Iowa Leads in Affordable Nursing Homes

Survey ranks states and geographic regions based on choice and affordability.

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Iowa. Land of tall corn, early political caucuses and, it turns out, more affordable nursing homes than any other state. Genworth Financial, a big player in the long-term care insurance market, released its annual survey of nursing home, assisted living, and home-care costs today. It found that nursing home and assisted living costs continue to rise at more than double the rate of inflation, while home-care hourly rates are increasing much more slowly. In addition, this year the company developed a "choice and affordability index," that ranks states based on nursing home affordability and the number of homes compared with the size of the 65-and-over population. Based on those two measures, Iowa comes in No. 1.

Here are the top 10 states, in rank order:

1. Iowa


2. South Dakota
3. Kansas
4. Nebraska
5. North Dakota
6. Oklahoma
7. Missouri
8. Arkansas
9. Wyoming
10.Louisiana Notice how they're clustered in the middle of the country? That's partly because prices tend to be lower, of course, but also because Middle America is more rural than the coasts and home-care services are thus harder to secure, even though most people would prefer to remain at home if they could, says Beth Ludden, senior vice president of long-term care product development for Genworth. That reality probably partially explains the five states that landed at the bottom of the ranking as well. They are:

50. New York


49. Hawaii
48. Oregon
47. California
46. New Jersey It's important to note that the choice and affordability index doesn't take into account whether there are actually available beds in a state. Nor does it factor in quality of care, a critical component. For quality information, check out U.S.News & World Report's recent ranking of America's Best Nursing Homes, which ranks more than 15,000 homes.

In addition to the index, Genworth released its annual cost of care figures for nursing homes, assisted living and home-care services for 2009. Nationally, the annual cost for nursing homes was $74,208, or $203 per day. Since 2005, nursing home costs have risen 4 percent per year, far higher than the 2.3 percent annual inflation rate over the same time period. Assisted living costs, meanwhile, have risen 5 percent annually since 2005, reaching $33,903 per year in the 2009 survey. Home-care services have increased the least in the past five years, growing just 2 percent a year, to $18.50 per hour for a licensed home health aide.

Check out our other recent coverage on how to evaluate the need for and pick a nursing home and how to pay for long-term care.