genworth financial 2008 cost of care surveygenworth financial 2008 cost of care survey april 2008...
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G E N W O R T H F I N A N C I A L 2 0 0 8 C O S T O F C A R E S U R V E Y
A P R I L 2 0 0 8
Home Care Providers, Adult Day Health Care Facilities,
Assisted Living Facilities and Nursing Homes
37522 04/30/08
I N T R O D U C T I O N
With the aging Baby Boomer generation 77 million strong and people living longer than in decades past, one of the biggest issues seniors and their families face is the prospect of needing, and potentially providing, long-term care at some point in their lives. Most Americans, though, have yet to seriously consider and plan for the emotional and financial consequences of aging, and many are not familiar with the care options available today or the associated costs.
Each year, Genworth Financial – a leading global financial services provider – conducts its benchmark Cost of Care survey to bring you an in-depth look at the cost of long-term care across the country, along with corresponding market trends. We do this to help consumers and financial professionals prepare for the future by arming you with the knowledge required to make long-term care decisions. Our report also informs policymakers, caregivers, advocates, the private business sector and media as they talk about issues critical to long-term care.
We have analyzed data from more than 10,000 nursing homes, assisted living facilities, home care providers and adult day health care facilities in all 50 states and the District of Columbia, including a comparative evaluation of 90 urban and rural regions in the United States. Also this year we include several new features. Tapping into our exclusive five years of Cost of Care survey data, we provide a five-year historical view of trends not available in any other industry report. We also offer for the first time adult day health care costs as well as a primer on long-term care options so that you may more fully benefit from the information presented in this report. And we encourage you to visit our easy-to-use, interactive Web site, including our popular U.S. Cost of Care map at genworth.com/CostofCare.
You will find a one page summary of data as well as a thorough review of findings in this report. In brief, we found that the average cost of care for nursing homes and assisted living facilities has steadily increased over the past five years, while the cost of non-skilled care delivered in a home setting has remained relatively flat. In addition, adult day health care – designed to meet the needs of and help adults who are functionally and/or cognitively impaired live more independently – is becoming more popular and more available across the country.
We are often asked what is influencing the cost of care. Long-term care is a complex issue and there is no simple answer. One key factor to note is that the U.S. is facing a critical long-term care labor shortage that will have significant implications on the quality and drastically increase the cost of care. With the enormous wave of Baby Boomers heading into their senior years, our health care system faces an increased demand for long-term care and qualified paraprofessional healthcare workers to administer this care. It is imperative that this workforce issue be positioned at the forefront of public policy discussions and that, as a nation, we recruit, cultivate and retain a highly trained workforce – an effort critical to bridging this gap and meeting the increased need for long-term care over the next few decades.
As the nation’s largest provider of long-term care insurance with more than 34 years in the industry, Genworth Financial has a unique view of the issues surrounding long-term care and is actively engaged in elevating awareness about the need to plan ahead. We designed this report to educate you about long-term care options and their costs by region and type of care. We hope this tool helps you make informed decisions and encourages you to proactively prepare for the future.
LIMRA International, U.S. Individual Long-Term Care Insurance Sales Survey, Fourth Quarter YTD 2007 and U. S. Group Long-Term Care Insurance Sales Survey, Fourth Quarter YTD 2007 in force results.
C O N T E N T S
Understanding Long-Term Care
Summary of 2008 Survey Findings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Long-Term Care Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
The Categories of Long-Term Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Emerging Trends and Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Cost of Care Maps and Tables
Homemaker Services (Non-Medicare Certified, Licensed) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Home Health Aide Services (Non-Medicare Certified, Licensed) . . . . . . . . . . . . . . . . . . . . . . . . . 13
Home Health Aide Services (Medicare Certified) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Home Health Aide Services (Both Provider Types) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Adult Day Health Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Assisted Living Facility (Private One Bedroom) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Nursing Home (Semi-Private Room) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Nursing Home (Private Room) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Appendix
State Regions With Counties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
1 Represents the compound annual growth rate based on Genworth Cost of Care survey data from 2004-2008.2 Represents the compound annual growth rate based on Genworth Cost of Care survey data from 2005-2008.
S U M M A R Y O F 2 0 0 8 S U R V E Y F I N D I N G S
Homemaker Services (Non-Medicare Certified, Licensed)
Provide “hands-off” care such as helping with cooking and running errands. Often referred to as “Personal Care Assistants” or “Companions.” This is the rate charged by a non-Medicare certified, licensed agency.• National average hourly rate of $18• 4% increase over 2007• Five-year annual growth of 2%1
Home Health Aide Services (Non-Medicare Certified, Licensed)
Provide “hands-on” personal care, but not medical care in the home with activities such as bathing, dressing, and transferring. This is the rate charged by a non-Medicare certified, licensed agency.• National average hourly rate of $19• 3% increase over 2007 • Five-year annual growth of 1%1
Home Health Aide Services (Medicare Certified)
Provide “hands-on” personal care and sometimes skilled care associated with a nurse visit in the home. Assist with activities such as bathing, dressing, and transferring. This is the rate charged by a Medicare certified agency.• National average hourly rate of $38• 18% increase over 2007• Four-year annual growth of 7%2
Adult Day Health Care
Provides social and other related support services in a community-based, protective setting during any part of a day, but less than 24-hour care.
• National average daily rate of $59
Assisted Living Facility (Private One Bedroom)
Provides “hands-on” personal care as well as medical care for those who are not able to live by themselves, but do not require constant care provided by a nursing home.• National average monthly rate of $3,008• 11% increase over 2007• Five-year annual growth of 6%1
Nursing Home (Semi-Private Room)
Provides skilled nursing care 24-hours/day.• National average daily rate $187• 4% increase over 2007• Five-year annual growth of 4%1
Nursing Home (Private Room)
Provides skilled nursing care 24-hours/day. • National average daily rate $209• 2% increase over 2007• Five-year annual growth of 4%1
Home
Community
Facility
1
2
L O N G T E R M C A R E O V E R V I E W
With all the talk today about the state of the economy, you can’t help but think about your financial future. By now, you may have saved a significant amount for retirement, and also may be well on your way to making progress to paying down your mortgage. Or perhaps you may be years away from retirement and are just starting to plan for your financial future.
But have you given much thought to what you would do if you needed long-term care? Long-term care is the kind of help you may need if you have a prolonged physical illness, disability, or cognitive impairment (such as Alzheimer’s disease) that keeps you from living an independent lifestyle. These limitations may prevent you from carrying out basic self-care tasks, called Activities of Daily Living (ADLs). ADLs may include things such as bathing, dressing or eating.
Review the OptionsInformation is power: the more you know about long-term care, the better decisions you can make about your future. For example, people who are thinking of relying on Medicare or Medicaid to provide long-term care services should be well informed about these programs.
Medicare Generally, Medicare is the federal program providing hospital and medical insurance to people aged 65 or older and to certain ill or disabled persons. Benefits may be available for home health care, but only if certain conditions are met. Additionally, Medicare may pay for up to 100 days of care in a skilled nursing facility per benefit period – 100% for the first 20 days (after a three-day hospital stay provided skilled care is needed). Then beginning on day 21-100, Medicare requires a co-payment. To help cover the co-payment, many seniors may also have a Medicare supplement insurance policy. In general, once Medicare stops paying for care, the supplement payment will end as well.
Medicaid Medicaid (in California referred to as Medi-Cal) generally pays for certain health services and nursing home care for those with low incomes and limited resources. Medicaid may also pay for some long-term care services at home and in the community. Medicaid has limitations on the amount of assets you can own and the amount of income you may receive each month before you are eligible for benefits. Who is eligible and what services are covered vary from state to state. There are also restrictions on transferring assets in order to qualify for Medicaid.
Learn the LevelsAlso, when talking about long-term care, people may not think about the type or level of care they may need. Long-term care can be therapeutic, rehabilitative or personal care delivered at home, in a community-based setting or in a facility. Here’s how each level of care differs:
• Custodial Care (Personal Care) is for those who need help with activities of daily living, and often involves non-medical personnel. An example would be having a helper come into your house to help with bathing, dressing, or eating and other ADLs.
• Intermediate Care is for those who need occasional nursing and rehabilitative care under the supervision of skilled medical personnel. It is less specialized and less comprehensive than skilled nursing care. Intermediate care is similar to skilled care except it is provided on a periodic basis. The caring for a wound every eight hours, for example, is considered intermittent treatment.
• Skilled Care is for those who have medical conditions that require care by medical professionals such as a registered nurse or professional therapist. This higher level of care can include physical therapy or supervising the administration of intravenous medication.
2
3
T H E C A T E G O R I E S O F L O N G T E R M C A R E
The good news is that today consumers have options when planning for a long-term care need. Here is a brief review of the categories of long-term care options available.
Homemaker ServicesThis service makes it possible for people to live in their own homes or to return to their homes by helping them complete household tasks that they can’t manage alone. Homemaker services aides may clean clients’ houses, cook meals or run errands.
Home Health AidesPersonal and home health aides help those who are elderly, disabled, or ill to live in their own homes or in residential care facilities instead of in nursing homes. Home health aides may offer care to people who need more extensive personal care than family or friends are able to or have the time or resources to provide. Home health aide agencies are broken up into two categories; Medicare certified and non-Medicare certified, licensed. Medicare certified agencies are certified to accept Medicare reimbursements while non-Medicare certified, licensed agencies are not certified by Medicare to receive Medicare reimbursements.
