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States with the most expensive nursing homes

  • States with the most expensive nursing homes

    The most expensive states in which to live in the United States are likely easy to guess: California and New York easily come to mind as costly places to pay rent, buy a home, and head out to dinner. But with the decision to move into a nursing home at the end of one’s life, the states where it is most and least expensive to do so are not as apparent.

    And the same is true in the opposite direction. States where the cost of living is low—West Virginia, for example—often have high costs of care in nursing homes and assisted living facilities. The patchwork of reasons for the gap between the cost of living in a state and the cost of nursing home care are varied and complex. In some cases, such as Alaska—the most expensive state in the country to live in a nursing home—geography plays a role, with the relative remoteness of the state making it difficult to recruit trained professionals.

    In other cases, policies surrounding Medicare and other federal reimbursements determine how much money the state or private providers will have to bear, and which costs they may pass on to patients.

    To determine the states with the most expensive nursing homes, Stacker consulted Genworth’s 2019 Cost of Care Survey. All 50 states are ranked based on the median annual cost of a semi-private room in a nursing home in 2019, with ties broken by the median annual cost of a private room. Additional data comes from SmartAsset, a financial technology company which ranked every state on its nursing homes using annual costs, nursing home availability, and other metrics, and the U.S. Census (2018 one-year median income estimates).

    One conclusion emerged from this review: States with high costs of care are hardly immune from poor quality of care. Some of the most egregious misdeeds at nursing homes occur in states where residents pay the most. Here, click through for a look at the states with the most expensive nursing homes.

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  • #50. Oklahoma

    - Median annual cost of a semi-private room: $58,400 (35.2% below national average; 1.99% five-year cost increase)
    - Median annual cost of a private room: $67,525 (33.9% below national average; 3.27% five-year cost increase)
    - State median household income: $51,924
    - SmartAsset rank: #15 best state for nursing homes
    --- 4.96 nursing homes per 10,000 seniors
    --- 3.62 average nurse staffing hours per resident per day

    Although Oklahoma has one of its lowest unemployment rates of the past decade, all is not rosy for senior health care in the state. Oklahoma has the second-highest uninsured rate in the country, which can push people into nursing homes before they might ordinarily need to go, for lack of preventive care.

  • #49. Texas

    - Median annual cost of a semi-private room: $58,400 (35.2% below national average; 2.85% five-year cost increase)
    - Median annual cost of a private room: $77,015 (24.6% below national average; 3.23% five-year cost increase)
    - State median household income: $60,629
    - SmartAsset rank: #36 best state for nursing homes
    --- 3.53 nursing homes per 10,000 seniors
    --- 3.42 average nurse staffing hours per resident per day

    Texas has a strong advocacy program for residents of nursing homes. An ombudsman for residents’ rights in the state focuses on improved communication and care for facilities statewide. Advocates in the state are also working diligently to recruit volunteers for homes.

  • #48. Missouri

    - Median annual cost of a semi-private room: $60,736 (32.6% below national average; 2.79% five-year cost increase)
    - Median annual cost of a private room: $68,255 (33.2% below national average; 2.66% five-year cost increase)
    - State median household income: $54,478
    - SmartAsset rank: #8 best state for nursing homes
    --- 5.19 nursing homes per 10,000 seniors
    --- 3.51 average nurse staffing hours per resident per day

    Missouri nursing home workers may soon get a raise to keep a thin workforce. The state faces a shortage of caregivers at nursing homes because of high turnover.

  • #47. Louisiana

    - Median annual cost of a semi-private room: $65,218 (27.7% below national average; 3.29% five-year cost increase)
    - Median annual cost of a private room: $68,109 (33.4% below national average; 3% five-year cost increase)
    - State median household income: $47,905
    - SmartAsset rank: #7 best state for nursing homes
    --- 3.96 nursing homes per 10,000 seniors
    --- 3.68 average nurse staffing hours per resident per day

    Louisiana may have relatively inexpensive nursing home care, but that’s not what it always told the federal government. The state got in trouble for inflating nursing home costs and trying to pass them off as legitimate charges for reimbursement by the federal government.

