15. Oregon | Average annual cost: $74,089 | Homemaker services: $61,776 | Home health aide: $64,064 | Day health care: $26,000 | Assisted living: $53,985 | Nursing home (semi-private): $114,610 | Nursing home (private): $124,100 (Photo: Shutterstock)
14. Rhode Island | Average annual cost: $75,747 | Homemaker services: $61,776 | Home health aide: $61,766 | Day health care: $21,255 | Assisted living: $62,385 | Nursing home (semi-private): $119,538 | Nursing home (private): $127,750 (Photo: Shutterstock)
13. Minnesota | Average annual cost: $76,156 | Homemaker services: $66,352 | Home health aide: $69,784 | Day health care: $21,840 | Assisted living: $45,600 | Nursing home (semi-private): $120,914 | Nursing home (private): $132,448 (Photo: Shutterstock)
12. Maine | Average annual cost: $76,898 | Homemaker services: $61,410 | Home health aide: $61,410 | Day health care: $30,160 | Assisted living: $62,031 | Nursing home (semi-private): $120,450 | Nursing home (private): $125,925 (Photo: Shutterstock)
11. Delaware | Average annual cost: $78,864 | Homemaker services: $56,056 | Home health aide: $56,056 | Day health care: $21,570 | Assisted living: $72,414 | Nursing home (semi-private): $130,761 | Nursing home (private): $136,328 (Photo: Shutterstock)

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10. North Dakota | Average annual cost: $79,608 | Homemaker services: $61,766 | Home health aide: $63,972 | Day health care: $24,705 | Assisted living: $40,860 | Nursing home (semi-private): $142,503 | Nursing home (private): $143,832 (Photo: Shutterstock)
9. Nevada | Average annual cost: $79,743 | Homemaker services: $51,480 | Home health aide: $51,480 | Day health care: $20,800 | Assisted living: $40,800 | Nursing home (semi-private): $91,250 | Nursing home (private): $111,325 (Photo: Shutterstock)
8. New York | Average annual cost: $80,133 | Homemaker services: $57,200 | Home health aide: $59,488 | Day health care: $22,100 | Assisted living: $55,563 | Nursing home (semi-private): $139,357 | Nursing home (private): $148,190 (Photo: Shutterstock)
7. New Jersey | Average annual cost: $80,141 | Homemaker services: $57,200 | Home health aide: $57,200 | Day health care: $22,100 | Assisted living: $76,800 | Nursing home (semi-private): $127,750 | Nursing home (private): $139,795 (Photo: Shutterstock)
6. Vermont | Average annual cost: $81,537 | Homemaker services: $62,348 | Home health aide: $62,348 | Day health care: $36,400 | Assisted living: $64,050 | Nursing home (semi-private): $128,663 | Nursing home (private): $135,415 (Photo: Shutterstock)

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5. Hawaii | Average annual cost: $82,590 | Homemaker services: $61,204 | Home health aide: $62,645 | Day health care: $18,980 | Assisted living: $52,500 | Nursing home (semi-private): $139,795 | Nursing home (private): $160,418 (Photo: Shutterstock)
4. Connecticut | Average annual cost: $84,214 | Homemaker services: $50,336 | Home health aide: $54,912 | Day health care: $22,100 | Assisted living: $58,560 | Nursing home (semi-private): $152,388 | Nursing home (private): $166,988 (Photo: Shutterstock)
3. District of Columbia | Average annual cost: $86,132 | Homemaker services: $62,920 | Home health aide: $62,920 | Day health care: NA | Assisted living: $135,450 | Nursing home (semi-private): $127,750 | Nursing home (private): $127,750 (Photo: Shutterstock)
2. Massachusetts | Average annual cost: $86,455 | Homemaker services: $62,234 | Home health aide: $62,920 | Day health care: $17,680 | Assisted living: $67,680 | Nursing home (semi-private): $149,672 | Nursing home (private): $158,545 (Photo: Shutterstock)
1. Alaska | Average annual cost: $162,087 | Homemaker services: $67,450 | Home health aide: $68,594 | Day health care: $39,941 | Assisted living: $72,000 | Nursing home (semi-private): $362,268 | Nursing home (private): $362,268 (Photo: Shutterstock)

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(Related: Top 15 Most Expensive States for Long-Term Care: 2018)

Aging at home has become more expensive than ever, according to Genworth’s 2019 cost of care survey.

The study showed that the cost of homemaker services, involving such tasks as cooking, cleaning and running errands, increased by 7.1% since last year to an annual median $51,480. And the cost of a home health aide to provide hands-on personal assistance has increased by 4.6% to $52,642.

“Considering that most people want to stay in their homes as they grow older and 65-year-olds today have a 70% chance of needing some type of long-term care services in their remaining years, it’s evident that planning for how to pay for long-term care is now more urgent than ever,” Gordon Saunders, senior brand marketing manager at Genworth, said in a statement.

Genworth’s annual survey contacted 53,901 long-term care providers nationwide to complete 15,178 surveys for nursing homes, assisted living facilities, adult day health facilities and home care providers. The survey includes 441 regions based on the Metropolitan Statistical Areas, defined by the Office of Management and Budget, comprising about 85% of the U.S. population.

Escalating LTC Costs

According to Genworth, providers blamed a dearth of care professionals to meet the increasing demand for in-home care, caused by a “perfect storm” of these factors:

  • Tight labor market
  • Costs of complying with new mandates in local, state and federal certifications and regulations
  • Shift in post-acute Medicare reimbursement, which is prompting hospitals to discharge patients sooner and with more care needs

While home care and adult day health care services costs increased over the past year, the cost of care in facilities has stabilized, with increases ranging from 1% to 2% for assisted living: facilities and nursing homes, according to Genworth.

The national annual median cost of care now ranges from $102,200 for a private room in a nursing home to $19,500 for adult day health care services (based on five days per week per year).

A new category in this year’s Cost of Care Survey is in-home skilled nursing at a national median cost of $87.50 per visit.

See the gallery for the most expensive states for long-term care, according to Genworth.

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