Cost of Long-Term Care Study 2020

This is proprietary research conducted by Northwestern Mutual in 2020. Use of this information is intended for reference. Northwestern Mutual's recent proprietary research is available here.

Over 12 million Americans are currently receiving paid long-term care services in a variety of care settings.¹ Long-term care services, such as assistance with daily living activities like bathing, dressing, transferring into and out of a chair or bed, and supervision for safety, are commonly needed as a result of an accident, illness and frailties associated with aging.

In 2020, the Long-Term Care Group, Inc. conducted customized Cost of Care research on behalf of Northwestern Long-Term Care Insurance Company. Cost of care information was obtained from a representative sample of 6,000 nursing homes, 10,000 assisted living facilities and 10,000 home care providers across the U.S.

This research is important in the understanding of accessibility and affordability of different types of care services by geographic location. The findings help consumers make informed decisions about their long-term care options and costs, which may allow them to stay in their homes or within their local communities in the event of functional limitation or cognitive impairment.

Visit the Cost of Care Calculator to learn more about costs in your area.

Home Care

Home health care organizations are licensed providers, such as home health care agencies, home care agencies and independent providers, that offer a broad range of services delivered in the home, typically including some range of skilled nursing services, speech, occupational, physical and respiratory therapies, nutrition and medical services, administration of medication and personal care.

For the Cost of Long Term-Care Study, 10,000 home care providers were surveyed in 2020. Key findings include:

• The national average hourly rate for Home Health Aides (HHAs) for all regions in this study is $26 per hour.
• The region with the highest average hourly rate for certified Home Health Aides (HHAs) is Minnesota and costs $31 per hour.
• The region with the lowest average hourly rate for Home Health Aides (HHAs) is West Virginia and costs $21 per hour.

Assisted Living

The popularity of Assisted Living Facilities (ALF) as an alternative to in-home or nursing home care is growing rapidly. According the LTCG, approximately 30% of those needing long-term care services received them in an ALF,² 

Assisted living provides coordinated, personalized 24-hour assistance and support (both scheduled and unscheduled) in a congregate residential setting. The choices, privacy, independence and rights of the persons served are proactively protected and promoted as an essential part of assisted living's core values and mission.

For the Cost of Long-Term Care Study, 10,000 assisted living facilities were surveyed in 2020. Key findings include:

• The national annual average cost for a one-bedroom ALF unit is $57,610. Overall costs may be higher in urban settings or if a resident has a high level of chronicity, which requires additional services.
• The national average monthly rate for a one-bedroom ALF unit is $4,800 in the regions surveyed.
• The region with the most expensive average monthly rate for a one-bedroom unit in an assisted living facility is New Jersey and costs $7,979 per month.
• The region with the lowest average monthly rate for a one-bedroom unit in an assisted living facility is Mississippi and costs $3,519 per month.

Nursing Homes

The nursing home industry is composed of establishments primarily engaged in providing inpatient nursing and rehabilitative services. The care is generally provided for an extended period of time to individuals requiring skilled nursing care.

For the Cost of Long-Term Care Study, over 6,000 nursing homes were surveyed in 2020. Key findings include:

• The national average annual cost of a private room in a nursing home based on the regions in the study is $113,850 per year.
• The national average daily rate for a private room in a nursing home is $312 in the markets surveyed.
• The region with the most expensive average daily rate for a private room in a nursing home is Connecticut, and costs $480 per day.
• The region with the least expensive daily average rate for a private room in a nursing home is Louisiana and costs $212 per day.

¹ LTCG Study, 2020

² LTCG, 2020