genworth 2010 cost of care survey - long term care & life … · home care providers, adult day...

G e n wo rt h 2 0 1 0 C o s t o f C a r e s u rv e ya p r i l 2 0 10

Home Care Providers, Adult Day Health Care Facilities, Assisted Living Facilities and Nursing Homes

37522 04/06/10

Genworth 2010 Cost of Care Survey 1

introduction

I N T R O D U C T I O N

As the economy recovers from one of the most challenging periods in history, one clear trend has emerged: Americans are getting back to basics. While families begin to rebuild their nest eggs and plans for a secure financial future, families now have a unique opportunity to address one of the most basic issues of all – preparing for the possibility that they will need long term care.

Nearly two-thirds of Americans over age 65 will need long term care at home or through adult day health care, or care in an assisted living facility or nursing home. And while most people think of long term care as impacting only those in their senior years, 40 percent of people currently receiving long term care services are ages 18 to 64.1

Unfortunately, long term care expenses can deplete a family’s hard-earned savings. Early conversations about care preferences and expectations – and how to fund costs and protect assets – before the need arises can help families address this issue.

A January 2010 Age Wave/Harris Interactive survey sponsored by the Genworth Financial companies (Genworth) revealed that medical expenses not covered by insurance are the top retirement concern of people age 55 and older.

Although the issue is currently a top concern, many are still not engaging in open conversa-tions about potential long term care expenses, or the type of long term care they would prefer, or may need in the future. In fact, more than 90 percent of those surveyed have not talked about critical long term care issues with their spouse/partner, aging parents or adult children.2

For the seventh year, we have surveyed the cost of long term care across the U.S. to help Americans prudently plan for the potential cost of this type of care in their preferred location and setting. The most comprehensive study of its kind, Genworth’s 2010 Cost of Care Survey, conducted by CareScout®, covers nearly 13,000 long term care providers in 436 regions nationwide.

Genworth is now in our 35th year as a provider of long term care insurance, educating American families, financial professionals, policymakers and others about the need to plan for long term care.

In addition to reviewing this Cost of Care Survey report, we invite you to get even more information online at genworth.com/costofcare and our “Let’s Talk” Web site, caringtalk.com, as important tools to plan for the future.


c o n t e n t s

C O N T e N T s

Understanding Long Term Care

Summary of 2010 Survey Findings .............................................................................................4

Emerging Trends and Findings ....................................................................................................5

Get More Details .........................................................................................................................6

Long Term Care Overview ..........................................................................................................8

Long Term Care Financing Options .............................................................................................9

Cost of Care Maps

Homemaker Services (Licensed) .............................................................................................14

Home Health Aide Services (Licensed) .....................................................................................15

Adult Day Health Care ..............................................................................................................16

Assisted Living Facility (One Bedroom/Single Occupancy) .......................................................17

Nursing Home (Semi-Private Room) ........................................................................................18

Nursing Home (Private Room) ..................................................................................................19

National, State and Major Metro Cost of Care Tables ........................................................20

Homemaker Services (Licensed)

Home Health Aide Services (Licensed)

Adult Day Health Care

Assisted Living Facility (One Bedroom/Single Occupancy)

Nursing Home (Semi-Private Room)

Nursing Home (Private Room)

Appendix

Methodology .............................................................................................................................88

End Notes ..................................................................................................................................91

Genworth 2010 Cost of Care Survey4

s u m m a r y

HoMeHomemaker Services (Licensed) Provides “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.

Home Health Aide Services (Licensed) Provides “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.

Adult Day Health CareProvides social and other related support services in a community-based, protective setting during any part of a day, but less than 24-hour care.

Assisted Living Facility (one Bedroom/Single occupancy) 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.

Nursing Home (Semi-Private Room)Provides skilled nursing care 24 hours a day.