Adult Day Health CareAdult Day Health Care (ADH) centers can offer a much-needed break to caregivers. This type of care provides service at a community-based center for adults who need assistance or supervision during the day but who do not need round the clock care. The centers may provide health services, therapeutic services and social activities.
Assisted Living FacilitiesAssisted living facilities (in California referred to as Residential Care Facilities) are living arrangements that provide personal care and health services for people who may need assistance with ADLs, but who wish to live as independently as possible and who do not need the level of care provided by a nursing home. It’s important to note that assisted living is not an alternative to a nursing home, but an intermediate level of long-term care.
Nursing Home CareA nursing home is for those people who may need a higher level of supervision and care than in an assisted living facility. They offer residents personal care, room and board, supervision, medication, therapies and rehabilitation, as well as skilled nursing care 24 hours a day.
Review the CostsAs you page through this brochure, you can look up the costs of various types of care in your state – homemaker services, home health aides, adult day health care, assisted living and nursing home. These costs can give you a good idea of how much money you or your family would need if you or a loved one required long-term care.
3
4
E M E R G I N G T R E N D S A N D F I N D I N G S
This is the 5th consecutive year Genworth has used a consistent methodology to survey long-term care service providers across the country within 90 Regions.3
Based on these survey results, Genworth recognizes some emerging trends across the long-term care services landscape.
Overall, the cost of care within facility-based providers has steadily increased while non-skilled related home care costs have remained relatively flat. For example, in 2008 the average annual rate for a private nursing home room was $76,460 compared with the 2004 average annual rate of $65,185. This increase represents a 4% compound annual growth rate over that period and means Americans can expect to pay over $10,000 more per year than five years ago.
Similarly, the monthly rate for a one-bedroom unit within a licensed assisted living facility has increased almost 6% annually over five years,4
excluding any one-time community fees that are typically charged by approximately one-third of all assisted living facilities surveyed.
In contrast to facility-based care, rates charged by home care providers for non-skilled related services have remained relatively flat over five years. For example, in 2004 the national, hourly private pay rate charged by a non-Medicare certified, licensed home health agency for a home health aide was $18. In 2008 the hourly rate has only increased to $19. Despite a slight spike in these rates in 2006, the historical compound annual growth rate for this type of care has been a mere 1% over five years of survey results. Potential reasons for this trend include the possibility that home care rates have remained flat due to increased competition among agencies, availability of unskilled labor, and because agencies can avoid, for the most part, the costs associated with maintaining stand-alone health care facilities.
3 The 2007 Genworth Cost of Care survey included 90 regions as well; however, prior to 2007, Genworth Cost of Care surveys
included 88 regions. The two newest regions are Richmond, Virginia and Nashville, Tennessee.4 Percentage increase represents the compound annual growth rate for surveys conducted by Genworth from 2004 to 2008.
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
$80,000
2004 2005 2006
Year
2007 2008
Nursing Home(Private Room)
Nursing Home (Semi-Private Room)
Assisted Living Facility (Private One Bedroom)
4.07%
4.36%
5.84%
% Compound Annual Growth Rate from 2004 to 2008
ANNUAL COSTS OF FACILITY-BASED CARE – NATIONAL FINDINGS
5
Another industry trend is the increase in Adult Day Health Care (ADH) facilities and programs. ADH is becoming more popular and more available across the country and is designed to meet the needs of adults who are functionally and/or cognitively impaired. Programs are structured and comprehensive, and take place in a protective setting that promotes well-being through a variety of health, social, and other support services. These services are intended to help enable individuals to live more independently in the community. They also may be intended to provide some relief for family caregivers.
There are at least three different models of adult day health care programs: social, medical, and combined.
Social Model: This model provides social activities, meals, recreation, and some health related services. The primary focus is on providing non-medical interventions such as basic care, supervision, social activities, transportation, meals, and recreation. Five
percent of ADH facilities surveyed offered this model.
Medical Model: This model is typically for individuals who have health care problems. Generally, the medical model provides nursing supervision and medical monitoring for each participant. Medical model programs may also offer physical, occupational, and speech therapy. Thirty-eight percent of ADH facilities surveyed offered this model.
Combined Model: Providers offering this model may provide both social and medical services. Usually a Registered Nurse (RN) or Licensed Practical Nurse (LPN) on staff oversees general health while participants take part in a variety of activities designed to stimulate cognition and movement. Fifty-seven percent of ADH facilities surveyed offered this model.
Nationally, the average daily rate charged by an ADH provider is $59/day.
2004 2005 2006
Year
2007 2008
Home Health Aide Services (Non-Medicare Certified, Licensed)
Homemaker Services (Non-Medicare Certified, Licensed)
$0
$5
$10
$15
$20
$25
1.00%
2.27%
% Compound Annual Growth Rate from 2004 to 2008
HOURLY COSTS OF HOME-BASED CARE – NATIONAL FINDINGS
C O S T O F C A R E M A P S A N D T A B L E S
HOMEMAKER SERVICES (NON-MEDICARE CERTIFIED, LICENSED) HOURLY RATESNational Average $18
AL
AZAR
CACO
CT DE
FL
GA
ID
ILIN
IA
KSKY
LA
ME
MDM
AM
I
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PARI
SC
SD
TN
TX
UT AK
HI
VT
VA
WA
WV
WI
WY
$19
$17
$19 $1
9
$19
$19
$18
$17
$17 $1
5
$13
$14
$15
$15$1
6
$16
$16
$18
$24
$18
$17
$16
$14
$17
$17
$18
$17
$19
$19
$19
$19
$18
$19
$20
$20 $2
1
$20
$19
$16
$16 $1
7
$16
$17
$20
$20
$20
$18
$18
$18
$19Sea
ttle
$23
Port
land
$20
San
Fr
anci
sco
$24
Sac
ram
ento
$21
Oak
land
$22
San
Jos
e$2
3 Los
Ang
eles
$19
Las
Veg
as$1
9
Den
ver
$19
Dal
las
$17
San
Ant
onio
$16A
usti
n$1
7H
oust
on$1
8
Chi
cago
$19
Atl
anta
$17
Jack
sonv
ille
$17 Orl
ando
$17
Mia
mi
$15
Tam
pa$1
9
Cha
rlot
te$1
6
Det
riot
$18
Syr
acus
eB
uffa
loR
oche
ster
$18
Indp
ls.
$18
Ric
hmon
d$1
7
Bos
ton
$22
Bri
dgep
ort
$19
New
ark/
Edis
on $
19N
ew Y
ork
$18
Bal
tim
ore
$18
Bet
hesd
a $1
7W
ashi
ngto
n D
C $
18
Phila
delp
hia
New
Yor
k C
ity
$18
Min
neap
olis
$22
$19
Kan
sas
Cit
y$1
8
Sai
nt L
ouis
$19
Nas
hvill
e$1
8S
anta
Ann
a$1
9
San
Die
go$2
1Ph
oeni
x$1
9
9
Minimum Maximum Average Five-YearState or Region Hourly Rate Hourly Rate Hourly Rate Annual Growth*
AKALARAZ - PhoenixAZ - Rest of StateCA - Los AngelesCA - OaklandCA - Rest of StateCA - SacramentoCA - Santa AnaCA - San DiegoCA - San FranciscoCA - San JoseCO - DenverCO - Rest of StateCT - BridgeportCT - Rest of StateDC - BethesdaDC - WashingtonDEFL - JacksonvilleFL - MiamiFL - OrlandoFL - Rest of StateFL - TampaGA - AtlantaGA - Rest of StateHIIAIDIL - ChicagoIL - Rest of StateIN - IndianapolisIN - Rest of StateKSKYLAMA - BostonMA - Rest of StateMD - BaltimoreMD - Rest of StateMEMI - DetroitMI - Rest of StateMN - Minneapolis
10
Minimum Maximum Average Five-YearState or Region Hourly Rate Hourly Rate Hourly Rate Annual Growth*
HOMEMAKER SERVICES (NON-MEDICARE CERTIFIED, LICENSED) HOURLY RATES
AKALARAZ - PhoenixAZ - Rest of StateCA - Los AngelesCA - OaklandCA - Rest of StateCA - SacramentoCA - Santa AnaCA - San DiegoCA - San FranciscoCA - San JoseCO - DenverCO - Rest of StateCT - BridgeportCT - Rest of StateDC - BethesdaDC - WashingtonDEFL - JacksonvilleFL - MiamiFL - OrlandoFL - Rest of StateFL - TampaGA - AtlantaGA - Rest of StateHIIAIDIL - ChicagoIL - Rest of StateIN - IndianapolisIN - Rest of StateKSKYLAMA - BostonMA - Rest of StateMD - BaltimoreMD - Rest of StateMEMI - DetroitMI - Rest of StateMN - Minneapolis
$231112171611171518181820161412151613161515111415161412141615141217131314
92018161016151418
$253018222026262724222226302222222224202318202323221920222820252420221918172523222423262127
$241515191819222021192124231918191917181917151718191716181917191718171616132221181820181822
9%3%1%4%0%3%3%
-2%1%2%7%2%3%4%3%
-2%-1%2%2%5%1%3%5%5%4%3%3%1%
-1%6%2%4%
-3%3%1%
-2%3%4%1%5%
-1%2%5%2%4%
10 *Represents the compound annual growth rate based on Genworth Cost of Care survey data from 2004-2008.
