It’s no secret that nursing home care is the most expensive type of senior living option. You’re paying for intensive medical care, including 24/7 support and specialized services by skilled medical professionals, as well as meals and facility upkeep.
Here, we break down the costs of nursing home care around the country, including where nursing homes are the most and least expensive and what you’re getting for your money.
[READ: How to Pay for Nursing Home Costs.]
Nursing Home Costs
According to Genworth and CareScout’s 2024 Cost of Care Survey, the median cost of a nursing home room is:
— $9,277 per month for a semi-private room
— $10,646 per month for a private room
That’s the national median. Often the “median” number is used in surveys such as this because the numbers are more accurate of what you’ll pay. Averages tend to produce numbers that look skewed because of the math involved in using extreme numbers. For instance, according to Genworth and CareScout’s survey, it’s far more expensive to pay for a nursing room in Alaska (a private room in a nursing home will typically cost $998) than in Texas (typically $233 a day).
Still, if you’re wondering, “What is the average monthly cost of a nursing home?,” according to SeniorLiving.org, the national average is $10,965. Whatever number your monthly total lands on, there are a wide range of factors that go into the price you end up paying:
— Level of care needed. Generally, the more services and support someone needs, the higher the cost. For this reason, skilled nursing care is typically the most expensive of the options.
— Type of facility. Some nursing homes, such as memory care, specialize in supporting individuals with certain conditions, such as Alzheimer’s disease and other forms of dementia. These facilities may be more expensive because staff need extra training and skills to render those services.
— Geographic location. Nursing home costs vary by area. For example, in cities with a higher cost of living, such as Boston and San Francisco, the median cost of a nursing home is significantly higher than in cities with a lower cost of living, such as St. Louis and San Antonio.
Location is perhaps the biggest factor in dictating cost. Kelsey Simasko, an elder law attorney with Simasko Law in Mount Clemens, Michigan, notes that in her state, “the average cost of one month in a nursing home is between $10,000 and $12,000.”
“But prices are going up. “One nursing home around my area just increased their prices to approximately $15,000 a month for a room,” Simasko says. Earlier in the year, it had been $12,000.
Operating costs also influence pricing.
“It takes a small army of skilled professionals to run a nursing home, and that small army needs to be paid,” Simasko says.
She adds that for some nursing homes, corporate status can be a factor.
Ownership can affect cost
“Most nursing homes are owned by for-profit organizations, and the more the facility charges, the more money the owners can make for themselves,” she explains.
“Private equity is decimating the care industry,” Simasko says. “When you look at these private-owned facilities, most of them are owned by private equity groups in another state. These groups care about one thing only — making money for their investors and themselves.”
Simasko says that private equity groups that own nursing homes, in general, don’t care about the quality of care, whether their employees get paid enough or whether there are enough employees to cover residents.
“Private equity-owned facilities will charge astronomical rates, provide mediocre-at-best care, and often bankrupt the facility leaving residents in a lurch to find care,” she says, adding that there are plenty of nursing homes that have troubles that aren’t owned by private equity groups, but she says that private equity has been an especially black mark on the industry.
Indeed, a report released in April 2025 by the nonprofit Private Equity Stakeholder Project suggests that private equity owned nursing homes are offering worse care, not better, and that part of the problem is that there is little oversight or transparency when it comes to nursing homes owned by private equity firms.
Your odds of finding a nursing home that isn’t run by a private equity firm is still fairly high. According to the report, it’s estimated that the percentage of American nursing homes owned by private equity ranges between 5% to 13%. It’s likely closer to 13%, the report stated, but it’s hard to determine due to the issues around nursing home ownership transparency.
[READ: How to Choose a Good Nursing Home: Expert Tips]
State Rankings Annual Cost of Nursing Homes
See the typical nursing home rooms — private and semi-private — ranked from most to least expensive, below.
[READ: Nursing Homes vs. Assisted Living.]
Top Most Expensive Metro Areas for Nursing Homes
Among the priciest nursing homes, ranked by the monthly median cost of a private room, are in the metro areas listed below.
While these figures are certainly eye-opening, there’s a lot more detail to be had if you look closer at specific metro areas. For example, when looking at the state as a whole, Texas has the lowest annual cost for both private and semi-private nursing home rooms. But within that least expensive state lies Brownsville, Texas, which is one of the most expensive metro area surveyed by Genworth and CareScout.
Least Expensive Metro Areas
Among the least expensive nursing homes ranked by private room monthly cost are the cities below.
What’s Included in the Cost?
Each nursing home structures its services and billing in its own way, and the charges might not be detailed as line items on your bill. But there are some basic items that are typically included in the cost of a nursing home:
— Room with functional furniture. A bed, bedside table and dresser are standard furniture pieces, along with some closet space for the resident’s belongings.
— Dietary services. Menu planning and meal preparation to meet the resident’s individual dietary needs and restrictions, with three daily meals, beverages and snacks, all fall under room and board.
— Personal care services and supervision. Certified nursing assistants provide care with activities of daily living, including helping residents with hygiene, dressing, toileting and transferring or walking as needed.