Nursing Home (Private Room)Provides skilled nursing care 24 hours a day.

s U M M A R Y O F 2 0 1 0 F I N D I N G s

NATIONAL MEDIAN HOURLy

RATE

$18

NATIONAL MEDIAN

HOURLy RATE

$19

INCREASE OvER 2009

12.0%

NATIONAL MEDIAN

MONTHLy RATE

$3,185

NATIONAL MEDIAN

DAILy RATE

$185

NATIONAL MEDIAN

DAILy RATE

$206

FIvE-yEAR ANNUAL GROWTH

2.4%3

INCREASE OvER 2009

2.7%

INCREASE OvER 2009

12.0%6

INCREASE OvER 2009

5.7%

INCREASE OvER 2009

5.1%

INCREASE OvER 2009

3.0%


1.7%4

NATIONAL MEDIAN

DAILy RATE

$60


6.7%7


4.6%8


4.5%9


N/A5


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

For the seventh consecu-tive year, Genworth has surveyed long term care service providers across the country. This year, Genworth expanded the survey to 436 regions, to include all Metropolitan

Statistical Areas defined for the 2010 U.S. census – offering an additional 105 regions to our 2009 survey.

Looking back at the past five years of survey results, Genworth recognizes emerging trends across the long term care services landscape. Overall, the cost of care among facility-based providers has steadily increased, while “non-skilled care”-related home care costs have remained relatively flat. For example, in 2005 the median annual rate for a private nursing home room was $60,225, compared with the 2010 median annual rate of $75,190. This means that Americans can expect to pay approximately $14,965 more per year today for a nursing home than they had to pay in 2005. This increase represents a 4.5 percent compound annual growth rate over that period.

In contrast to facility-based care, rates charged by home care providers for “non-skilled” services have remained relatively flat over the past five years. For example, whereas the national hourly private pay median rate charged by a licensed home health agency for a home health aide was $17.50 in 2005, the 2010 hourly rate has only slowly crept up to $19. The historical compound annual growth rate for this type of care service has been only 1.7 percent over a five-year period. Home care rates have remained flat in part because of increased competition

among agencies and the availability of unskilled labor, and by avoiding costs associated with maintaining stand-alone health care facilities.

The trend in pricing among Assisted Living Facilities has changed considerably. Over the last decade, Assisted Living Facilities have continued to adapt to the wide range of care needs presented by our growing elder population. Many facilities now provide services to residents who need continual care or supervision – while still providing a lower level of care to healthier individuals. As the range of services becomes broader, so does the range of monthly costs. In 2010, we asked our assisted living survey participants to provide their monthly rates for both the lowest level of care and the highest level of care. Our aggregated survey results use the average of these ranges. We feel this average is the most reliable indicator of the true cost of assisted living care in the surveyed

regions. Given this change in methodology, a comparison to survey results from five years would overstate the compound annual growth rate. However, we do not see any indication in the base data that the increase rate for Assisted Living Facility care would be dramatically different from the 4.5 percent compound annual growth rate for nursing homes.

t r e n d s


d e t a i l s

G e T M O R e D e TA I L s

Our Web site – genworth.com/costofcare – provides much more information about the cost of care. visit our site to:

• Find specific cost information that matters to you – by state and care type for 436 cities and regions across the country

• Compare costs across four locations – for instance, where you currently live, where your parents live, and where you would like to retire

• Calculate the cost of care 10, 15, 20, 25 and 30 years out, so you can plan well for your future

• Print or email your comparisons and calculations to family, friends and your financial professional

• Download the survey report, complete with executive summary, and overviews of long term care services and financing options


d e t a i l s

Let’s Talk: Conversations That Make a Difference

Initiating the conversation around long term care planning can be awkward. It can be difficult to talk to parents, spouses or partners, children and other loved ones about preparing for long term care needs and what the future may hold. By talking now and taking charge, you can be prepared for life’s twists and turns. Families are in much better emotional shape to discuss long term care related plan-ning before there’s an urgent need.

