costs from roughly $6,500/month in the least expensive states to over $14,000/month in the most expensive — a gap that compounds to hundreds of thousands of dollars over a multi-year care stay. Location is one of the single biggest cost drivers in elder care.
The Six Types of Elder Care
The CareScout Cost of Care Survey — the most widely cited national elder care cost benchmark — tracks six distinct care types. Understanding the differences is essential because families often move through multiple care levels as needs increase over time.
| Care Type | Monthly (Median) | What It Provides |
|---|---|---|
| Adult Day Health Care | ~$2,000 | Daytime supervision, meals, and activities; person goes home at night |
| Homemaker Services | ~$6,100 | Non-medical help at home: cooking, cleaning, errands, companionship |
| Home Health Aide | ~$6,292 | Personal care at home: bathing, dressing, mobility, medication reminders |
| Assisted Living | ~$6,200 | Residential facility with ADL assistance, meals, and social programming |
| Nursing Home (Semi-Private) | ~$9,581 | 24/7 skilled nursing, shared room, full medical oversight |
| Nursing Home (Private Room) | ~$10,646 | 24/7 skilled nursing, private room, full medical oversight |
Source: CareScout Cost of Care Survey 2025 CareScout Cost of Care Survey 2025 National medians. Actual costs vary by state, metro area, and individual facility
Compiled by the " research team.
Note that home care costs (homemaker services and home health aide) are based on 44 hours per week of service. For families needing around-the-clock home care — 168 hours per week — the actual monthly cost can exceed $20,000, often more expensive than a nursing home.
Regional Cost Patterns
Elder care costs closely follow regional cost-of-living patterns, but the variation is more extreme than many families expect. The gap between the cheapest and most expensive states for a semi-private nursing home room exceeds $8,000 per month — nearly $100,000 per year.
Most Expensive Regions
The Northeast corridor (Connecticut, Massachusetts, New York, New Jersey) and the West Coast (California, Washington) consistently rank as the most expensive markets for all care types. Alaska is an outlier with extremely high costs due to remoteness, limited supply, and high labor costs.
In these states, a semi-private nursing home room typically exceeds $12,000–$15,000 per month. Assisted living often runs $7,000–$10,000 per month. The premium extends to home care as well, driven by higher hourly wages for caregivers.
Least Expensive Regions
The South (Louisiana, Oklahoma, Alabama, Mississippi, Arkansas) and parts of the Midwest (Missouri, Iowa, Kansas) offer the lowest costs. Semi-private nursing home rooms in these states can be found for $6,000–$7,500 per month. Assisted living may run $3,500–$5,000.
However, lower costs sometimes reflect lower staffing levels, fewer facility amenities, or thinner markets with less competition. Review CMS quality ratings by state alongside cost data to get the full picture.
Mid-Range States
The majority of states fall in a middle band: semi-private nursing home rooms between $7,500 and $10,500 per month. Many families in these states find that the cost is still far higher than anticipated. A two-year nursing home stay at the national median costs over $230,000 — a figure that exceeds most families' liquid savings.
Why Costs Vary So Much
Several factors drive state-by-state variation:
- Labor costs: Nursing and aide wages are the single largest expense for care facilities. States with higher minimum wages and tighter labor markets pay more.
- Real estate: Facility construction, maintenance, and property taxes add to overhead, particularly in high-cost-of-living markets.
- Medicaid reimbursement rates: In states where Medicaid reimburses facilities below cost, private-pay residents often subsidize the difference through higher rates.
- Regulatory requirements: States with stricter staffing mandates or building codes create higher baseline operating costs.
- Market competition: Areas with more facilities and more options tend to have more competitive pricing; rural areas with limited supply often have less price pressure.
Cost Trends Over Time
Elder care costs have consistently outpaced general inflation. Nursing home costs have risen approximately 3–5% per year over the past decade, driven primarily by labor shortages, rising wages, and increasing regulatory requirements.
For planning purposes, this means that the cost at the time care is actually needed will likely be significantly higher than current published figures. A family planning for care five years from now should budget 15–25% more than today's rates as a baseline estimate.
The COVID-19 pandemic accelerated some cost increases, particularly in states that raised staffing requirements in response. Post-pandemic labor shortages in healthcare continue to push wages — and therefore facility costs — upward.
Using This Data for Planning
Start by understanding costs in the state or states where care is most likely to be needed. Then build a planning framework:
- Estimate the likely care level needed (home care → assisted living → nursing home) and the expected duration at each level
- Look up state-specific costs on our state data pages for each care type
- Apply a 3–5% annual inflation factor to project costs forward to the anticipated start date
- Inventory funding sources: savings, long-term care insurance, Veterans benefits, home equity, and Medicaid eligibility timeline (see our payment guide)
- Identify the funding gap — the difference between projected costs and available resources — and start addressing it now
Explore Costs in Your State
View nursing home, assisted living, and home care costs for every state, with CMS quality ratings and county-level breakdowns where available.
View All States →What do families ask most?
How much does a nursing home cost per month in the United States? +
The national median is approximately $9,581/month for a semi-private room and $10,646/month for a private room (CareScout 2025). Costs range from about $6,500/month in the least expensive states to over $14,000/month in the most expensive.
Which states have the most expensive elder care? +
Connecticut, Massachusetts, New York, New Jersey, Alaska, and California consistently rank among the most expensive for all care types, often exceeding $12,000–$15,000/month for a semi-private nursing home room.
Which states have the cheapest nursing home care? +
Louisiana, Oklahoma, Missouri, Texas, and Alabama typically have the lowest nursing home costs, with semi-private rooms often in the $6,000–$7,500/month range. Lower costs may sometimes correlate with lower staffing levels.
What are the six types of elder care and how do they compare on cost? +
From least to most expensive nationally: adult day health care (~$2,000/month), homemaker services (~$6,100/month), home health aide (~$6,292/month), assisted living (~$6,200/month), nursing home semi-private (~$9,581/month), and nursing home private room (~$10,646/month). All figures are CareScout 2025 national medians.
How fast are elder care costs rising? +
Nursing home costs have risen approximately 3–5% per year, outpacing general inflation. Key drivers include labor shortages, minimum wage increases, and regulatory compliance costs. For planning purposes, budget 15–25% more than current rates if care is expected in 5 or more years.
