The Most—And Least—Expensive Nursing Homes By State, Mapped

Health care costs can add up quickly when you're older, especially if you're on a fixed income, and it's hard to know exactly where to spend your cash. There are plenty of options such as in-home care, assisted living, or a nursing home, and the wide selection of costs and care can be daunting when you're trying to decide the best options.

Where you live can also be a big factor with some states costing much more than others. That could be an issue if you're not willing to relocate, or you may find it difficult to figure out where you want to move to cut down on costs if you decide to go somewhere else.

But where should you go? Or where is it affordable enough for you to stay? The Genworth Cost of Care Survey 2025 (per Visual Capitalist) took on the task of looking into the cost of nursing home care, ranking states by how expensive it would be to have a semi-private room in a nursing home for a year. You may be surprised by which states ended up being the most expensive and which were the most affordable.

Pacific States Are Priciest

The overall cost of living by state is shaped by things like everyday costs as well as big-ticket items such as housing. That's the case for the top five most expensive states for nursing home costs. All of them are in the top 15 most expensive states, according to data from the Council of Community & Economic Research (C2ER).

Alaska tops the list for a semi-private room in a nursing home with a whopping annual cost of $333,975, or $27,831 per month. Second-place Oregon is still expensive but more than $100,000 cheaper at $201,115 per year. On the East Coast, third-place New York checks in at $185,332.

For remote states like Alaska and Hawaii, geographic isolation already contributes to a high cost of living. Hawaii is the most expensive state to live in, according to C2ER, while Alaska is the fifth-most expensive state to live in.

Worker shortages also contribute to rising costs across the country, especially in rural areas. A survey in Oregon, for example, found that 94% of facilities there said they had major staffing shortages.

See the top 5 list of most expensive states by annual costs:

1. Alaska - $333,975
2. Oregon - $201,115
3. New York - $186,332
4. Hawaii - $185,679
5. Connecticut - $182,500

Southern States Save Money

Costs in Southern states are much more affordable for residents who need a semi-private nursing home—and all of them are able to do it for only a five-figure cost. (Illinois in sixth-place with $99,645 annually was the only other state to come in under the $100,000 mark.)

Texas led the way with an annual cost of $67,525 annually for a nursing home, or $5,627 per month. That's more than $265,000 less than the same housing in the most-expensive state of Alaska.

See the list of top 5 least expensive states by annual costs:

1. Texas - $67,525
2. Missouri - $80,893
3. Oklahoma - $84,315
4. Arkansas - $89,425
5. Louisiana - $91,250

Why Are Nursing Homes So Expensive?

There are several factors that contribute to the high cost of nursing homes, making it hard for many Americans to afford them.

One of the biggest issues may be the rise of aging Baby Boomers, who need additional care now that they're getting older. But that boom in the population is putting a strain on nursing homes, where there is more demand for care than they can provide.

Staffing issues can also be a big factor when it comes to paying short-staffed nursing home employees to care for an aging population. The demand for home health and personal care aides, for example, is expected to rise 17% between 2024 and 2034, making it one of the fastest-growing job sectors in the country, according to the U.S. Bureau of Labor Statistics.

That makes it one of the top 20 fastest growing positions in the country along with other health care positions like nurse practitioners, physicians assistants, and nursing instructors, who will also be needed to care for a growing population in nursing homes.