MN - Rest of StateMO - Kansas CityMO - Rest of StateMO - St. LouisMSMTNC - CharlotteNC - Rest of StateNDNENHNJ - New YorkNJ - Rest of StateNMNV - Las VegasNV - Rest of StateNYCNY - Buffalo, Rochester, SyracuseNY - New York, Newark, Edison (Not NYC)NY - Rest of StateOHOKOR - PortlandOR - Rest of StatePA - PhiladelphiaPA - Rest of StateRISCSDTN - NashvilleTN - Rest of StateTX - AustinTX - DallasTX - HoustonTX - Rest of StateTX - San AntonioUTVA - RichmondVA - Rest of StateVTWA - Rest of StateWA - SeattleWIWVWYNational
11
Minimum Maximum Average Five-YearState or Region Hourly Rate Hourly Rate Hourly Rate Annual Growth*
$161615171117151214151414161217171212111514141715151316121615121414121211151311161719151217$9
$272221211820172119182821222822222221252625252528242422252022172023242719242022222228251620
$30
$191817191419161717162018191819201818191917172019191719161918151717181616201716201923181419
$18
-4%2%6%0%1%5%2%2%1%4%5%2%
-4%8%4%5%3%2%5%4%3%1%3%4%2%
-2%2%4%
-2%-1%-1%1%5%2%2%4%3%2%2%2%2%4%3%1%5%2%
11
Minimum Maximum Average Five-YearState or Region Hourly Rate Hourly Rate Hourly Rate Annual Growth*
HOMEMAKER SERVICES (NON-MEDICARE CERTIFIED, LICENSED) HOURLY RATES
**Represents state-wide growth as city-specific data was added in 2007.
**
**
AL
AZAR
CACO
CT DE
FL
GA
ID
ILIN
IA
KSKY
LA
ME
MDM
AM
I
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PARI
SC
SD
TN
TX
UT AK
HI
VT
VA
WA
WV
WI
WY
$19
$17
$20 $1
9
$19
$22
$18
$19
$18 $1
6
$14
$14
$15
$16$1
6
$17
$17
$19
$24
$20
$18
$17
$14
$18
$19
$20
$18
$20
$22
$19
$20
$19
$22
$22
$24 $2
2
$21
$20
$19
$17 $1
7
$16
$19
$21
$20
$21
$19
$18
$19
$20Sea
ttle
$23
Port
land
$21
San
Fr
anci
sco
$24
Sac
ram
ento
$21
Oak
land
$22
San
Jos
e$2
4 Los
Ang
eles
$19
Las
Veg
as$2
0
Den
ver
$21
Dal
las
$18
San
Ant
onio
$16A
usti
n$1
9H
oust
on$1
8
Chi
cago
$20
Atl
anta
$17
Jack
sonv
ille
$18 Orl
ando
$18
Mia
mi
$16
Tam
pa$2
0
Cha
rlot
te$1
7
Det
riot
$19
Syr
acus
eB
uffa
loR
oche
ster
$21
Indp
ls.
$19
Ric
hmon
d$1
7
Bos
ton
$23
Bri
dgep
ort
$20
New
ark/
Edis
on $
19N
ew Y
ork
$19
Bal
tim
ore
$19
Bet
hesd
a $1
8W
ashi
ngto
n D
C $
19
Phila
delp
hia
New
Yor
k C
ity
$18
Min
neap
olis
$25
$20
Kan
sas
Cit
y$1
9
Sai
nt L
ouis
$19
Nas
hvill
e$1
9S
anta
Ann
a$2
0
San
Die
go$2
1Ph
oeni
x$2
0
HOME HEALTH AIDE SERVICES (NON-MEDICARE CERTIFIED, LICENSED) HOURLY RATESNational Average $19
13
AKALARAZ - PhoenixAZ - Rest of StateCA - Los AngelesCA - OaklandCA - Rest of StateCA - SacramentoCA - Santa AnaCA - San DiegoCA - San FranciscoCA - San JoseCO - DenverCO - Rest of StateCT - BridgeportCT - Rest of StateDC - BethesdaDC - WashingtonDEFL - JacksonvilleFL - MiamiFL - OrlandoFL - Rest of StateFL - TampaGA - AtlantaGA - Rest of StateHIIAIDIL - ChicagoIL - Rest of StateIN - IndianapolisIN - Rest of StateKSKYLAMA - BostonMA - Rest of StateMD - BaltimoreMD - Rest of StateMEMI - DetroitMI - Rest of StateMN - Minneapolis
Minimum Maximum Average Five-YearState or Region Hourly Rate Hourly Rate Hourly Rate Annual Growth*
HOME HEALTH AIDE SERVICES (NON-MEDICARE CERTIFIED, LICENSED) HOURLY RATES
$231312181713171518181920161412151914161516131515161412141615151217131515
92219181416161520
$253018222128262724242226302622252526232321202325251929252820252423241918172727222425262327
$241516201919222121202124242119202218192018161819201717202017201919191716142322191921191825
1%2%1%2%
-3%0%2%0%2%
-4%3%2%1%5%3%
-1%-1%1%3%
-1%1%
-2%5%2%2%0%0%8%
-6%2%2%3%
-1%-2%2%
-4%-2%2%1%5%
-1%2%1%2%5%
14 *Represents the compound annual growth rate based on Genworth Cost of Care survey data from 2004-2008.
MN - Rest of StateMO - Kansas CityMO - Rest of StateMO - St. LouisMSMTNC - CharlotteNC - Rest of StateNDNENHNJ - New YorkNJ - Rest of StateNMNV - Las VegasNV - Rest of StateNYCNY - Buffalo, Rochester, SyracuseNY - New York, Newark, Edison (Not NYC)NY - Rest of StateOHOKOR - PortlandOR - Rest of StatePA - PhiladelphiaPA - Rest of StateRISCSDTN - NashvilleTN - Rest of StateTX - AustinTX - DallasTX - HoustonTX - Rest of StateTX - San AntonioUTVA - RichmondVA - Rest of StateVTWA - Rest of StateWA - SeattleWIWVWYNational
$181615171117151414152214171518181217111714141915151320121815121614141213151514181719161217$9
$272421211828182322282822222825232226252625252528252430282022182123242719251922272328251620
$30
$221918191420171819192419191820201821192018172120201822171919161918181616211717221923201419
$19
-4%1%
-1%-5%0%4%1%1%3%4%0%0%
-3%3%5%0%3%1%2%5%2%1%3%4%1%
-2%0%3%0%
-1%-1%2%3%2%0%3%3%1%1%3%
-1%2%
-2%1%5%1%
15
Minimum Maximum Average Five-YearState or Region Hourly Rate Hourly Rate Hourly Rate Annual Growth*
HOME HEALTH AIDE SERVICES (NON-MEDICARE CERTIFIED, LICENSED) HOURLY RATES
**Represents state-wide growth as city-specific data was added in 2007.
**
**
17
AL
AZAR
CACO
CT DE
FL
GA
ID
ILIN
IA
KSKY
LA
ME
MDM
AM
I
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PARI
SC
SD
TN
TX
UT AK
HI
VT
VA
WA
WV
WI
WY
$83
$33
$27 $2
9
$21
$28
$35
$44
$23 $2
6
$69
$74
$76
$48$6
2
$41
$63
$22
$74
$45
$41
$31
$49
$18
$24
$30
$25
$37
$30
$36
$43
$35
$22
$26
$39 $3
6
$54
$36
$26
$27 $4
1
$40
$29
$27
$72
$38
$33
$28
$36
$47Sea
ttle
$52
Port
land
$45
San
Fr
anci
sco
$45
Sac
ram
ento
$49
Oak
land
$72
San
Jos
e$7
7 Los
Ang
eles
$38
Las
Veg
as$3
3
Den
ver
$36
Dal
las
$51
San
Ant
onio
$36A
usti
n$4
0H
oust
on$3
1
Chi
cago
$33
Atl
anta
$69
Jack
sonv
ille
$32 Orl
ando
$18
Mia
mi
$18
Tam
pa$2
2
Cha
rlot
te$3
7
Det
riot
$29
Syr
acus
eB
uffa
loR
oche
ster
$27
Indp
ls.