The information and tools offered on caringtalk.com will help you prepare for productive conversations with those you care about. Ways to break the ice, guidance from experts, and helpful tips and insights are all available to provide families with the resources, education and motivation to successfully plan for potential long term care needs.

visit caringtalk.com to learn more.


o v e r v i e w

Two-thirds of people over age 65 will need long term care in their lifetime.10 Long term care is the type of care you may need if you have a prolonged physical illness, disability or severe cognitive impairment

(such as Alzheimer’s disease) that keeps you from living independently. These limitations may prevent you from carrying out basic self-care tasks – such as bathing, dressing or eating, called Activities of Daily Living (ADLs).

Today, consumers have more choices than ever when planning for potential long term care needs. Here is an overview of available long term care options:

Homemaker ServicesThis service makes it possible for people to live in their own homes or to return to their homes by helping complete household tasks they can’t manage alone. Homemaker services aides may clean 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.

Adult Day Health Care (ADH)Adult Day Health Care 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

around-the-clock care. There are a variety of “models” of Adult Day Health Care programs. All models are intended to offer socialization, supervision and structured activities designed for the individual needs of the participants at the center. Some programs also may provide personal care, transportation, medication management, health-related services, intergen-erational programming, social services, meals, personal assistance and therapeutic activities.

Assisted Living Facilities (ALF)Assisted living facilities (referred to as Residential Care Facilities in California) 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 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 CareNursing homes are for those people who may need a higher level of supervision and care than provided in an assisted living facility. They offer residents personal care, room and board, super-vision, medication, therapies and rehabilitation, as well as skilled nursing care, 24 hours a day.

L O N G T e R M C A R e O V e R V I e W

Most consumers prefer to receive long term care in their homes. In our experience, 73% of Genworth’s initial benefit claims are for home health care.11


f i n a n c i n g

L O N G T e R M C A R e F I N A N C I N G O P T I O N s

Another factor to con-sider in planning for long term care is, of course, how to pay for it. With median costs ranging from $38,220 to $75,190 per year depending on the type of care needed,

finding a way to pay for long term care can be a challenge for many people. As an example, assuming the average stay in a nursing home is three years, costs can easily surpass $225,000 for the entire long term care event.

People generally think there are four basic ways to pay for long term care: Medicare, Medicaid or private pay – either out of pocket or through long term care insurance. Those who are thinking of relying on Medicare or Medicaid to provide long term care services should be well informed about both the advan-tages and limitations of these programs.

MedicareGenerally, Medicare is the federal program that provides 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. 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, for days 21-100, Medicare requires a co-payment. To help cover the co-payment, many seniors also have a Medicare supplement insurance policy. In general, once Medicare stops paying for care, the supple-ment payment also will end.

MedicaidMedicaid (referred to as Medi-Cal in California) 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 also are restrictions on transferring assets to others in order to qualify for Medicaid.

Self-Insure (or out-of-Pocket Payment)As you page through this report, you can look up the costs of various types of care in your state – private and semi-private nursing home; assisted living facility; home health aides and homemaker services. These costs can give

“Contrary to what most Americans believe and expect, Medicare does not provide meaningful coverage for long term care. And, help with Medicaid – the largest payer of long term care – requires individuals to spend down their income and assets to a level of impoverishment.”

Opening Statement of Senator John D. Rockefeller Iv, Chairman, Subcommittee on Health Care, to the

Senate Finance Health Subcommittee, March 25, 2009


f i n a n c i n g

you a good idea of how much money you or your family would need if you or a loved one requires long term care.

Long Term Care Insurance Long term care insurance helps pay for your care and can help protect your assets by reimbursing you for covered expenses up to the amounts set forth in your policy. Depending upon the type of policy you choose, this insurance can reimburse you for a wide variety of home, community-based and facility care services, and can offer you care options that may not be covered through government programs.

