Key Findings
- The U.S. state leading in senior care costs, but with low quality, is Alaska, with the most expensive nursing homes and only 1.1% of high-quality facilities for long-term care.
- Louisiana stands out with the highest in-home care cost, with $8.8K on average.
- When it comes to nurse care, New York has the fewest nurse staffing hours, with 3.6 per resident.
Recent federal data shows that more than 40% of Americans now expect to spend over $100,000 on elder care during retirement. That number highlights just how serious the issue of care affordability has become nationwide.
At Your Insurance Attorney, we recently conducted a study to better understand where in the U.S. the financial burden of senior care is the highest compared to the quality of care being delivered. Our goal was to identify the states where people may be overpaying for care that doesn’t meet the mark.
To do that, we compared states across several key indicators—nursing home costs, nurse staffing hours, access to healthcare, and the rate of high-quality nursing and long-term care facilities. We then calculated an elder-care inefficiency score using the most recent data available from the Centers for Medicare & Medicaid Services, as well as the Medicare and Medicare Guide, looking closely at important health benchmarks.
This study helps shine a light on the gaps in our elder-care system and where reforms are most urgently needed.
Here is the summary of the findings:
| US States | Nursing home average cost | In-Home Care Average Cost (Full Time) | Reported Total Nurse Staffing Hours per Resident per Day | % of Nursing Facilities Meeting High Standards | Healthcare Access Score | High-quality Long-term Care Facilities | Elder-Care Inefficiency Score |
| Alaska | $21,727 | $7,040 | 6.90 | 88% | 14.82 | 1.14% | 84.83 |
| Louisiana | $7,770 | $8,800 | 3.81 | 75% | 14.23 | 7.66% | 72.75 |
| West Virginia | $10,073 | $5,632 | 3.70 | 47% | 22.63 | 4.14% | 65.32 |
| Virginia | $9,164 | $6,688 | 3.77 | 60% | 11.83 | 11.84% | 65.03 |
| New York | $11,545 | $4,928 | 3.68 | 57% | 13.72 | 25.42% | 59.46 |
| Vermont | $11,200 | $5,280 | 4.16 | 52% | 24.68 | 1.47% | 59.04 |
| Wyoming | $8,772 | $4,928 | 3.90 | 41% | 16.11 | 1.39% | 58.76 |
| Maryland | $10,527 | $6,160 | 3.89 | 77% | 14.51 | 9.47% | 58.60 |
| Utah | $9,125 | $5,632 | 4.06 | 53% | 10.54 | 4.69% | 57.55 |
| Connecticut | $12,453 | $5,280 | 3.76 | 83% | 22.04 | 8.58% | 57.53 |
*You can find the full research, along with all the metrics and methodology here.
The state where we found the biggest mismatch between high senior care costs and low quality is Alaska, with an elder-care inefficiency score of 84.8. Nursing homes are the most expensive in the top 10, averaging $21,700 a month, yet only 1.14% of long-term care facilities meet high standards. In-home care isn’t much better—$7,000 a month on average.
Louisiana came in second on our list, with a score of 72.7. While nursing home costs there are nearly three times less than in Alaska, Louisiana struggles with nurse staffing—residents only receive about 3.8 hours of care per day, and just 75% of nursing facilities meet high standards.
West Virginia holds third place with a score of 65.3. The state offers the second-fewest staffing hours, just 3.7 per patient, and only 47% of facilities meet the quality mark, worse than both Louisiana and Alaska.
In fourth place is Virginia, with a score of 65. Nurse staffing hours here are about the same as West Virginia’s, but what stands out is the low healthcare access, just 11.8 on our index, the second-lowest in the top 10.
We ranked New York fifth, scoring 59.4. It has the lowest staffing hours in the nation, just 3.68 per patient. And while only 57% of facilities meet high standards, care still costs $11,500 per month.
Vermont follows with a score of 59. Only 52% of its nursing homes meet high standards, and just 1.47% of long-term care facilities are rated highly, third-lowest in the top 10.
Wyoming is seventh, scoring 58.7. Though nursing home costs here average $8,700, just 41% of facilities are considered high-quality, and only 1.39% of long-term care facilities meet that mark, second-lowest in our ranking.
In eighth place, Maryland scored 58.6. The average nursing home cost is $10,500, but access to healthcare is low (index of 14.5), and only 9.4% of long-term care facilities are rated high quality.
Next is Utah, scoring 57.7. It has the lowest healthcare access in the top 10 (index of 10.5), and while in-home care runs about $5,000/month, nursing homes average $9,100, without the care quality you’d expect.
Connecticut rounds out our list with a score of 57.5. Nursing homes here are more expensive than in New York or Vermont, at $12,400/month, and though more facilities meet quality standards, staffing remains an issue, with just 3.7 hours per patient.
We see it all the time, families spending a fortune on senior care, only to receive services that fall far short of what their loved ones deserve. In states like Alaska, people are paying top dollar, but the quality just isn’t there. This gap between cost and care isn’t just frustrating; it’s dangerous, especially as our population ages. That’s why our nursing home claim lawyers are dedicated to fighting for families who have been let down by subpar care. We need real change. Elder care should be both affordable and reliable, no matter where you live.