$24
Ric
hmon
d$3
2
Bos
ton
$29
Bri
dgep
ort
$26
New
ark/
Edis
on $
34N
ew Y
ork
$28
Bal
tim
ore
$30
Bet
hesd
a $2
1W
ashi
ngto
n D
C $
22
Phila
delp
hia
New
Yor
k C
ity
$22
Min
neap
olis
$28
$32
Kan
sas
Cit
y$4
1
Sai
nt L
ouis
$29
Nas
hvill
e$3
5S
anta
Ann
a$4
4
San
Die
go$4
6Ph
oeni
x$3
8
HOME HEALTH AIDE SERVICES (MEDICARE CERTIFIED) HOURLY RATESNational Average $38
AKALARAZ - PhoenixAZ - Rest of StateCA - Los AngelesCA - OaklandCA - Rest of StateCA - SacramentoCA - Santa AnaCA - San DiegoCA - San FranciscoCA - San JoseCO - DenverCO - Rest of StateCT - BridgeportCT - Rest of StateDC - BethesdaDC - WashingtonDEFL - JacksonvilleFL - MiamiFL - OrlandoFL - Rest of StateFL - TampaGA - AtlantaGA - Rest of StateHIIAIDIL - ChicagoIL - Rest of StateIN - IndianapolisIN - Rest of StateKSKYLAMA - BostonMA - Rest of StateMD - BaltimoreMD - Rest of StateMEMI - DetroitMI - Rest of StateMN - Minneapolis
Minimum Maximum AverageState or Region Hourly Rate Hourly Rate Hourly Rate
HOME HEALTH AIDE SERVICES (MEDICARE CERTIFIED) HOURLY RATES
$211413151916231719211823262020172317152315131513181714181815121717151220121818181720121418
$11513069
15092
1751851059490
140106119707035383040
11010063256435
12011311099
1251279938759090
150557675858490
10035
$747626383638723849444645773633263021224332181822226963453633334424242762692936303554293528
18
Annual growth rates are not provided
for this category. Because Medicare
certified rates include rates associated
with skilled service visits in the home
(along with rates for non-skilled
visits), the wide variety of ranges in
the skilled rates skew the average
rates from year to year. Given this
fluctuation and the random sampling
methodology employed by the survey,
compound annual growth rates do
not provide a true indication of
annual growth on a regional basis
for this category.
MN - Rest of StateMO - Kansas CityMO - Rest of StateMO - St. LouisMSMTNC - CharlotteNC - Rest of StateNDNENHNJ - New YorkNJ - Rest of StateNMNV - Las VegasNV - Rest of StateNYCNY - Buffalo, Rochester, SyracuseNY - New York, Newark, Edison (Not NYC)NY - Rest of StateOHOKOR - PortlandOR - Rest of StatePA - PhiladelphiaPA - Rest of StateRISCSDTN - NashvilleTN - Rest of StateTX - AustinTX - DallasTX - HoustonTX - Rest of StateTX - San AntonioUTVA - RichmondVA - Rest of StateVTWA - Rest of StateWA - SeattleWIWVWYNational
$171215155015161518142219171318231619141712141818191418141817151712101012201613172022151420
$10
$451246585
1496360
110100507588659075
1753537906045
104157102939027752465
1301001751251258535
1209045
11714667
10078
$185
$284123297427374129263928362833722227343718414547322522412135484051314036273231268352304929
$38
19
Minimum Maximum AverageState or Region Hourly Rate Hourly Rate Hourly Rate
HOME HEALTH AIDE SERVICES (MEDICARE CERTIFIED) HOURLY RATES
21
AL
AZAR
CACO
CT DE
FL
GA
ID
ILIN
IA
KSKY
LA
ME
MDM
AM
I
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PARI
SC
SD
TN
TX
UT AK
HI
VT
VA
WA
WV
WI
WY
$51
$25
$23 $2
4
$20
$25
$27
$32
$20 $2
1
$41
$44
$46
$32$3
9
$29
$43
$20
$49
$32
$29
$24
$32
$18
$21
$25
$24
$28
$26
$28
$31
$27
$22
$24
$32 $2
9
$38
$28
$23
$22 $2
9
$28
$24
$24
$46
$29
$26
$23
$28
$33Sea
ttle
$38
Port
land
$33
San
Fr
anci
sco
$34
Sac
ram
ento
$35
Oak
land
$47
San
Jos
e$5
0 Los
Ang
eles
$29
Las
Veg
as$2
7
Den
ver
$28
Dal
las
$34
San
Ant
onio
$26A
usti
n$2
9H
oust
on$2
4
Chi
cago
$27
Atl
anta
$43
Jack
sonv
ille
$25 Orl
ando
$18
Mia
mi
$17
Tam
pa$2
1
Cha
rlot
te$2
7
Det
riot
$24
Syr
acus
eB
uffa
loR
oche
ster
$24
Indp
ls.
$21
Ric
hmon
d$2
5
Bos
ton
$26
Bri
dgep
ort
$23
New
ark/
Edis
on $
27N
ew Y
ork
$24
Bal
tim
ore
$25
Bet
hesd
a $1
9W
ashi
ngto
n D
C $
20
Phila
delp
hia
New
Yor
k C
ity
$20
Min
neap
olis
$26
$26
Kan
sas
Cit
y$3
0
Sai
nt L
ouis
$24
Nas
hvill
e$2
7S
anta
Ann
a$3
2
San
Die
go$3
3Ph
oeni
x$2
9
HOME HEALTH AIDE SERVICES (BOTH PROVIDER TYPES) HOURLY RATESNational Average $29
AKALARAZ - PhoenixAZ - Rest of StateCA - Los AngelesCA - OaklandCA - Rest of StateCA - SacramentoCA - Santa AnaCA - San DiegoCA - San FranciscoCA - San JoseCO - DenverCO - Rest of StateCT - BridgeportCT - Rest of StateDC - BethesdaDC - WashingtonDEFL - JacksonvilleFL - MiamiFL - OrlandoFL - Rest of StateFL - TampaGA - AtlantaGA - Rest of StateHIIAIDIL - ChicagoIL - Rest of StateIN - IndianapolisIN - Rest of StateKSKYLAMA - BostonMA - Rest of StateMD - BaltimoreMD - Rest of StateMEMI - DetroitMI - Rest of StateMN - Minneapolis
Minimum Maximum AverageState or Region Hourly Rate Hourly Rate Hourly Rate
HOME HEALTH AIDE SERVICES (BOTH PROVIDER TYPES) HOURLY RATES
$211312151713171518181820161412151914151515131513161412141615121217131215
91818181416121418
$11513069
15092
1751851059490
140106119707035383040
11010063256435
12011311099
1251279938759090
150557675858490
10035
$494621292829472935323334502826232619203125171820214340322825273221212239412629252738242726
22
Annual growth rates are not provided
for this category. Because Medicare
certified rates include rates associated
with skilled service visits in the home
(along with rates for non-skilled
visits), the wide variety of ranges in
the skilled rates skew the average
rates from year to year. Given this
fluctuation and the random sampling
methodology employed by the survey,
compound annual growth rates do
not provide a true indication of
annual growth on a regional basis
for this category.
MN - Rest of StateMO - Kansas CityMO - Rest of StateMO - St. LouisMSMTNC - CharlotteNC - Rest of StateNDNENHNJ - New YorkNJ - Rest of StateNMNV - Las VegasNV - Rest of StateNYCNY - Buffalo, Rochester, SyracuseNY - New York, Newark, Edison (Not NYC)NY - Rest of StateOHOKOR - PortlandOR - Rest of StatePA - PhiladelphiaPA - Rest of StateRISCSDTN - NashvilleTN - Rest of StateTX - AustinTX - DallasTX - HoustonTX - Rest of StateTX - San AntonioUTVA - RichmondVA - Rest of StateVTWA - Rest of StateWA - SeattleWIWVWYNational
$171215151115151414142214171318181217111712141815151318121815121612101012151513171719151417$9
$451246585
1496360
110100507588659075
1753537906045
104157102939030752465
1301001751251258535
1209045
11714667
10078
$185
$253020244423272924233224282327462024272818293333262222292027322934242826242524245138253224
$29
23
Minimum Maximum AverageState or Region Hourly Rate Hourly Rate Hourly Rate
HOME HEALTH AIDE SERVICES (BOTH PROVIDER TYPES) HOURLY RATES
25
AL
AZAR
CACO
CT DE
FL
GA
ID
ILIN
IA
KSKY
LA
ME
MDM
AM
I
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PARI
SC
SD
TN
TX
UT AK
HI
VT
VA
WA
WV
WI
WY
$58
$66
$67 $6
0
$15
$49
$47
$61
$61 $4
3
$52
$43
$32
$49$5
6
$50
$56
$57
$99
$59
$45
$55
$42
$47
$49
$53
$46
$54
$71
$81
$67
$68
$64
$59
$58 $5
4
$44
$66
$55
$72 $4
8
$29
$73
$37
$69
$73
$63
$23
$50
$102S
eatt
le$5
2
Port
land
$63
San
Fr
anci
sco
$73
Sac
ram
ento
$73
Oak
land
$97
San
Jos
e$6
5 Los
Ang
eles
$77
Las
Veg
as$7
7
Den
ver
$50
Dal
las
$34
San
Ant
onio
$29A
usti
n$5
5H
oust
on$4
0
Chi
cago
$51
Atl
anta
$43
Jack
sonv
ille
$52 Orl
ando
$57
Mia
mi
$52
Tam
pa$4
2
Cha
rlot
te$4
5
Det
riot
$53
Syr
acus
eB
uffa
loR
oche
ster
$64
Indp
ls.
