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A year in a nursing home costs more than most people earn in a year. That sentence surprises a lot of families, because nobody sits around pricing nursing homes the way they price cars or colleges. Then a parent has a stroke or a fall, the hospital says discharge is Friday, and suddenly the number matters.
The national median for a semi-private room now sits just under $115,000 a year. A private room runs close to $130,000. Those are medians, not worst cases. In expensive states the same year of care can top $180,000.
This guide lays out what nursing homes cost across the country right now, why the price swings so much from one state to the next, and what those numbers mean for your planning. Every figure below comes from the CareScout Cost of Care Survey, which Genworth has run for over two decades and which is the standard reference insurers and planners use.
The national numbers for 2025
CareScout released its 2025 survey results showing the national median daily rate for a semi-private nursing home room at $315 a day. That works out to $114,975 for a full year, a 2% increase over the prior year. A private room runs $355 a day, or $129,575 a year, up 1%.
The modest growth is actually the story. For a few years care costs were climbing at double-digit rates. The 2024 survey showed semi-private rooms jumping 7% to $111,325 a year and private rooms rising 9% to $127,750. The 2025 increases of 1–2% suggest the post-pandemic spike is cooling, though CareScout notes the increases still reflect ongoing inflation and workforce pressure in high-acuity settings.
Here is the national picture at a glance:
- Semi-private room: $315/day, $114,975/year
- Private room: $355/day, $129,575/year
- Assisted living (for comparison): $6,200/month, $74,400/year
- Home health aide (for comparison): roughly $77,800/year at 44 hours a week (2024 figure)
A semi-private room means you share with another resident. The $40-a-day premium for a private room adds up to about $14,600 over a year, which is real money but small next to the base price.
What nursing homes cost by state
State medians from the 2024 survey show just how far apart the numbers run. A few examples, using the annual median for a semi-private room:
- Vermont: $164,250 a year ($182,500 for a private room) — among the most expensive in the country
- Wyoming: $118,990 a year, slightly above the national median of $111,325
- Virginia: $104,025 a year, a bit below the national median
- Illinois: $94,900 a year, roughly 15% below the national median
The spread between the cheapest and priciest states can exceed $70,000 a year for the same room type. Alaska, Connecticut, Massachusetts, and New York consistently rank near the top. States like Missouri, Kansas, Oklahoma, and parts of the South tend to sit at the bottom.
Why the gap? Three things drive most of it. Labor costs differ enormously — a certified nursing assistant in Boston earns far more than one in Tulsa, and staffing is the biggest line item in any facility’s budget. Real estate and regulatory costs vary too. And Medicaid reimbursement rates, which set the floor for what facilities accept, differ state by state.
How long people actually stay
The sticker price is only half the math. The other half is duration. The average long-term disability-style stay is not the right frame here; for nursing homes, industry data consistently shows the average stay runs a little over two years, with a wide spread. Some residents are there for a few months of rehab after surgery and go home. Others live in a facility for five years or more with dementia.
Multiply a $115,000 annual rate by two to three years and you get $230,000 to $345,000. That is the number to hold in your head when you think about whether to insure, self-fund, or plan around Medicaid. A family with $400,000 in savings can watch a single extended stay erase most of it.
What the price actually includes
Nursing home rates cover room, board, 24-hour supervision, nursing care, and help with daily activities like bathing, dressing, and eating. They do not always cover everything families assume. Medications, physical therapy beyond what the care plan includes, dental work, and personal items are often billed separately.
When you tour a facility, ask what is bundled and what is extra. Two homes with the same daily rate can differ by hundreds a month once the add-ons are counted.
How people pay for it
There are really four ways nursing home bills get paid, and most families end up using a combination:
Out of pocket. About a third of nursing home residents pay privately at first. Savings, home equity, and retirement accounts cover the gap until money runs low.
Long-term care insurance. A traditional policy pays a daily or monthly benefit once you need help with daily activities. The cost of a policy climbs steeply with the age you buy, which is why planners push people to shop in their mid-50s.
Medicare. This one trips people up. Medicare covers up to 100 days of skilled nursing after a hospital stay, and only when the care is rehabilitative. It does not pay for long-term custodial care. Day 101 is on you.
Medicaid. Medicaid is the largest payer of nursing home care in the country. It kicks in once countable assets drop to around $2,000 in most states, which is why families do Medicaid spend-down planning — and why the program looks back five years at asset transfers before approving coverage.
The bottom line
Nursing home care costs roughly $115,000 a year at the national median and can run far higher depending on your state. The price keeps rising faster than general inflation, and a multi-year stay can consume a lifetime of savings. Knowing your state’s numbers is the starting point. The next step is deciding how you would pay — insurance, savings, or a Medicaid plan built years before you need it.
For a fuller picture of what policies cover, see what long-term care insurance covers, including the difference between nursing homes, assisted living, and home care.