Many states participate in the Long Term Care Insurance Partnership Program (“Partner-ship Program”). The Partnership Program is designed to encourage individuals to plan for their long term care needs by allowing them to protect more assets than would otherwise be allowed under state Medicaid eligibility requirements. As a result, policyholders are able to protect assets that they would otherwise have to spend down prior to qualifying for Medicaid benefits. Individuals can participate in their state’s Partnership

Program by owning a long term care insurance policy that meets the requirements for the Partnership Program. Policies qualifying under the Partnership Program generally do not cost more than non-qualified policies with similar benefits.

G e N W O R T h 2 0 1 0C O s T O F C A R e M A P s

G e N W O R T h 2 0 1 0C O s T O F C A R e N AT I O N A L , s TAT e A N D M A j O R M e T R O D ATA TA b L e s


q U I C k F I N D

s t a t e s

Maps by Category of Care .................................................................................................14-19

National and State Data Tables

USA ...........................................................................................................................................20

A-I .........................................................................................................................................21-36

K-N ........................................................................................................................................37-55

O-W ......................................................................................................................................56-72

Major Metro Data Tables ........................................................................................................73


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0

$86,

461

$82,

125

$84,

571

$72,

818

US

A $

75,1

90

*Num

bers

exc

lude

Pue

rto

Ric

o

m a P s


u s a

USA

U s A

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1

Five-year Annual Growth2

HoMeMAkeR SeRvICeS HoURLy RATeS (LICENSED)

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3


HoMe HeALTH AIDe SeRvICeS HoURLy RATeS (LICENSED)

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4


ADULT DAy HeALTH CARe DAILy RATeS

Minimum Monthly Rate

Maximum Monthly Rate

Median Monthly Rate

Median Annual Rate5


ASSISTeD LIvINg FACILITy MoNTHLy RATeS (ONE BEDROOM/SINGLE OCCUPANCy)

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6


NURSINg HoMe DAILy RATeS (SEMI-PRIvATE ROOM)

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6


NURSINg HoMe DAILy RATeS (PRIvATE ROOM)

$10 $38 $18 $41,184 2%

$12 $38 $19 $43,472 2%

$12 $202 $60 $15,600 N/A

$700 $11,550 $3,185 $38,220 7%

$80 $870 $185 $67,525 5%

$90 $876 $206 $75,190 5%


A L A b A M A

a l

A-I

$13 $22 $15 $34,320 4%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$13 $22 $15 $34,320 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$15 $58 $25 $6,500 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,675 $5,175 $2,820 $33,840 10%



Median Monthly Rate

Median Annual Rate5



$94 $204 $160 $58,400 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$104 $281 $175 $63,875 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




a K

A-I

A L A s k A

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$24 $33 $25 $57,200 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$3,930 $8,100 $5,500 $66,000 6%



Median Monthly Rate

Median Annual Rate5



Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$452 $876 $554 $202,210 3%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$23 $29 $25 $58,298 4%

$66 $123 $88 $22,994 N/A

$452 $870 $599 $218,453 4%


a Z

A-I

A R I Z O N A

$15 $25 $19 $43,472 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$15 $25 $20 $45,760 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$62 $88 $78 $20,150 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4





Median Monthly Rate

Median Annual Rate5



$140 $238 $175 $63,875 3%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$162 $390 $219 $79,840 4%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$1,300 $6,000 $3,050 $36,600 5%


a r

A-I

A R k A N s A s

$13 $19 $16 $36,608 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$13 $20 $17 $37,752 4%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$40 $64 $64 $16,640 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,200 $3,900 $2,560 $30,720 11%



Median Monthly Rate

Median Annual Rate5



$109 $387 $139 $50,735 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$120 $285 $155 $56,575 6%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




c a

C A L I F O R N I A

$11 $30 $20 $45,646 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$12 $36 $21 $46,904 1%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$43 $160 $77 $20,020 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,350 $8,550 $3,500 $42,000 7%