$52
Ric
hmon
d$4
9
Bos
ton
$59
Bri
dgep
ort
$70
New
ark/
Edis
on $
75N
ew Y
ork
$82
Bal
tim
ore
$70
Bet
hesd
a $7
0W
ashi
ngto
n D
C $
62
Phila
delp
hia
New
Yor
k C
ity
$95
Min
neap
olis
$67
$81
Kan
sas
Cit
y$6
3
Sai
nt L
ouis
$56
Nas
hvill
e$4
6S
anta
Ann
a$7
8
San
Die
go$7
9Ph
oeni
x$4
1
ADULT DAY HEALTH CARE DAILY RATESNational Average $59
AKALARAZ - PhoenixAZ - Rest of StateCA - Los AngelesCA - OaklandCA - Rest of StateCA - SacramentoCA - Santa AnaCA - San DiegoCA - San FranciscoCA - San JoseCO - DenverCO - Rest of StateCT - BridgeportCT - Rest of StateDC - BethesdaDC - WashingtonDEFL - JacksonvilleFL - MiamiFL - OrlandoFL - Rest of StateFL - TampaGA - AtlantaGA - Rest of StateHIIAIDIL - ChicagoIL - Rest of StateIN - IndianapolisIN - Rest of StateKSKYLAMA - BostonMA - Rest of StateMD - BaltimoreMD - Rest of StateMEMI - DetroitMI - Rest of StateMN - Minneapolis
Minimum Maximum Average AverageState or Region Daily Rate Daily Rate Daily Rate Annual Rate◊
ADULT DAY HEALTH CARE DAILY RATES
$701626
n/a10505048307072485541306262554030324050491230204444304049463055283554514436
n/a353054
$1257552
n/a67
10016484
1008685
1058066
11380809070996360608159558087
12510072736080
100729565568375
n/a756383
$993243415077977373787973655063707170626752525757424356596666516152497256525954706844534767
$25,6758,377
11,05010,54613,00019,95025,31418,92319,00620,23820,54519,10016,83513,00516,28918,07318,47618,13516,01917,32113,59313,64014,84614,74210,87611,05014,68715,24917,12917,16013,15615,95913,42412,84418,75414,43313,55915,33714,00918,07817,68511,55013,72512,18417,529
26
‡ ‡
‡ ‡
◊ Assumes five days a week. ‡Represents an imputed daily rate calculated by multiplying the average hourly rate within the region by eight hours and applying a 49.7% discount.
MN - Rest of StateMO - Kansas CityMO - Rest of StateMO - St. LouisMSMTNC - CharlotteNC - Rest of StateNDNENHNJ - New YorkNJ - Rest of StateNMNV - Las VegasNV - Rest of StateNYCNY - Buffalo, Rochester, SyracuseNY - New York, Newark, Edison (Not NYC)NY - Rest of StateOHOKOR - PortlandOR - Rest of StatePA - PhiladelphiaPA - Rest of StateRISCSDTN - NashvilleTN - Rest of StateTX - AustinTX - DallasTX - HoustonTX - Rest of StateTX - San AntonioUTVA - RichmondVA - Rest of StateVTWA - Rest of StateWA - SeattleWIWVWYNational
$43563036133230273817505577
56058403540202745257658305745
814355030271325253045
n/a5045442060$5
$6365757078
1255561
1659568918450
10585
1751221511056259
101150845580823080806570608035486596
n/a6657646360
$175
$4963615643674545735558828123776995647554474863
102814664501546495543402929374955595852534260
$59
$12,80016,27315,83714,66711,29217,45611,66111,81718,99014,22515,02021,23421,0785,923
20,02018,02624,63516,67419,52913,94612,09012,44116,44826,63221,16411,84316,58812,9903,986
12,00412,77914,30011,09410,3357,5567,5459,646
12,77614,21915,27515,16613,64213,72810,96915,600
$15,236
27
Minimum Maximum Average AverageState or Region Daily Rate Daily Rate Daily Rate Annual Rate◊
ADULT DAY HEALTH CARE DAILY RATES
‡ ‡
29
AL
AZAR
CACO
CT DE
FL
GA
ID
ILIN
IA
KSKY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PARI
SC
SD
TN
TX
UT AK
HI
VT
VA
WA
WV
WI
WY
$2,5
98
$2,7
49
$2,8
26 $2,4
49
$2,1
91
$2,7
31
$2,5
33
$2,9
56
$2,0
48
$1,9
81
$2,5
28
$2,2
77$2
,440
$2,7
29$2,7
93
$2,6
69
$2,1
84
$2,4
80
$4,5
67
$3,4
43
$2,3
95
$2,8
86$2
,717
$2,9
32$2
,979
$3,1
70
$2,6
63
$2,9
55
$3,51
1
$3,7
74$2
,827
$3,1
36
$2,5
69 $3,42
6$3
,870$4
,103
$2,6
14$2
,335 $2
,468 $2
,138
$2,4
79
$2,2
36
$2,4
33
$2,9
33
$2,9
89$3
,105
$2,9
81$2
,761
$3,4
30
$4,92
1
Sea
ttle
$3,4
67
Port
land
$2,7
97
San
Fr
anci
sco
$3,6
68
Sac
ram
ento
$2,7
16
Oak
land
$3,1
97
San
Jos
e$2
,599 Lo
s A
ngel
es$3
,318
Las
Veg
as$2
,076
Den
ver
$3,3
92
Dal
las
$2,7
63
San
Ant
onio
$3,0
19Aus
tin
$2,9
98H
oust
on$2
,562
Chi
cago
$4,5
07
Atl
anta
$2,4
95
Jack
sonv
ille
$2,4
90 Orl
ando
$2,7
26
Mia
mi
$2,7
53
Tam
pa$2
,760
Cha
rlot
te$3
,066
Det
riot
$3,1
17
Syr
acus
eB
uffa
loR
oche
ster
$2,9
69
Indp
ls.
$2,4
84R
ichm
ond
$3,1
40
Bos
ton
$4,5
04
Bri
dgep
ort
$4,3
46
New
ark/
Edis
on $
3,93
8N
ew Y
ork
$4,4
42
Bal
tim
ore
$2,9
12B
ethe
sda
$3,6
93W
ashi
ngto
n D
C $
4,02
7
Phila
delp
hia
New
Yor
k C
ity
$3,3
19
Min
neap
olis
$3,6
77
$3,7
08
Kan
sas
Cit
y$3
,521
Sai
nt L
ouis
$2,8
48
Nas
hvill
e$2
,984
San
ta A
nna
$3,3
79
San
Die
go$2
,922
Phoe
nix
$2,4
73
ASSISTED LIVING FACILITY (PRIVATE ONE BEDROOM) MONTHLY RATESNational Average $3,008
AKALARAZ - PhoenixAZ - Rest of StateCA - Los AngelesCA - OaklandCA - Rest of StateCA - SacramentoCA - Santa AnaCA - San DiegoCA - San FranciscoCA - San JoseCO - DenverCO - Rest of StateCT - BridgeportCT - Rest of StateDC - BethesdaDC - WashingtonDEFL - JacksonvilleFL - MiamiFL - OrlandoFL - Rest of StateFL - TampaGA - AtlantaGA - Rest of StateHIIAIDIL - ChicagoIL - Rest of StateIN - IndianapolisIN - Rest of StateKSKYLAMA - BostonMA - Rest of StateMD - BaltimoreMD - Rest of StateMEMI - DetroitMI - Rest of StateMN - Minneapolis
$2,1001,5131,200
5501,300
920950
1,0001,6501,6001,0002,0001,3001,7501,5002,4001,6002,0003,3501,0001,5001,1501,5001,020
9251,000
8501,2001,6251,5002,0001,6801,0951,6751,9001,5252,0002,8703,0001,0001,2002,0001,200
7512,000
$6,5003,9152,8005,2504,5008,7006,0005,8005,6006,8006,2006,0004,8005,1255,9706,2005,0606,1004,8606,3903,8004,8954,5005,6004,2986,0004,0006,1164,6274,0006,6006,3005,5204,2503,9185,7004,2006,9004,6505,3504,8507,1705,5004,8008,850
$4,5672,4401,9812,4732,7613,3183,1972,9892,7163,3792,9223,6682,5993,3923,1054,3463,5113,6934,0273,7742,4902,7532,7262,4802,7602,4952,1843,4432,6142,7494,5072,9562,4842,9792,4682,7932,5284,5043,8702,9122,8274,1033,1172,5333,677
$54,80929,28023,77429,67633,13439,81538,35835,87032,59140,54335,06144,01131,18340,70337,26152,15142,12644,32048,32845,28229,88033,03232,71829,76533,12429,94326,21441,31031,36332,98554,08935,47229,80735,74929,61433,51330,33654,05246,44034,93833,92749,24037,40830,39344,125
30
9%5%4%2%4%7%3%4%4%7%7%6%
-1%6%7%2%4%4%7%5%4%6%6%
12%9%4%5%
10%7%
10%12%1%5%9%
-2%2%8%6%1%2%8%6%0%5%9%
Minimum Maximum Average Average Five-YearState or Region Monthly Rate Monthly Rate Monthly Rate Annual Rate Annual Growth*
ASSISTED LIVING FACILITY (PRIVATE ONE BEDROOM) MONTHLY RATES
*Represents the compound annual growth rate based on Genworth Cost of Care survey data from 2004-2008.
