New report ranks senior care by state: Alaska worst for value
The October 2026 report concludes that Alaska ranks as the worst state for senior care value. Nursing home and full-time in-home care there carry the highest costs nationwide while the state maintains the smallest share of five-star facilities. The study assigns Alaska an elder-care inefficiency score of 84.83 out of 100, the highest among all states examined.
Researchers reviewed all fifty states. They compared average monthly nursing-home costs and full-time in-home aide costs against nurse staffing hours per resident per day, the percentage of facilities meeting high standards, the shares of five-star and one- or two-star facilities, and a healthcare access score. Cost and quality metrics received equal weight in a composite score out of 100.
The report lists the following data for the ten states: Alaska nursing home cost $21,727 in-home care $7,040 staffing 6.90 hours high standards 88 percent healthcare access 14.82 high-quality facilities 1.14 percent score 84.83; Louisiana $7,770 $8,800 3.81 75 percent 14.23 7.66 percent 72.75; West Virginia $10,073 $5,632 3.70 47 percent 22.63 4.14 percent 65.32; Virginia $9,164 $6,688 3.77 60 percent 11.83 11.84 percent 65.03; New York $11,545 $4,928 3.68 57 percent 13.72 25.42 percent 59.46; Vermont $11,200 $5,280 4.16 52 percent 24.68 1.47 percent 59.04; Wyoming $8,772 $4,928 3.90 41 percent 16.11 1.39 percent 58.76; Maryland $10,527 $6,160 3.89 77 percent 14.51 9.47 percent 58.60; Utah $9,125 $5,632 4.06 53 percent 10.54 4.69 percent 57.55; Connecticut $12,453 $5,280 3.76 83 percent 22.04 8.58 percent 57.53.
Alaska records the highest nursing-home average of $21,727 per month, producing an annual total exceeding $260,000. Full-time in-home care averages $7,040 monthly. The state posts 6.90 nurse staffing hours per resident per day and 88 percent of facilities meeting high standards, yet only 1.14 percent of long-term care facilities hold five-star ratings, the lowest share nationally, yielding the top inefficiency score of 84.83.
Louisiana places second with an elder-care inefficiency score of 72.75. Full-time in-home care there costs $8,800 monthly, the highest figure for any state and $1,760 above Alaska. Louisiana remains the sole state where in-home care exceeds nursing-home cost. Among rated facilities, 63.7 percent hold one- or two-star ratings, the largest such share recorded.
West Virginia ranks third with a score of 65.32. Only 47 percent of its nursing facilities meet high standards of care, the second-lowest percentage. One- and two-star homes outnumber higher-rated homes combined. Families choosing a nursing home pay roughly 79 percent more per month than the cost of a full-time in-home aide.
Virginia occupies fourth position with a score of 65.03. Full-time aide care averages $6,688 monthly. Sixty percent of facilities clear the high-standard threshold. Fewer than one in eight facilities hold five-star ratings.
New York finishes fifth with a score of 59.46. Average nursing-home cost reaches $11,545 monthly. Fifty-seven percent of facilities meet high standards. One- or two-star homes comprise 43 percent of rated facilities, making them the most common rating level encountered.
The remaining states in the top ten show these figures: Vermont nursing-home cost $11,200 in-home $5,280 staffing 4.16 hours high standards 52 percent healthcare access 24.68 high-quality facilities 1.47 percent score 59.04; Wyoming $8,772 $4,928 3.90 41 percent 16.11 1.39 percent 58.76; Maryland $10,527 $6,160 3.89 77 percent 14.51 9.47 percent 58.60; Utah $9,125 $5,632 4.06 53 percent 10.54 4.69 percent 57.55; Connecticut $12,453 $5,280 3.76 83 percent 22.04 8.58 percent 57.53.
A financial expert from The Elder Justice Firm commented: "What a nursing home or an in-home aide charges each month tells you what you'll pay, not how good the care will be. Price and quality are two separate questions, and they deserve two separate answers. Before you sign anything, look up how the home is rated and ask how many hours nurses spend with each resident in a day. Then put the monthly bill for a nursing home next to the cost of bringing an aide into the house, so you can see the gap for yourself. Together, those checks tell a family more about a home than its price alone."
