How much does a nursing home cost in each state?

Start with the national median

The national figures are a useful anchor before the state list. The 2025 CareScout survey puts the national median for a semi-private room at $9,581 a month ($114,972 a year) and a private room at $10,798 a month. Nursing homes bill every day of the year, so a monthly figure is the annual one divided by 12 rather than a flat 30 days.

Those are medians, not averages. The difference matters here more than in most markets: a state's top facilities charge several times the middle, and a single $20,000-a-month facility pulls an average up in a way it cannot pull a median. 29 of the 50 states sit above the $9,581 national median and 20 sit below it — the national nursing home cost page works through how the room type and the billing period move the bill.

Every state, ranked

These are the survey's own medians, ranked from the most expensive semi-private room to the least. Both columns come straight from the same state tables — the private-room figure is published, not calculated from the semi-private one. Where a state name is a link, that state has its own page on this site with the daily, monthly and annual rates side by side.

One N/A appears above: the survey reports no usable private-room sample for the highest state on the list, so that cell stays blank rather than borrowing a neighbour's number.

The most and least expensive states

The spread is wide enough that the state a person lives in changes the bill more than any choice of facility within it. Alaska is the most expensive at $27,831 a month semi-private — nearly five times Texas at $5,627. The top of the list is the coasts and the Northeast, where wages and operating costs are highest; the bottom is the South and the middle of the country.

For a private room the ranking shifts slightly: Oregon is the most expensive at $18,448 a month, and Texas the cheapest at $7,604. Read across the two columns and a pattern holds: the private-room premium is larger in the expensive states, so the choice between a shared and a single room costs more in the places where the room itself already costs more.

If a family is weighing a move to bring a parent nearer, this table is the starting point, not the answer. The state median is the middle of that state's market; the facility they actually choose will sit above or below it. The assisted living versus nursing home comparison covers what the higher nursing-home figure buys in care, and the in-home care hourly rate by state covers the alternative for families who can keep the person at home with help.

What Medicare and Medicaid pay

The state median is what a facility charges. What a family actually pays depends on who is funding the stay, and the federal rules do most of that work — they do not change from state to state.

Medicare covers a nursing home stay only as skilled care after a hospital admission. You need a qualifying inpatient hospital stay of at least 3 days in a row — time in observation or the emergency room does not count toward it — and Part A then pays for up to 100 days in each benefit period. In 2026 you pay the $1,736 Part A deductible, then $0 a day for days 1 through 20 and $217 a day for days 21 through 100; from day 101 you pay the full cost. The Medicare nursing home guide walks through the qualifying-stay and benefit-period rules in full.

Medicare does not pay for long-term custodial care, which is the help with daily living that most nursing home residents need over months and years. Medicaid covers that care for people who qualify financially, and it is the largest payer of long-term nursing home care. But eligibility — the income limit, the asset limit, the transfer look-back, and any waiver that applies — is set by each state, so the answer for a given family depends on where the person lives. This page does not estimate anyone's eligibility. The Medicaid nursing home guide and the Medicare-versus-Medicaid comparison set out the federal framework; your state Medicaid agency is the authoritative source for the rules that apply to you.

How to read a state median

A state median answers "what does a typical facility in this state charge," and it is worth knowing what it does not answer.

• It is not a quote. Facilities within one state still differ by thousands of dollars a month, by ownership, staffing levels and whether they accept Medicaid. Get two or three written fee schedules from facilities you would actually consider.
• It is a median, not an average, and not a price for one person. Two residents in the same state can pay very different amounts depending on the room and the level of care.
• It does not include the add-ons. Therapy after a Medicare benefit ends, medications, supplies, personal items and a higher care tier are usually billed on top of the room rate. Our guide to the charges beyond the room rate lists the ones that show up most often.
• It moves. The same survey reports that the national semi-private rate rose year over year, so a rate quoted to you later in the year may sit above the median printed here.

The care cost calculator turns a monthly rate into the annual figure to hold against savings and income, and the guide to choosing a nursing home covers the questions to ask before signing.

Where these numbers come from

Every state figure on this page is a median published in the CareScout Cost of Care Survey 2025, ranked median costs by state (fieldwork July through November 2025). The national semi-private and private medians are the same survey's national figures. The monthly and annual comparisons are arithmetic on those published rates and are labelled as derived rather than quoted. No state rate here is estimated, rounded to a rounder number, or carried over from another state. The Medicare rules — the 3-day qualifying stay, the 100-day benefit period, and the 2026 cost-sharing — were read from Medicare.gov. Nothing on this page is a quote from a facility or financial advice for any individual.