MN - Rest of StateMO - Kansas CityMO - Rest of StateMO - St. LouisMSMTNC - CharlotteNC - Rest of StateNDNENHNJ - New YorkNJ - Rest of StateNMNV - Las VegasNV - Rest of StateNYCNY - Buffalo, Rochester, SyracuseNY - New York, Newark, Edison (Not NYC)NY - Rest of StateOHOKOR - PortlandOR - Rest of StatePA - PhiladelphiaPA - Rest of StateRISCSDTN - NashvilleTN - Rest of StateTX - AustinTX - DallasTX - HoustonTX - Rest of StateTX - San AntonioUTVA - RichmondVA - Rest of StateVTWA - Rest of StateWA - SeattleWIWVWYNational
$1,3062,0351,1251,3001,2501,6621,7001,1181,7251,0091,2002,5963,7501,800
9001,9601,1252,2871,6501,500
750616
1,9501,100
9251,1251,1281,2001,6001,9001,6001,5001,4401,100
5581,8501,5251,2001,0751,2001,2301,880
7701,1551,541$550
$4,8306,5004,6205,2652,9653,9104,8005,0003,1283,8957,1706,3507,8004,9504,0004,8505,5004,2607,9805,9705,7003,7203,9954,1756,4505,3104,9503,9013,2805,8754,4284,6004,4005,6004,4004,3503,7204,2005,8504,4184,2007,5936,7715,5503,525
$8,850
$2,7313,5212,0482,8482,2772,8263,0662,3952,2362,3353,4264,4424,9212,9812,0762,9333,3192,9693,9382,9552,9322,1382,7973,4303,7082,6633,1362,6692,1912,9842,7292,9982,7632,5622,4793,0192,4333,1402,8862,5692,5983,4673,1702,7172,449
$3,008
$32,77142,24724,57434,17827,32933,90736,79528,73426,82928,01641,11753,30759,05035,77224,91135,19539,82535,63247,26035,46335,18025,65333,56941,15544,49831,95537,62632,02726,29635,81432,74435,97333,15530,74729,75136,22729,19337,67634,63330,82231,18041,60738,04332,60129,388
$36,090
31
3%15%1%9%3%8%4%4%5%2%3%5%
11%6%1%7%
-2%6%8%
11%5%1%3%9%5%7%9%8%3%8%8%3%2%3%4%9%4%7%7%1%2%4%9%7%6%6%
Minimum Maximum Average Average Five-YearState or Region Monthly Rate Monthly Rate Monthly Rate Annual Rate Annual Growth*
ASSISTED LIVING FACILITY (PRIVATE ONE BEDROOM) MONTHLY RATES
**Represents state-wide growth as city-specific data was added in 2007.
**
**
33
AL
AZAR
CACO
CT DE
FL
GA
ID
ILIN
IA
KSKY
LA
ME
MDMA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PARI
SC
SD
TN
TX
UT AK
HI
VT
VA
WA
WV
WI
WY
$193
$172
$157 $1
67
$142
$121
$187
$132
$119 $1
25
$118
$169
$149
$150$1
55
$149
$135
$183
$515
$267
$170
$159
$176
$173
$154
$183
$205
$241
$240
$197 $186
$224
$220
$238 $2
76
$208
$125
$142
$124 $1
20
$109
$125
$143
$186
$176
$176
$149
$163
$179
$306
Sea
ttle
$213
Port
land
$201
San
Fr
anci
sco
$212
Sac
ram
ento
$196
Oak
land
$202
San
Jos
e$2
03 Los
Ang
eles
$166
Las
Veg
as$1
80
Den
ver
$182
Dal
las
$118
San
Ant
onio
$127
Aus
tin
$123
Hou
ston
$120
Chi
cago
$171
Atl
anta
$162
Jack
sonv
ille
$177 O
rlan
do$1
87
Mia
mi
$213
Tam
pa$1
92
Cha
rlot
te$1
71
Det
riot
$195
Syr
acus
eB
uffa
loR
oche
ster
$263
Indp
ls.
$157
Ric
hmon
d$1
63
Bos
ton
$281
Bri
dgep
ort
$336
New
ark/
Edis
on $
332
New
Yor
k $2
64
Bal
tim
ore
$215
Bet
hesd
a $2
16W
ashi
ngto
n D
C $
203
Phila
delp
hia
New
Yor
k C
ity
$380
Min
neap
olis
$146
$241
Kan
sas
Cit
y$1
54
Sai
nt L
ouis
$146
Nas
hvill
e$1
45S
anta
Ann
a$1
91
San
Die
go$1
89Ph
oeni
x$1
60
NURSING HOME (SEMI-PRIVATE ROOM) DAILY RATESNational Average $187
AKALARAZ - PhoenixAZ - Rest of StateCA - Los AngelesCA - OaklandCA - Rest of StateCA - SacramentoCA - Santa AnaCA - San DiegoCA - San FranciscoCA - San JoseCO - DenverCO - Rest of StateCT - BridgeportCT - Rest of StateDC - BethesdaDC - WashingtonDEFL - JacksonvilleFL - MiamiFL - OrlandoFL - Rest of StateFL - TampaGA - AtlantaGA - Rest of StateHIIAIDIL - ChicagoIL - Rest of StateIN - IndianapolisIN - Rest of StateKSKYLAMA - BostonMA - Rest of StateMD - BaltimoreMD - Rest of StateMEMI - DetroitMI - Rest of StateMN - Minneapolis
$385124100128133125164135158155135123125150144235165177163170155135168150155130105195102154120
88110108
90134
96220242174153155158
99115
$850198151200210215240242235300225267250214254392358238245220199300215249239190187375183198228220194201163201137365325256278247248240199
$515149125160163166202176196191189212203182176336306216203197177213187183192162135267125172171132157154124155118281276215186208195187146
$187,81354,25845,58058,43759,32960,66073,82864,06871,38069,69268,88277,48574,02166,52764,058
122,501111,78078,71274,27271,83264,60777,90968,14766,88370,06959,06349,25697,60145,55062,60562,37448,35257,45156,12045,09656,75442,903
102,691100,57478,55067,80975,92871,20968,43753,229
34
0%3%3%2%3%3%4%5%6%6%4%1%4%6%3%6%4%5%4%
-1%4%6%4%5%5%2%0%7%4%4%7%5%3%5%4%
-1%3%4%4%5%3%4%5%4%
-1%
Minimum Maximum Average Average Five-YearState or Region Daily Rate Daily Rate Daily Rate Annual Rate Annual Growth*
NURSING HOME (SEMI-PRIVATE ROOM) DAILY RATES
*Represents the compound annual growth rate based on Genworth Cost of Care survey data from 2004-2008.
MN - Rest of StateMO - Kansas CityMO - Rest of StateMO - St. LouisMSMTNC - CharlotteNC - Rest of StateNDNENHNJ - New YorkNJ - Rest of StateNMNV - Las VegasNV - Rest of StateNYCNY - Buffalo, Rochester, SyracuseNY - New York, Newark, Edison (Not NYC)NY - Rest of StateOHOKOR - PortlandOR - Rest of StatePA - PhiladelphiaPA - Rest of StateRISCSDTN - NashvilleTN - Rest of StateTX - AustinTX - DallasTX - HoustonTX - Rest of StateTX - San AntonioUTVA - RichmondVA - Rest of StateVTWA - Rest of StateWA - SeattleWIWVWYNational
$100133
99110150135149136110100195187208135147142290201225171109
85179122175140180115117116125
8585966595
115139135185140198113130150$65
$148200141180210198187217140236295310275184201233454325485361234150220202293274279170170160180183175168152162165199187260255236263214187
$850
$121154119146169157171170125142238264240149180186380263332241173120201179241205224149142145150123118120109127143163159220193213183176167
$187
$44,06256,37743,38053,21561,52357,17262,42361,91345,75851,93186,92096,46787,48854,54165,65867,767
138,63495,892
121,04188,14562,98843,79573,27465,33587,96274,83081,74654,53351,93053,10654,70245,06742,99543,85939,79146,38452,05359,62358,19480,25870,33377,67266,72664,20660,951
$68,408
35
-1%5%3%8%7%5%3%3%2%6%2%3%2%3%5%
-2%3%4%4%3%5%4%7%5%4%5%5%5%4%4%4%5%2%4%5%5%5%4%4%4%4%3%3%0%5%4%
Minimum Maximum Average Average Five-YearState or Region Daily Rate Daily Rate Daily Rate Annual Rate Annual Growth*
NURSING HOME (SEMI-PRIVATE ROOM) DAILY RATES
**Represents state-wide growth as city-specific data was added in 2007.
**
**
37
AL
AZAR
CACO
CT DE
FL
GA
ID
ILIN
IA
KSKY
LA
ME
MDMA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PARI
SC
SD
TN
TX
UT AK
HI
VT
VA
WA
WV
WI
WY
$211
$185
$163 $1
76
$157
$141
$201
$157
$126 $1
37
$125
$174
$158
$159$1
77
$158
$143
$202
$515
$295
$183
$170
$185
$191
$188
$198
$221
$251
$210
$195
$248
$232
$259 $2
91
$233
$137
$156
$133 $1
41
$144
$139
$157
$209
$200
$206
$162
$197
$193
$328
$263
Sea
ttle
$230
Port
land
$222
San
Fr
anci
sco
$274
Sac
ram
ento
$252
Oak
land
$254
San
Jos
e$2
47 Los
Ang
eles
$209
Las
Veg
as$2
13
Den
ver
$198
Dal
las
$166
San
Ant
onio
$185
Aus
tin
$150
Hou
ston
$155
Chi
cago
$199
Atl
anta
$173
Jack
sonv
ille
$193 O
rlan
do$2
07
Mia
mi
$249
Tam
pa$2
12
Cha
rlot
te$1
84
Det
riot
$217
Syr
acus
eB
uffa
loR
oche
ster
$272
Indp
ls.