  • #46. Arkansas

    - Median annual cost of a semi-private room: $66,065 (26.7% below national average; 3.15% five-year cost increase)
    - Median annual cost of a private room: $73,000 (28.6% below national average; 3.18% five-year cost increase)
    - State median household income: $47,062
    - SmartAsset rank: #1 best state for nursing homes
    --- 4.63 nursing homes per 10,000 seniors
    --- 4.09 average nurse staffing hours per resident per day

    Nursing care costs in Arkansas also may be relatively low, but that doesn’t always mean the quality of care is high. One facility was forced to close after a state board found quality-of-care issues.

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  • #45. Kansas

    - Median annual cost of a semi-private room: $67,525 (25.1% below national average; 2.95% five-year cost increase)
    - Median annual cost of a private room: $74,095 (27.5% below national average; 3.01% five-year cost increase)
    - State median household income: $58,218
    - SmartAsset rank: #18 best state for nursing homes
    --- 7.53 nursing homes per 10,000 seniors
    --- 4.04 average nurse staffing hours per resident per day

    Low-cost though it may be, some troubling stories have emerged from Kansas nursing home facilities in recent months. “Careless use of smoking materials” was responsible for a fire in early December at one facility in which a resident died.

  • #44. Illinois

    - Median annual cost of a semi-private room: $71,175 (21.1% below national average; 2.78% five-year cost increase)
    - Median annual cost of a private room: $82,125 (19.6% below national average; 1.93% five-year cost increase)
    - State median household income: $65,030
    - SmartAsset rank: #30 best state for nursing homes
    --- 3.73 nursing homes per 10,000 seniors
    --- 3.4 average nurse staffing hours per resident per day

    The nursing home industry in Illinois lags in meeting quality standards. Seventy-one nursing homes in the state were recently cited for poor care, partly because overburdened workers don’t have the resources to care for their patients.

  • #43. Iowa

    - Median annual cost of a semi-private room: $76,103 (15.6% below national average; 4.29% five-year cost increase)
    - Median annual cost of a private room: $82,537 (19.2% below national average; 4.1% five-year cost increase)
    - State median household income: $59,955
    - SmartAsset rank: #13 best state for nursing homes
    --- 8.37 nursing homes per 10,000 seniors
    --- 3.68 average nurse staffing hours per resident per day

    Elder advocates in Iowa are concerned that the state might not be fulfilling its obligations under federal law, including the Older Americans Act. The advocates claim that many nursing homes in the state cannot provide proper oversight to ensure that cases of abuse and neglect do not go undetected.

  • #42. Alabama

    - Median annual cost of a semi-private room: $76,650 (15% below national average; 2.24% five-year cost increase)
    - Median annual cost of a private room: $81,395 (20.4% below national average; 2.61% five-year cost increase)
    - State median household income: $49,861
    - SmartAsset rank: #10 best state for nursing homes
    --- 2.84 nursing homes per 10,000 seniors
    --- 3.9 average nurse staffing hours per resident per day

    Alabama recently pioneered a new model of care for senior citizens. Thanks to the state lobbying the federal government, a collaboration between state care and federal Medicaid will give over 20,000 residents expanded choices for later-life care, including the option to receive care at home that they would ordinarily receive in a nursing home.

  • #41. Utah

    - Median annual cost of a semi-private room: $76,833 (14.8% below national average; 4.06% five-year cost increase)
    - Median annual cost of a private room: $91,250 (10.7% below national average; 4.56% five-year cost increase)
    - State median household income: $71,414
    - SmartAsset rank: #9 best state for nursing homes
    --- 3.01 nursing homes per 10,000 seniors
    --- 4.09 average nurse staffing hours per resident per day

    Elder advocates in Utah are concerned that the federal government’s new push to deregulate nursing homes will cause a lower quality of care. The Trump administration has proposed “relaxing” the rules covering nursing homes, which advocates suggest will effectively lower standards for many residents in nursing care.

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