How This Works
State averages come from the Genworth/CareScout Cost of Care Survey, the most comprehensive annual study of elder care costs by state and care type. Data reflects 2024–2025 rates. Monthly figures represent median costs — half of facilities in the state charge more, half charge less.
The same care type varies by up to 80% between states. Alaska assisted living at $6,300/month is not 70% better than Mississippi at $3,500 — they're the same service at different labor and real estate costs. If you're deciding where a family member will receive care, state cost differences are one legitimate factor to consider.
Within-State Variation Is As Large As Between States
State medians mask large urban/rural gaps. Assisted living in San Francisco runs $6,500–$9,000/month; rural Central Valley runs $3,500–$4,500. Both are California. If you're paying above your state median in a rural area, that's worth investigating. In a major metro, above-median is expected.
What Pushes Costs Above the Median
Memory care adds $800–$2,000/month to any care setting. Private rooms cost $400–$1,200 more than shared. Amenity tiers (resort-style facilities vs. standard) add another 30–50%. For nursing homes, the difference between a 3-star and 5-star CMS rating often reflects staffing ratios — and it costs more to maintain higher ratios.
Medicaid and the Income/Asset Limit
Medicaid covers nursing home care for those who qualify — and in most states, it pays the facility the same daily rate whether you're private-pay or Medicaid. The catch: asset limits (typically $2,000 for a single person) and income limits apply. Spousal protection rules let the community spouse retain more assets. If nursing home care is likely, consult an elder law attorney before spending down assets — the rules are state-specific and complex.