$193
Ric
hmon
d$1
89
Bos
ton
$300
Bri
dgep
ort
$362
New
ark/
Edis
on $
355
New
Yor
k $2
90
Bal
tim
ore
$230
Bet
hesd
a $2
38W
ashi
ngto
n D
C $
216
Phila
delp
hia
New
Yor
k C
ity
$398
Min
neap
olis
$171
$274
Kan
sas
Cit
y$1
75
Sai
nt L
ouis
$184
Nas
hvill
e$1
64S
anta
Ann
a$2
38
San
Die
go$2
26Ph
oeni
x$2
09
NURSING HOME (PRIVATE ROOM) DAILY RATESNational Average $209
AKALARAZ - PhoenixAZ - Rest of StateCA - Los AngelesCA - OaklandCA - Rest of StateCA - SacramentoCA - Santa AnaCA - San DiegoCA - San FranciscoCA - San JoseCO - DenverCO - Rest of StateCT - BridgeportCT - Rest of StateDC - BethesdaDC - WashingtonDEFL - JacksonvilleFL - MiamiFL - OrlandoFL - Rest of StateFL - TampaGA - AtlantaGA - Rest of StateHIIAIDIL - ChicagoIL - Rest of StateIN - IndianapolisIN - Rest of StateKSKYLAMA - BostonMA - Rest of StateMD - BaltimoreMD - Rest of StateMEMI - DetroitMI - Rest of StateMN - Minneapolis
$385130100155148130180145194185165165190160169245170187163175158150175160170135105210108157120
95163126103145104240260200160175164106132
$850203185300321360335345450360262365345230340433380280292235227350250289289207202375225218279341235338182340144375335263278326334274239
$515158137209197209254200252238226274247198206362328238216210193249207202212173143295137185199157193188133177125300291230195233217201171
$187,90257,59149,97676,20272,08476,45992,74072,91992,09486,93482,560
100,10189,97372,35975,259
131,958119,67887,00378,88776,65070,37391,02275,38773,83377,21263,17652,139
107,57549,91867,67572,56757,36270,28368,65548,65664,74045,539
109,396106,32183,80471,27385,11279,02773,48162,355
38
0%3%3%2%1%4%5%6%
10%4%2%3%2%3%5%5%4%4%2%0%4%6%4%4%5%3%0%6%4%5%7%6%2%5%2%
-1%1%2%4%4%3%5%4%3%
-2%
Minimum Maximum Average Average Five-YearState or Region Daily Rate Daily Rate Daily Rate Annual Rate Annual Growth*
NURSING HOME (PRIVATE ROOM) DAILY RATES
*Represents the compound annual growth rate based on Genworth Cost of Care survey data from 2004-2008.
MN - Rest of StateMO - Kansas CityMO - Rest of StateMO - St. LouisMSMTNC - CharlotteNC - Rest of StateNDNENHNJ - New YorkNJ - Rest of StateNMNV - Las VegasNV - Rest of StateNYCNY - Buffalo, Rochester, SyracuseNY - New York, Newark, Edison (Not NYC)NY - Rest of StateOHOKOR - PortlandOR - Rest of StatePA - PhiladelphiaPA - Rest of StateRISCSDTN - NashvilleTN - Rest of StateTX - AustinTX - DallasTX - HoustonTX - Rest of StateTX - San AntonioUTVA - RichmondVA - Rest of StateVTWA - Rest of StateWA - SeattleWIWVWYNational
$116137104127153145157148114110200198224146178162290215250177109
89191135185147195129125131130118
90115
95135130149142200145200145135158$89
$180229151255210207206237162243315450302202360277476342500377259215250221488286287175214176186240240218220250225212192284302265281227200
$850
$141175126184174163184183139156259290263162213209398272355251191141222193274221248158157164159150166155144185157189170232211230198185176
$209
$51,34263,98046,01867,24263,62359,39567,25966,83050,60356,84694,641
105,77996,00958,96577,78776,429
145,39299,378
129,57091,58869,61151,60780,84870,39599,84080,70490,64057,54557,25059,77858,13954,89060,64056,59252,59067,62457,33269,04162,09684,80276,94983,84672,27267,54964,058
$76,460
39
2%4%3%
12%6%4%3%3%1%6%2%2%2%2%5%0%3%4%4%1%3%5%7%4%4%6%6%5%5%6%6%5%3%0%5%8%3%3%3%4%4%3%2%2%3%4%
Minimum Maximum Average Average Five-YearState or Region Daily Rate Daily Rate Daily Rate Annual Rate Annual Growth*
NURSING HOME (PRIVATE ROOM) DAILY RATES
**Represents state-wide growth as city-specific data was added in 2007.
**
**
A P P E N D I X
STATE REGIONS WITH COUNTIESListed alphabetically by state abbreviation
42
State Name State or Region CountiesAlaska AK All countiesAlabama AL All countiesArkansas AR All countiesArizona AZ - Phoenix Maricopa, Pinal
AZ - Rest-of-State All remaining countiesCalifornia CA - Los Angeles Los Angeles
CA - Oakland Alameda, Contra CostaCA - Rest-of-State All remaining countiesCA - Sacramento El Dorado, Yolo, Placer, SacramentoCA - Santa Ana OrangeCA - San Diego San DiegoCA - San Francisco Marin, San Mateo, San FranciscoCA - San Jose Santa Clara, San Benito
Colorado CO - Denver Adams, Arapahoe, Broomfield, Clear Creek, Elbert, Denver, Douglas, Gilpin, Jefferson, Park
CO - Rest-of-State All remaining countiesConnecticut CT - Bridgeport Fairfield
CT - Rest-of-State All remaining countiesDistrict of Columbia DC - Bethesda Frederick, Montgomery
DC - Washington Charles County, Prince Georges and Calvert County in MD; All remaining counties in DC; Manassas City, Warren, Stafford, Spotsylvania, Fairfax, Manassas Park City, Fairfax City, Prince William, Clarke, Fredricksburg City, Falls Church City, Loudoun, Fauquier, Alexandria City Counties in VA
Delaware DE All countiesFlorida FL - Jacksonville Baker, Clay, St Johns, Nassau, Duval
FL - Miami Miami-Dade, Broward, Palm BeachFL - Orlando Osceola, Seminole, Orange, LakeFL - Rest-of-State All remaining countiesFL - Tampa Hillsborough, Pasco, Hernando, Pinellas
Georgia GA - Atlanta Haralson, Newton, Walton, Lamar, Fulton, Barrow, Pickens, DeKalb, Bartow, Gwinnett, Butts, Coweta, Paulding, Cherokee, Jasper, Clayton, Meriwether, Cobb, Douglas, Spalding, Forsyth, Carroll, Henry, Dawson, Rockdale, Pike, Fayette, and Heard
GA - Rest-of-State All remaining countiesHawaii HI All countiesIowa IA All countiesIdaho ID All counties
43
STATE REGIONS WITH COUNTIES (CONT.)
Listed alphabetically by state abbreviation
State Name State or Region CountiesIllinois IL - Chicago Kenosha, McHenry, Lake, DeKalb, Kane, Kendall, DuPage, Cook, Will,
Grundy, Lake (IN), Porter, Newton, JasperIL - Rest-of-State All remaining counties
Indiana IN - Indianapolis Brown, Shelby, Hendricks, Marion, Johnson, Hamilton, Hancock, Morgan, Boone, Putnam
IN - Rest-of-State All remaining countiesKansas KS All counties (excluding portions of state within MO-Kansas City region)Kentucky KY All countiesLouisiana LA All countiesMassachusetts MA - Boston Essex, Norfolk, Suffolk, Middlesex, Plymouth
MA - Rest-of-State All remaining countiesMaryland MD - Baltimore Harford, Anne Arundel, Queen Annes, Baltimore, Howard, Carroll
MD - Rest-of-State All remaining countiesMaine ME All countiesMichigan MI - Detroit Livingston, Lapeer, Oakland, St Clair, Wayne, Macomb
MI - Rest-of-State All remaining countiesMinnesota MN - Minneapolis Washington, Carver, Ramsey, Isanti, Hennepin, Scott, Wright, Anoka,
Sherburne, Dakota, ChisagoMN - Rest-of-State All remaining counties
Missouri MO - Kansas City Wyandotte, Miami, Johnson, Franklin, Leavenworth, Linn Counties in KS; Bates, Cass, Lafayette, Clinton, Jackson, Ray, Clay, Platte, and Caldwell Counties in MO
MO - Rest-of-State All remaining countiesMO - St. Louis St Charles, Crawford, Washington, Warren, Lincoln, Jefferson,
St Louis, FranklinMississippi MS All countiesMontana MT All countiesNorth Carolina NC - Charlotte Anson, Cabarrus, Mecklenburg, Gaston, Union
NC - Rest-of-State All remaining countiesNorth Dakota ND All countiesNebraska NE All countiesNew Hampshire NH All countiesNew Jersey NJ - New York Bergen, Union, Hunterdon, Monmouth, Somerset, Morris, Sussex,
Middlesex, Passaic, Hudson, Ocean, EssexNJ - Rest-of-State All remaining counties
New Mexico NM All countiesNevada NV - Las Vegas Clark
NV - Rest-of-State All remaining counties
STATE REGIONS WITH COUNTIES (CONT.)