Median Monthly Rate

Median Annual Rate5



$115 $460 $200 $73,000 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$145 $600 $239 $87,345 4%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



A-I


c o

A-I

C O L O R A D O

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4





Median Monthly Rate

Median Annual Rate5



Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$12 $25 $20 $45,760 2%

$12 $26 $21 $48,574 2%

$44 $144 $56 $14,430 N/A

$1,900 $6,150 $3,325 $39,900 7%

$146 $226 $198 $72,234 6%

$157 $400 $218 $79,570 4%


Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1


Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3


Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4




Median Monthly Rate

Median Annual Rate5


Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6


Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6


c t

A-I

C O N N e C T I C U T

$13 $27 $19 $42,328 1%


$14 $28 $22 $49,192 -1%


$68 $124 $76 $19,630 N/A


$2,000 $9,650 $4,430 $53,160 8%


$160 $498 $346 $126,108 5%


$175 $598 $376 $137,058 5%



d e

A-I

D e L AWA R e

$20 $21 $20 $45,760 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$20 $22 $21 $48,048 1%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$60 $104 $80 $20,800 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$2,850 $6,205 $4,890 $58,680 9%



Median Monthly Rate

Median Annual Rate5



$168 $250 $227 $82,855 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$211 $266 $244 $89,060 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




d c

A-I

D I s T R I C T O F C O L U M b I A

$18 $19 $19 $43,129 N/A

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$18 $21 $19 $44,570 N/A

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$61 $105 $83 $21,580 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$3,700 $7,450 $4,313 $51,750 N/A



Median Monthly Rate

Median Annual Rate5



N/A N/A N/A N/A N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$360 $360 $360 $131,400 18%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




f l

A-I

F L O R I D A

$10 $26 $17 $37,752 1%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$12 $26 $18 $41,710 1%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$35 $96 $55 $14,300 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$800 $5,694 $2,550 $30,600 5%



Median Monthly Rate

Median Annual Rate5



$150 $325 $205 $74,825 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$166 $420 $225 $82,125 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




g a

A-I

†Less than 0.5% growth or decline.

G e O R G I A

$13 $20 $17 $38,324 1%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$13 $24 $17 $38,896 1%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$24 $89 $55 $14,300 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$900 $5,525 $2,350 $28,200 †



Median Monthly Rate

Median Annual Rate5



$110 $225 $155 $56,575 4%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$118 $270 $170 $61,926 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




H i

A-I

h AWA I I

$15 $21 $20 $45,188 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$14 $26 $23 $51,480 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$42 $87 $65 $16,900 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,500 $6,800 $3,750 $45,000 †



Median Monthly Rate

Median Annual Rate5



$210 $688 $310 $113,059 6%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$223 $450 $315 $114,975 4%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6





A-I

i d

I D A h O

$13 $20 $17 $38,896 4%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$15 $23 $17 $38,896 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$23 $120 $80 $20,800 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4

Five-year Annual Growthv


$1,750 $4,400 $3,283 $39,390 7%



Median Monthly Rate

Median Annual Rate5



$150 $240 $189 $68,985 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$158 $250 $206 $75,190 6%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




i l

A-I

I L L I N O I s

$16 $28 $19 $43,358 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$16 $29 $20 $45,760 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$48 $81 $62 $16,120 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,228 $8,525 $3,585 $43,020 5%



Median Monthly Rate

Median Annual Rate5



$97 $300 $152 $55,480 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$101 $350 $174 $63,601 4%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




A-I

i n

I N D I A N A

$14 $21 $18 $41,184 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$16 $27 $19 $43,472 1%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$40 $96 $63 $16,458 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,825 $6,650 $3,625 $43,500 11%



Median Monthly Rate

Median Annual Rate5



$115 $263 $174 $63,375 6%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$145 $372 $207 $75,606 6%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




i a

A-I

I O WA

$13 $36 $20 $45,760 5%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$15 $36 $20 $46,858 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$32 $80 $51 $13,169 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,200 $5,400 $3,171 $38,049 9%



