Home › Protecting Your Parents’ Legacy › Nursing Home Costs & Quality by State
The national median nursing home now costs $315 a day for a semi-private room — $114,975 a year ($355/day and $129,575/year for a private room, CareScout 2025 Cost of Care Survey).
- 14,693 Medicare/Medicaid-certified facilities operate nationwide with 1.57 million certified beds (CMS, August 2026)
- Quality varies sharply by state: average overall star ratings run from 2.5 in Louisiana to 3.68 in Hawaii on CMS’s 5-star scale
- Medicare covers at most 100 days of skilled nursing after a hospital stay ($217/day copay after day 20 in 2026) — long-term custodial care is paid privately or by Medicaid
Nursing Home Capacity & Quality by State (CMS Data, 2026)
| State | Certified Facilities | Certified Beds | Avg. Overall Rating (1–5) | Avg. Nurse Staffing (hrs/resident/day) |
|---|---|---|---|---|
| Alabama | 224 | 26,504 | 3.0 | 3.88 |
| Alaska | 20 | 815 | 3.45 | 6.69 |
| Arizona | 140 | 15,984 | 3.38 | 3.97 |
| Arkansas | 221 | 24,167 | 3.47 | 4.03 |
| California | 1,165 | 114,990 | 3.17 | 4.52 |
| Colorado | 210 | 19,757 | 3.12 | 3.72 |
| Connecticut | 191 | 22,696 | 3.0 | 3.73 |
| Delaware | 44 | 4,717 | 3.23 | 4.35 |
| District of Columbia | 17 | 2,485 | 3.41 | 4.87 |
| Florida | 694 | 84,517 | 3.26 | 3.82 |
| Georgia | 356 | 39,494 | 2.68 | 3.57 |
| Hawaii | 43 | 4,248 | 3.68 | 4.99 |
| Idaho | 80 | 6,099 | 3.14 | 4.04 |
| Illinois | 667 | 85,157 | 2.56 | 3.44 |
| Indiana | 507 | 48,888 | 3.14 | 3.68 |
| Iowa | 388 | 25,198 | 3.09 | 3.81 |
| Kansas | 296 | 18,094 | 3.09 | 4.05 |
| Kentucky | 267 | 25,352 | 3.01 | 3.93 |
| Louisiana | 266 | 32,316 | 2.5 | 3.72 |
| Maine | 78 | 5,830 | 3.08 | 4.34 |
| Maryland | 221 | 27,307 | 3.12 | 3.88 |
| Massachusetts | 341 | 40,961 | 3.04 | 3.87 |
| Michigan | 422 | 44,005 | 3.1 | 3.99 |
| Minnesota | 338 | 24,064 | 3.18 | 4.19 |
| Mississippi | 202 | 17,496 | 2.75 | 4.18 |
| Missouri | 487 | 50,043 | 2.51 | 3.43 |
| Montana | 60 | 4,997 | 2.86 | 4.05 |
| Nebraska | 180 | 13,711 | 2.78 | 3.98 |
| Nevada | 66 | 7,235 | 3.26 | 4.3 |
| New Hampshire | 73 | 7,326 | 2.99 | 3.91 |
| New Jersey | 348 | 51,022 | 3.3 | 3.85 |
| New Mexico | 68 | 6,919 | 2.85 | 3.53 |
| New York | 594 | 111,493 | 3.04 | 3.62 |
| North Carolina | 419 | 43,850 | 2.93 | 3.82 |
| North Dakota | 72 | 4,909 | 3.17 | 4.42 |
| Ohio | 922 | 81,107 | 3.15 | 3.68 |
| Oklahoma | 283 | 27,475 | 2.67 | 3.78 |
| Oregon | 128 | 10,600 | 3.12 | 5.04 |
| Pennsylvania | 656 | 83,064 | 2.98 | 3.89 |
| Rhode Island | 72 | 8,190 | 2.92 | 3.71 |
| South Carolina | 187 | 19,594 | 3.01 | 3.83 |
| South Dakota | 96 | 5,848 | 2.86 | 3.81 |
| Tennessee | 303 | 34,613 | 2.96 | 3.8 |
| Texas | 1,177 | 133,403 | 2.65 | 3.39 |
| Utah | 97 | 8,379 | 3.3 | 4.07 |
| Vermont | 33 | 2,951 | 2.88 | 4.22 |
| Virginia | 289 | 32,648 | 2.96 | 3.77 |
| Washington | 193 | 18,781 | 3.23 | 4.37 |
| West Virginia | 123 | 10,717 | 2.98 | 3.66 |
| Wisconsin | 323 | 24,758 | 2.99 | 4.22 |
| Wyoming | 36 | 2,938 | 2.97 | 3.87 |
Original aggregation of CMS Care Compare provider data (14,693 facilities), August 2026. Ratings are CMS overall five-star ratings; staffing is reported total nurse hours per resident per day. Each state links to our estate planning guide for that state.
What It Costs
CMS publishes quality data but not prices. The benchmark cost figures come from the CareScout (Genworth) 2025 Cost of Care Survey, published March 2026: national median $315/day semi-private ($114,975/year) and $355/day private ($129,575/year), with year-over-year growth of 1–2%. High-cost states (Alaska, Connecticut, New York, Massachusetts) run well above these medians; parts of the South and Midwest run below.
Why This Belongs in an Estate Plan
At $115,000 a year, three years of nursing home care consumes what many families assume is an untouchable inheritance — and a revocable trust does not protect assets from care costs. Planning tools that do exist (Medicaid-compliant strategies, long-term care insurance, the 5-year look-back) are covered in our long-term care guide. State quality data above can also inform the harder question of where care happens.
Long-term care planning sits on top of the basic documents every family needs first: a will, a durable power of attorney, and healthcare directives. If the will is still missing, start with what a will costs and what your state requires.
Cite or Link This Page
Cite with attribution:
Nursing Home Costs & Quality by State (2026), Family Estate Guide, https://familyestateguide.com/nursing-home-costs-by-state/
Licensed under CC BY 4.0 — reuse, republish, or adapt this material, including commercially, with credit to Family Estate Guide and a link to this page. The license covers our compilation and analysis; underlying source data remains subject to its original terms.
Update Log
- August 2026 — Published. CMS provider data pulled August 2026; cost figures from the CareScout 2025 Cost of Care Survey (March 2026 release).
- August 2026 — Released under CC BY 4.0; reuse permitted with attribution.
Last updated: August 2026. CMS aggregation refreshed with the quality data; cost benchmarks updated with each annual survey. Educational information, not medical, legal, or financial advice.