Listed alphabetically by state abbreviation
New York NYC New YorkNY - Buffalo-
Rochester- Syracuse
Oswego, Niagara, Onondaga, Orleans, Monroe, Erie, Wayne, Livingston, Ontario, Madison
NY - Newark- Edison (not NYC)
Kings, Westchester, Rockland, Putnam, Queens, Bronx, Richmond, Nassau, Suffolk
NY - Rest-of-State All remaining countiesOhio OH All countiesOklahoma OK All countiesOregon OR - Portland Columbia, Washington, Multnomah, Clackamas, Yamhill Counties in OR;
Clark, Skamania Counties in WAOR - Rest-of-State All remaining counties
Pennsylvania PA - Philadelphia New Castle County in DE; Cecil County in MD; Gloucester, Salem, Burlington, Camden Counties in NJ; Philadelphia, Delaware, Bucks, Montgomery, Chester Counties in PA
PA - Rest-of-State All remaining countiesRhode Island RI All countiesSouth Carolina SC All countiesSouth Dakota SD All countiesTennessee TN - Nashville Robertson, Sumner, Trousdale, Macon, Dickson, Cheatham, Davidson,
Wilson, Smith, Hickman, Williamson, Rutherford, CannonTN - Rest-of-State All remaining counties
Texas TX - Austin Bastrop, Caldwell, Williamson, Hays, TravisTX - Dallas Ellis, Tarrant, Wise, Delta, Kaufman, Collin, Dallas, Rockwall, Johnson,
Parker, Hunt, DentonTX - Houston Liberty, Austin, San Jacinto, Montgomery, Chambers, Waller, Brazoria,
Harris, Galveston, Fort BendTX - Rest-of-State All remaining countiesTX - San Antonio Wilson, Atascosa, Bandera, Bexar, Medina, Comal, Kendall, Guadalupe
Utah UT All countiesVirginia VA - Richmond Amelia, Caroline, Charles City, Chesterfield, Cumberland, Dinwiddie,
Goochland, Hanover, Henrico, King and Queen, King William, Louisa, New Kent, Powhatan, Prince George, Sussex, Colonial Heights, Hopewell, Petersburg, Richmond
VA - Rest-of-State All remaining countiesVermont VT All countiesWashington WA - Rest-of-State All remaining counties
WA - Seattle Snohomish, Pierce, KingWisconsin WI All countiesWest Virginia WV All countiesWyoming WY All counties
44
4545
M E T H O D O L O G Y
CareScout conducted the 2008 Cost of Care survey for Genworth. CareScout, located in Wellesley, Massachusetts, has specialized in developing eldercare provider databases and helping families select appropriate providers nationwide since 1997. CareScout contacted over 40,000 providers in order to complete over 10,000 surveys of nursing homes, assisted living facilities, adult day health care, and home care providers in all 50 states and the District of Columbia between December 2007 and February 2008.
CareScout researchers conducted telephone interviews with long-term care providers within 90 regions5 across the U.S. The 90 regions cover every state including the District of Columbia. In some states more than one region was surveyed to account for more heavily populated areas. The heavily populated regions correspond geographically with their Metropolitan Statistical Areas as defined by the U.S. Census Bureau.
To determine historical trends, CareScout used Genworth Financial Cost of Care survey results dating back to 2004 to calculate compound annual growth rates.6
Home Care ProvidersAcross 90 individual regions, researchers polled, on average, at least 13% of home care providers across both Medicare certified and non-Medicare certified, licensed provider types to determine the hourly private pay rates charged for the services of a “home health aide.” Researchers also surveyed non-Medicare certified, licensed home care providers to determine the hourly private pay rates charged for the services of a “homemaker.”
On rare occasions where an area had a small sample size, a minimum of 10 providers completed surveys for each region. In many areas, the sample size was significantly larger. Researchers completed over 3,000 surveys.
Where a rate range was provided by an agency, the midpoint was used. Some agencies charge a higher hourly rate when the patient uses less than four hours of services in a week; where such a practice was employed, surveyors used the hourly rate associated with four or more hours of service in a week (that is, the rate more closely aligned with typical long-term care services utilization). All rates are weekday (Monday – Friday) rates.
Adult Day Health Care Across 90 individual regions, researchers polled more than 25% of Adult Day Health Care (ADH) facilities, and in no region did less than 10% of providers complete the survey. With limited exception, at least 10 facilities completed the survey in all regions. More than 980 providers completed the survey. The survey evaluated the daily private pay rates for sending an individual to an ADH provider for services.
NUMBER OF REGIONS AND PROVIDERS SURVEYED
Provider Type Geographic Regions
Providers Surveyed
Home Care Providers 90 > 3,000
Adult Day Health Care 90 > 980
Assisted Living Facilities
90 > 4,500
Nursing Homes 90 > 2,000
5 The 2007 Genworth Cost of Care survey included 90 regions as well; however, prior to 2007, Genworth Cost of Care surveys
included 88 regions. The two newest regions are Richmond, Virginia and Nashville, Tennessee.6 Compound annual growth rate = [(Ending Value ÷ Beginning Value)1/n] – 1; where “n” is the number of time periods.
46
There are at least three different models of ADH programs: social, medical, and combined. All models are intended to offer socialization, supervision, and structured activities designed for the individual needs of the participants at the center. Some programs may provide personal care, transportation, medication management, health-related services, intergenerational programming, social services, meals, personal assistance, and therapeutic activities.
In interpreting the survey results, where a daily range was provided that included a low-end rate range of less than $25, the high-end rate within the range was used. For example, where the ADH provider charged between zero and $40 “depending upon income level,” CareScout used the $40/day rate. Where the ADH provider charged between $25 and $40, for example, CareScout used the midpoint of the range. This method proves conservative in that it avoids underestimating the private pay cost of ADH due to the “$0.0” rates for people who cannot afford the care. Where three rates were provided for three levels of care, CareScout used the middle care level rate. Where an hourly range was provided, CareScout used the average of the range. All rates exclude transportation fees.
This is the first Genworth-published ADH survey and therefore a historical trend analysis is not available.
Assisted Living FacilitiesAcross 90 individual regions, researchers polled approximately 11% of the licensed facilities and, with limited exception completed surveys with at least 10 facilities per region. In many areas, the sample size was significantly larger. More than 4,500 providers completed the survey.
Unlike nursing homes, there is no national, uniform regulatory protocol for assisted living facilities. As a consequence, states
have instituted licensing standards that vary from state to state. CareScout’s researchers interviewed assisted living facilities, which go by a number of different names including “Residential Care Facility” which were licensed according to the licensure requirements of the state in which the assisted living facility was located.
The survey evaluated the monthly base private pay rate for a one-bedroom unit in an assisted living facility. Where a rate range was provided, CareScout calculated and used the average of the high and low range rates. Researchers also determined whether a non-refundable community or entrance fee was typically charged by a facility. While community and entrance fee rates are not included in the average monthly assisted living rate calculations, 33% of the assisted living facilities surveyed charged a one-time, non-refundable fee ranging from $35 to $118,180 with a national average one-time fee of $2,316.
Nursing HomesAcross 90 individual regions, researchers polled at least 13% of all certified and licensed nursing homes and in no region did less than 10% of providers complete the survey. With limited exception, at least 10 facilities completed the survey in all regions. In many areas, the sample size was significantly larger. More than 2,000 providers completed the survey.
The survey evaluated the daily rate for a private room (single occupant) and a semi-private room (double occupancy) in Medicare certified nursing facilities. Medicare certified nursing homes represent more than 90% of all nursing homes in the U.S. Rates for transitional care units (typically hospital-based certified nursing homes) were not included. The daily room charge usually includes services beyond rent such as three meals a day, laundry, sundries, basic nurse supervision, and generic-brand, non-prescription pharmaceuticals.
ABOUT CARESCOUTHeadquartered in Wellesley, Massachusetts, CareScout helps Americans in every state find quality care providers at preferred rates. Large employers, insurance companies, risk underwriters and families rely on CareScout’s proprietary quality of care ratings systems, discount network and database of more than 90,000 nursing homes, assisted living facilities and home care agencies.
ABOUT GENWORTH FINANCIALGenworth Financial (NYSE: GNW) is a leading insurance holding company, serving the lifestyle protection, retirement income, investment and mortgage insurance needs of more than 15 million customers, with operations in 24 countries, including the U.S., Canada, Australia, the U.K. and more than a dozen other European countries. The Long Term Care Insurance business of Genworth Financial is a leading provider of long term care insurance in the United States. For more information, visit genworth.com/CostofCare.
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