Long Term Care

The Rising Costs of Caring

Genworth’s 15th Annual Cost of Care Survey Shows Continuing Rise in Long Term Care Costs

Long term care support services have outpaced the 2.1% U.S. inflation rate1 from 2017-2018. Over 15 years, all care settings have seen increases in cost ranging from 19% to 67%.

RICHMOND, Va., Oct. 16, 2018 — Living longer has its advantages, but it also increases the likelihood of needing long term care2, a proposition that is getting more costly with every passing year. According to the 15th annual Genworth Cost of Care Survey released today, the blended annual median cost of long term care support services has increased an average of 3 percent from 2017 to 2018, with some care categories exceeding two to three times the 2.1 percent U.S. inflation rate.

The annual median cost of care now ranges from $18,720 for adult day care services to $100,375 for a private room in a nursing home. Between 2017 and 2018, assisted living facilities increased the most at 6.67 percent, followed by a semi-private room in a nursing home at 4.11 percent. Based on the five-year compound average growth rate (CAGR), the largest increase occurred within the nursing home facilities category at over 3 percent.

Topline Results from 2018 Cost of Care Survey

CategoryYear Over Year IncreaseHourlyDailyMonthlyAnnually5 YR CAGR
Assisted Living Facilities*6.67%$132$4,000$48,0003.00%
Nursing Home – Semi Private4.11%$245$7,441$89,2973.44%
Nursing Home – Private3.00%$275$8,365$100,3753.64%
Adult Day Care2.86%$72$1,560$18,7202.07%
Home Health Aide2.33%$22$138$4,195$50,3362.51%
Homemaker Services0.24%$21$132$4,004$48,0482.85%
*Referred to as Residential Care Facilities in California


“For the past 15 years, Genworth has been the leader in helping families prepare for the potential of needing long term care by providing our annual Cost of Care Survey and underscoring the importance of planning ahead for these costs,” said David O’Leary, President and CEO of Genworth’s U.S. Life Insurance division. “This year’s study shows cost increases across all care settings, costs that affect the economic reality for individuals, families, employers and communities. We strongly advocate people at all stages of life begin planning now for the very real possibility of needing care as they grow older. Starting a conversation about potential long term care needs and the issues of aging isn’t always easy. But honest conversations are essential to making sure that people can live life on their own terms as they grow older.”

“The year-over-year cost of any kind of long term care is rising quickly, with no sign of slowing down,” said Gordon Saunders, Senior Brand Marketing Manager at Genworth, who manages the Cost of Care Survey. “Increasingly, people and their loved ones are finding that the cost of long term care services is staggering and often they are unaware of it in advance. Our mission is to help people who need care age on their own terms and live their lives the way they want. We do that by providing research and resources that can help educate people about the cost associated with long term care well before they need it. We hope these resources will encourage them to start meaningful conversations with family and friends about their care because to live well, we all must plan well.”

Why Costs Are Rising

Several factors3 are driving up the cost of care across all care options, including home care, which has increased significantly over the past two to three years after remaining flat for some time4:

  • The shortage of skilled workers. It’s a simple case of supply and demand: With demand outpacing the supply of workers, caregivers know they can demand more and companies are willing to pay more for the best workers. Also, fewer caregivers mean more overtime, which means consumers pay more for care.
  • Higher minimum wages and changes in overtime pay rules.Difficulty attracting and retaining qualified workers.
  • Business constraints facing home care agencies, such as differing laws on certification of caregivers, compliance obligations, razor-thin margins, balancing care quality and costs.
  • The increasing incidence of Alzheimer’s Disease and dementia, which is increasing the need for more specialized care – and higher hourly wages.
  • Aging Americans needing more specialized care, the result of waiting too long to receive professional care. By then, the diagnosis has progressed beyond the need for basic care to very specialized and intensive levels of care, which is more expensive.

“As the costs of labor and facilities rise, finding affordable care options becomes much harder for caregivers and families nationwide,” said Jennifer Johnson R.N., Clinical Director of CareScout®, which conducts the Cost of Care Survey. “Most people prefer to receive care in their homes, which poses the unique challenge of finding enough caregivers to meet those needs. Simultaneously, at-home care remains the most affordable option for patients. With the continuing rise of care costs for both in the home and in care facilities, the burden increasingly falls on family and friends to find the means to afford care for their loved ones.”