— Nursing services. Licensed practical or licensed vocational nurses provide higher-level care, such as monitoring vital signs and administering medications and wound care. Registered nurses develop residents’ treatment plans for identified health issues and optimize their activities of daily living. They are responsible for advanced care, such as starting intravenous infusions, monitoring blood glucose levels, giving oxygen, collaborating with physicians and supervising other nursing staff.
— Activities. Recreational, spiritual and other types of group programs are standard nursing home activities.
— Bedding and linens. Sheets, pillowcases, towels, washcloths and sleep gowns are all provided.
— Housekeeping. The residence provides room and facility cleaning and sanitation services.
— Personal hygiene items. Nursing homes stock routine items, such as hand soap, bath soap, shampoo, toothbrushes and toothpaste.
— In-house laundry. Residents’ personal clothing items are laundered as needed.
— Prescription drug administration. Medication management and administration are essential nursing home services.
Behind-the-scenes costs, such as trash and lawn services, are also built into the budget. Transportation services, often using facility-run vans or minivans, may be incorporated into the basic rate as well. However, it may be limited to certain purposes or destinations, like doctor visits.
Additionally, what’s considered a standard feature can vary among individual facilities or nursing home companies. For example, in many homes, common conveniences, such as tissues and toilet paper, are included in the daily rate. In others, incontinence briefs may be included.
In all cases, the nursing home may mark up the cost of certain items. This is more common in for-profit nursing homes than in not-for-profit homes, but any of them may tack on a convenience fee for providing such items.
Additional or special services
While most of the basics are included in your nursing home costs, there may be additional services or items that must be paid for separately, such as:
— Dental care, including visits to the dentist for cleanings or fillings
— Podiatry services
— Medical supplies, such as feeding tubes or catheters
— Over-the-counter and prescription medications
— In-room cable TV, internet services or private phone lines
— Barber or beauty salon services
— Physical, occupational and speech therapy
— Private-duty nursing, in which a hired nurse provides one-on-one care for special needs, such as complex wound care
— Dry cleaning
[SEE: How to Decorate a Nursing Home Room to Feel Like Home]
Understanding Your Financial Responsibilities
If your loved one needs the type of care provided by a skilled nursing facility, you’ll receive a breakdown of costs as you make initial arrangements and go over the contract for long-term care.
“Typically, when you sign up to go into a facility, the director or financial person will sit down with you and go through everything that’s included and not included and what the costs are for the stuff that’s not included,” says Shanna Reed, a financial planner and co-founder of the investment firm Heritage Financial Strategies in Gilbert, Arizona. “Then you’ll get an invoice.”
You can’t assume that rates will remain the same indefinitely, particularly for an extended nursing home stay. A resident’s care needs often grow over time. Costs likewise increase to ensure the health, safety and well-being of the individual and to cover additional staff and fees for therapy, prescriptions and medical supplies.
“Typically on an annual basis, they’ll reevaluate if you need more services or not,” Reed says. “Sometimes that happens as we age. Sometimes that happens as maybe somebody has a fall or an illness and they may need more care.”
Will Medicare Pay for a Nursing Home?
Medicare does not pay for typical nursing home care. Medicare typically provides coverage for short-term skilled nursing care but does not cover nursing homes beyond 100 days, and even then, certain criteria must be met. But generally, you’re going to be on your own or relying on long-term care insurance or a life insurance policy (some policies allow you to use money to pay for a nursing home) or your own funds.
Medicaid, however, the state-administered health insurance program for low-income individuals, can cover the cost of a nursing home for people who meet income-based eligibility criteria. In fact, Medicaid is the primary payer for 63% of seniors residing in nursing homes, according to 2024 figures from KFF.
Ask the administrator for a full breakdown of services and costs and find out whether they offer a payment plan or if they would be willing to negotiate any costs with you.
In some cases, community programs can help cover some costs. Also, attorneys who work with seniors on estate planning can help you figure out how best to spend down your assets to qualify for Medicaid.
How Much Does a Nursing Home Cost Compared to Assisted Living?
As you might expect, a nursing home is far more expensive than living in an assisted living facility. If you live in an assisted living facility, you may be living in your own apartment in a building or on a campus and even driving around town and traveling but partaking in helpful services such as having your home cleaned or laundry done. Or you may need far more help, such as getting assistance with bathing and grooming. But generally, day to day, you’re probably able to function pretty well. You may need daily assistance, but you likely don’t need to be monitored and cared for the way you do in a nursing home.
According to the median numbers offered in the aforementioned Genworth and CareScout’s 2024 Cost of Care Survey, a month in an assisted living center will probably run you $5,900 a month — and a month in a private room in a nursing room will likely cost you $10,646.
Still, wherever you or a loved one decide to live, you’ll want to ask a lot of questions and really do research on a nursing home — or assisted living facility — before deciding to move in. You shouldn’t assume that a high price is going to mean you’ll be living in the lap of luxury.
“The big thing to keep in mind is that cost of care does not equal quality of care,” Simasko says.
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How Much Do Nursing Homes Cost? originally appeared on usnews.com
Update 11/24/25: This story was published at an earlier date and has been updated with new information.
