Most families have no idea what nursing home care actually costs until they need it. Then the number is a shock. The national average for a private room is $355 per day, or roughly $10,798 per month. That's before add-on charges for therapy, specialized medications, and incontinence supplies.
But the national average hides enormous variation. Your state matters more than almost any other factor. Here's what the 2026 data actually shows, drawn from the CareScout/Genworth Cost of Care Survey.
National Averages (2026)
The Most Expensive States
Geography drives cost more than quality. High-cost states reflect high labor costs, real estate, and regulatory requirements, not necessarily better care.
Alaska is in its own category. At $31,620/month, a year of nursing home care in Alaska runs over $379,000. This reflects extreme labor costs and the logistical difficulty of staffing remote facilities.
The Most Affordable States
Even the most affordable states are expensive. Louisiana at $7,908/month means $94,896 per year. The difference between Louisiana and Connecticut is $9,412 per month, or over $112,000 per year.
What's Not Included in the Rate
The daily or monthly rate you see published is the base room-and-board rate. It typically covers: the room itself, three meals, basic nursing care, and housekeeping. It does not cover:
- Physical, occupational, or speech therapy
- Most prescription medications
- Incontinence supplies (at many facilities)
- Specialized wound care supplies
- Physician visit fees
- Cable, telephone, or internet
- Personal care items
- Memory care programming surcharges (often $500–$1,500/month on top of base rate)
For many residents, actual monthly costs run 15–30% above the published base rate once ancillary charges are included. Ask for an itemized fee schedule before signing anything.
Who Pays: Medicare, Medicaid, or Private Pay?
Medicare covers short-term skilled nursing stays: 100% for days 1–20 after a qualifying 3-day hospital admission, then a $217/day copayment for days 21–100, then nothing. Most long-term nursing home residents are not covered by Medicare.
Medicaid pays for long-term care, but only after assets have been spent down to state thresholds (typically around $2,000 in countable assets for an individual). Medicaid reimbursement rates average about 70% of private-pay rates. Some facilities limit their Medicaid beds accordingly.
How Long-Term Care Insurance Changes the Math
Long-term care insurance, if purchased before health decline makes you uninsurable, can significantly reduce the financial burden. Policies typically cover a daily benefit ($150–$300/day is common) for a set period (2–5 years). At $300/day of coverage in a state where care costs $355/day, you're covering 85% of the private-room rate.
The window to buy LTC insurance is generally ages 50–65. Premiums rise sharply after that, and many applicants become uninsurable due to health conditions. It's a conversation worth having now if you haven't.
Search by state on CareScope to see facility-level cost data alongside quality ratings. Use our comparison tool to evaluate cost and quality side by side for up to three facilities.