Most people prefer to receive care in their homes, which poses the unique challenge of finding enough caregivers to meet those needs. Simultaneously, at-home care remains the most affordable option for patients...

Findings Over 15-Year Life of Study

For 15 years, Genworth has been studying the cost of care through its annual survey, providing families with the information necessary to make plans and decisions for how they want to receive and pay for care as they grow older.
During the 15 years of the Cost of Care Survey, the cost of long term care in assisted living facilities has increased 67 percent and private nursing home rooms have increased 54 percent5. By comparison, a private nursing home room now costs 1.6 times the national median annual household income, which was $62,685 in August 20186. While facility costs have trended upwards, the annual cost of in-home care has remained relatively flat over the life of the study. It is only in recent years that home care costs have risen at a higher pace than previous years, increasing 19 percent for a home aide and 26 percent for homemaker services since 2004.

“For many families, the cost of long term care is a significant challenge that is already difficult to talk about and our Cost of Care research continues to show that care across the nation isn’t becoming more affordable or accessible,” said Saunders. “The key to being able to handle a care event is to plan for the future. We’ve had years of experience helping people to make decisions about their future care and we want everyone to have the resources and information to be able to plan for their best future so they can live well.”

Resources for Understanding Care Financing Options

We believe people of all ages should understand the opportunities and challenges associated with living longer in today’s world. Planning well now expands the choices available for care later as we grow older. People of all ages can take advantage of the following resources to educate themselves about the cost of care and alternative funding options:

  • Visit https://www.genworth.com/aging-and-you/finances/cost-of-care.html to learn more about the total cost of long term care in your area and how costs have changed over time.
  • Download Genworth’s Cost of Care App from iTunes.
  • To explore long term care financing options, please visit genworth.com/longtermcare
  • Beyond traditional insurance products, an underwritten single premium immediate need annuity can be purchased by older, less healthy Americans or their families to provide a guaranteed lifetime source of income that can be used for any purpose including, to pay for care or other expenses. Learn more here: www.genworth.com/products/immediate-need-annuity.html.




[1] United States Department of Labor, Bureau of Labor Statistics, accessed 10/03/18.
2Recent research suggests that most Americans turning age 65 will need long-term care services at some point in their lives. Source:   2018 U.S. Department of Health and Human Services (www.longtermcare.gov). November 14, 2017
3Online discussions with long term care providers across all care settings in key geographical locations, conducted for the 15th anniversary of Genworth’s Cost of Care Survey by J&K Solutions, LLC, September 2018.
4Genworth’s Cost of Care Survey, conducted by CareScout®, 2016-18.
5 Genworth’s Cost of Care Surveys, conducted by CareScout®, 2004-18.
6 Household Income Trends, August 2018, by Gordon Green and John Coder, Sentier Research, LLC, September 2018.


About Genworth’s 2018 Cost of Care Survey
Genworth’s annual Cost of Care Survey, one of the most comprehensive studies of its kind, contacted more than 49,000 long term care providers nationwide to complete 15,000 surveys for nursing homes, assisted living facilities, adult day health facilities and home care providers. The survey includes 440 regions based on the Metropolitan Statistical Areas, defined by the Office of Management and Budget, and include approximately 85 percent of the U.S. population. Genworth annually surveys the cost of long term care across the U.S. to help Americans plan for the potential cost associated with the various types of long term care available in their preferred location and setting. The survey also provides state-specific cost of care data for all 50 states and Washington, D.C., and comparison to the national median. Genworth’s 2018 Cost of Care findings also highlight the 15 year tends in care costs as measured in the Cost of Care data over the last 15 years. CareScout®, part of the Genworth Financial family of companies, has conducted the survey since 2004. Located in Waltham, Massachusetts, CareScout has specialized in helping families find long term care providers nationwide since 1997.
About Genworth Financial
Genworth Financial, Inc. (NYSE: GNW) is a Fortune 500 insurance holding company committed to helping families achieve the dream of homeownership and address the financial challenges of aging through its leadership positions in mortgage insurance and long term care insurance. Headquartered in Richmond, Virginia, Genworth traces its roots back to 1871 and became a public company in 2004. For more information, visit genworth.com.
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