Nursing Home, Assisted Living and Other Extended Care Costs Continue to Rise in the U.S.


Nursing Home, Assisted Living and Other Extended Care Costs Continue to Rise in the U.S.

Annual Market Survey from the MetLife Mature Market Institute Contains Costs in Each State

NEW YORK--(BUSINESS WIRE)-- According to the newly released2012 MetLife Market Survey of Nursing Home, Assisted Living, Adult Day Services and Home Care Costs, conducted for the tenth year by the MetLife Mature Market Institute, national average rates for long-term care in the U.S. continue to rise.Theaverage cost of a semi-private room in a nursing homerose 3.7% in 2012, from $214 daily or $78,110 annually in 2011, to $222 or $81,030 annually.Assisted living base rates increased by 2.1%, from $3,477 monthly or $41,724 annually to $3,550 or $42,600 annually. The average rate for a homemaker increased by 5.3%, from $19 to $20 per hour. Only rates for home health aides and adult day services were unchanged year to year, remaining at $21 per hour and $70 per day respectively.

The five-year trend in costs reveals that the annual cost for a private room in a nursing home has increased an average of 4.0% per year while a semi-private room has increased almost as much at 3.8%. Assisted living costs have increased the most, at an average of 4.1% annually over the past five years. Homemaker costs have increased at an average annual rate of 2.7% in the same time period, closely followed by Adult Day Services at 2.3%. The five-year average annual cost increase for Home Health Aide services was the lowest at 1.3% annually.

Most Expensive and Least Expensive Regions

The "rest of state" area of Oklahoma (excluding Oklahoma City and Tulsa) had the lowest private room nursing home rates in 2012, averaging $147 per day. For a semi-private room, the "rest of state" area of Texas (excluding Austin, Dallas/Fort Worth and Houston) had the lowest average rates at $131 per day. As in the past, the highest rates were in Alaska, $687 (private) and $682 (semi-private). For assisted living communities, the "rest of state" area of Arkansas (excluding Little Rock) had the lowest average monthly base rate at $2,355; Washington, D.C. had the highest at $5,933.

The lowest costs for home care were in Shreveport, Louisiana at $13 per hour for both home health aides and homemaker/companions. The highest rates for home care were in Rochester, Minnesota at $32 per hour for a home health aide and $28 for a homemaker. Montgomery, Alabama had the lowest adult day care rate at $26 per day; Vermont had the highest at $141. Rates for these centers varied greatly, both locally and statewide, partly due to varying state licensing requirements and other regulations.

"This year's cost increases come on top of significant escalations from 2010 to 2011 and previous years.These costs, added to the health care inflation rate, which currently hovers around 4%, can derail a family's financial security," said Sandra Timmermann, Ed.D., director of the MetLife Mature Market Institute."We attribute some of the higher pricing to rising energy and overall operating and employment costs.Those planning for long-term care for themselves or their parents will do well to consider such pricing, and to save and invest bearing in mind that these expenses have a history of rising measurably from year to year."

The MetLife Market Survey and accompanying report provide a detailed breakdown of information regarding various types of long-term care available in the U.S. and trends in the industry, along with a detailed breakdown of costs by state.

Nursing Homes:

According to the U.S. Census Bureau, in 2011, 66% of nursing home residents were women, and only 16% of all residents were under the age of 65. The median age of residents was 82.6 years. Over half (56%) of the nursing homes surveyed provide Alzheimer's or dementia care, of which approximately 80% charge the same rate for someone with Alzheimer's or dementia.

Assisted Living:

Current estimates indicate that the average age of an assisted living resident is 86.4 years old. Most assisted living communities create an individual care plan for each resident that details the services required, so costs vary depending on which services are required. Oversight of assisted living communities is primarily in the hands of state governments rather than federal regulation.

Home Health Care:

Most agencies surveyed provide an hourly rate; 76% require a minimum number of hours per day ranging from 30 minutes to a maximum of 10 hours (approximately 3 hours on average). A small percentage of agencies (3%) provide a daily rate. Three in 10 (31%) surveyed have a 24-hour or live-in rate, which averages $251 per day for a home health aide and $247 for a homemaker/companion.

Adult Day Services:

The National Adult Day Services Association (NADSA) estimates that there are over 5,000 adult day centers in the U.S. serving 260,000+ participants and family caregivers. More than three-quarters of those surveyed are open Monday through Friday; 7% are also open on Saturdays and 11% are open seven days a week. Sixty-three percent of centers provide transportation, half of which do not charge; of those that do, the average one-way fee is just under $10.

2012 MetLife Market Survey of Nursing Home, Assisted Living, Adult Day Services and Home Care Costs can be downloaded from


The survey of 2,078 nursing homes, 1,513 assisted living communities, 1,732 home care agencies and 1,363 adult day services centers in all 50 states and the District of Columbia was conducted by telephone between April and August 2012, by LifePlans, Inc. for the MetLife Mature Market Institute. States were divided into three groups, according to their population—under 3 million, 3 to 10 million, and over 10 million. Cities/areas surveyed were chosen on the basis of population and the ability to obtain a representative sampling of facilities and providers.

LifePlans, Inc.

LifePlans, Inc., a risk management and consulting firm, provides data analysis and information to the health and long-term care insurance industries. The firm works with insurers, the federal government, industry groups, and other organizations to conduct research that helps these groups monitor their business, understand industry trends, perform effective advocacy, and modify their strategic direction.

The MetLife Mature Market Institute®

Celebrating its 15-year anniversary in 2012, the MetLife Mature Market Institute is Metropolitan Life Insurance Company's (MetLife) center of expertise in aging, longevity and the generations and is a recognized thought leader by business, the media, opinion leaders and the public. The Institute's groundbreaking research, insights, strategic partnerships and consumer education expand the knowledge and choices for those in, approaching or working with the mature market.

The Institute supports MetLife's long-standing commitment to identifying emerging issues and innovative solutions for the challenges of life. MetLife, Inc. is a leading global provider of insurance, annuities and employee benefit programs, serving 90 million customers. Through its subsidiaries and affiliates, MetLife holds leading market positions in the United States, Japan, Latin America, Asia, Europe and the Middle East. For more information, please visit:

DJC Communications
Debra Caruso, 212-971-9708
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