15. California │ Average Annual Cost: $62,698
Adult day care: $20,150 │ Licensed home care: $59,488
Assisted living: $54,000 │ Nursing home (private room): $117,804
14. Oregon │ Average Annual Cost: $64,527
Adult day care: $23,790 │ Licensed home care: $59,488
Assisted living: $55,110 │ Nursing home (private room): $119,720
8. Minnesota │ Overall Rank: 8 │ Total Score: 59.13
Student Loan Indebtedness Rank: 5 │ Grant & Student Work Opportunities Rank: 49

Minnesota has the fifth highest average student debt and is tied with Pennsylvania for fourth highest proportion of students with debt. It also has the second highest percentage of student-loan borrowers 50 and older.
8. Washington | Cost of living: 38 | Crime: 37 | Culture: 29 | Health care quality: 34 | Taxes: 17 | Weather: 36 | Well-being: 22
11. Maine │ Average Annual Cost: $67,167
Adult day care: $28,600 │Licensed home care: $59,488
Assisted living: $59,400 │ Nursing home (private room): $121,180

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10. Delaware │ Average Annual Cost: $67,449
Adult day care: $21,570 │ Licensed home care: $52,624
Assisted living: $64,200 │ Nursing home (private room): $131,400
9. Vermont │ Average Annual Cost: $67,486
Adult day care: $35,360 │ Licensed home care: $61,776
Assisted living: $54,000 │ Nursing home (private room): $118,808
8. North Dakota │ Average Annual Cost: $67,716
Adult day care: $29,029 │ Licensed home care: $61,776
Assisted living: $39,780 │ Nursing home (private room): $140,277
4. New Hampshire │ Overall Rank: 4 │ Total Score: 65.15
Student Loan Indebtedness Rank: 2 │ Grant & Student Work Opportunities Rank: 43

New Hampshire has the highest average student debt in the country and the third highest proportion of students with debt, as well as the third highest percentage of student-loan borrowers 50 and older.
8. New York │ State income tax: 4.0% (on taxable income less than $8,500/single, $17,150/joint)/8.82% (on taxable income more than $1,070,550/single, $2,155,350/joint). Average local income tax: 1.94% │ Average local sales tax: 8.49% │ Gas taxes and fees: $0.46/gallon (varies by county) │ Property taxes: median $4,738 on median home value of $286,300 │ Estates exceeding $5,250,000 subject to estate tax, with a top rate of 16%. In 2019, it will be indexed to the federal exemption. │ Sin taxes: Yes

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5. Connecticut │ Average Annual Cost: $73,331
Adult day care: $22,100 │ Licensed home care: $52,624
Assisted living: $56,400 │ Nursing home (private room): $164,798
4. New Jersey │ Average Annual Cost: $73,361
Adult day care: $23,400 │ Licensed home care: $54,912
Assisted living: $72,780 │ Nursing home (private room): $142,350
3. Massachusetts │ Average Annual Cost: $74,644
Adult day care: $17,332 │ Licensed home care: $62,005
Assisted living: $65,940 │ Nursing home (private room): $153,300
2. Hawaii │ Overall Rank: 50 │ Total Score: 15.60
Student Loan Indebtedness Rank: 50 │ Grant & Student Work Opportunities Rank: 46

Hawaii has the lowest student debt as a percentage of income and the lowest percentage of student-loan debtors 50 and older.
1. Alaska │ Average Annual Cost: $123,906
Adult day care: $27,373 │ Licensed home care: $61,776
Assisted living: $75,600 │ Nursing home (private room): $330,873 (Photo: AP)

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(Related: 15 Most Expensive States for Long-Term Care: 2017)

It would be tough to keep up with the price hikes for long-term care for anyone, much less those on already tight budgets.

According to Genworth’s 15th annual Cost of Care Survey, over the last 15 years, the costs of all types of care — nursing home, adult day care, assisted living — have risen 19% to 67%. And who among us has gotten a pay raise of 67% to keep pace?

Genworth says that the “blended annual median cost of long-term care support services has increased an average of 3% from 2017 to 2018, with some care categories exceeding two to three times the 2.1% U.S. inflation rate.”

LTC Price Hikes Not Over

There’s likely more news of that variety to come, since a shortage of skilled workers is yet another force pushing prices up.

Other factors affecting the cost include more overtime (thanks in part to that scarcity of staff); higher minimum wages and changes in overtime rules; recruiting and retention challenges; issues faced by home care agencies including compliance obligations and caregiver certification issues; rising instances of Alzheimer’s and other forms of dementia; and the need for more specialized (and thus more expensive) care, thanks in part to people waiting too long to get care.

Private Nursing Home Room Costs Rise 54%

So it should come as no surprise that care is growing ever more expensive. Still, says Genworth, over the last 15 years of its survey, that 67% figure we mentioned earlier is how much the cost of long-term care in assisted living facilities has risen. Private nursing home rooms have gone up by 54%.

And in case you were wondering, the report says that “a private nursing home room now costs 1.6 times the national median annual household income, which was $62,685 in August 2018.”

The only good news (sort of) is that in-home care costs have stayed relatively flat over the life of the study, with price increases accelerating only recently. Home health aide costs are up 19% since 2004, while homemaker services are up 26% over the same period.

Check out the gallery above for the 15 most expensive states for long-term care.

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