Median Monthly Rate

Median Annual Rate5



$110 $250 $143 $52,195 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$120 $250 $155 $56,393 4%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




K-N

K s

k A N s A s

$15 $21 $18 $40,612 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$15 $22 $18 $41,481 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$45 $80 $65 $16,900 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$2,240 $6,500 $3,400 $40,800 8%



Median Monthly Rate

Median Annual Rate5



$114 $320 $143 $52,013 6%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$122 $262 $155 $56,575 6%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




K-N

K y

k e N T U C k Y

$12 $20 $16 $ 36,608 1%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$12 $20 $17 $38,896 -1%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$38 $96 $62 $16,120 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,250 $5,500 $2,557 $30,678 7%



Median Monthly Rate

Median Annual Rate5



$135 $247 $171 $62,415 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$140 $281 $190 $69,350 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




K-N

l a

L O U I s I A N A

$13 $20 $15 $33,176 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$13 $20 $16 $35,464 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$38 $70 $57 $14,820 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,825 $5,415 $3,027 $36,324 6%



Median Monthly Rate

Median Annual Rate5



$99 $210 $130 $47,556 6%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$100 $290 $140 $51,056 6%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




K-N

m e

M A I N e

$15 $23 $20 $45,760 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$17 $27 $23 $52,624 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$68 $120 $96 $24,960 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,425 $10,260 $4,350 $52,200 5%



Median Monthly Rate

Median Annual Rate5



$190 $345 $253 $92,206 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$200 $360 $278 $101,302 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




m d

M A R Y L A N D

$14 $24 $19 $43,472 4%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$15 $24 $20 $45,760 4%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$55 $96 $74 $19,240 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$950 $7,000 $3,175 $38,100 7%



Median Monthly Rate

Median Annual Rate5



$165 $294 $220 $80,300 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$180 $368 $229 $83,585 3%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



K-N


K-N

m a

M A s s A C h U s e T T s

$17 $28 $23 $51,480 4%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$19 $29 $24 $54,912 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$40 $81 $59 $15,210 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$2,200 $6,988 $4,550 $54,600 5%



Median Monthly Rate

Median Annual Rate5



$190 $725 $298 $108,770 4%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$204 $730 $321 $116,983 3%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




K-N

m i

M I C h I G A N

$13 $28 $19 $42,328 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$13 $28 $19 $43,197 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$30 $148 $64 $16,640 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$788 $6,000 $2,600 $31,200 12%



Median Monthly Rate

Median Annual Rate5



$145 $290 $207 $75,555 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$163 $390 $225 $82,125 4%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




K-N

m n

M I N N e s O TA

$16 $27 $22 $50,336 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$18 $38 $25 $57,200 1%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$45 $117 $72 $18,590 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$700 $10,500 $2,818 $33,817 4%



Median Monthly Rate

Median Annual Rate5



$140 $403 $183 $66,795 7%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$154 $416 $204 $74,460 8%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




K-N

m s

M I s s I s s I P P I

$13 $19 $16 $35,464 4%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$13 $26 $16 $36,608 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$13 $125 $64 $16,640 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,350 $5,670 $2,700 $32,400 6%



Median Monthly Rate

Median Annual Rate5



$140 $220 $178 $64,970 6%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$155 $260 $186 $68,010 6%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




K-N

m o

M I s s O U R I

$15 $24 $18 $41,184 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$15 $25 $18 $41,184 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$55 $88 $70 $18,252 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$850 $6,690 $2,245 $26,940 1%



Median Monthly Rate

Median Annual Rate5



$103 $192 $131 $47,815 3%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$109 $272 $140 $51,191 3%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




K-N

m t

M O N TA N A

$16 $23 $19 $43,838 5%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$17 $23 $20 $45,028 6%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$35 $108 $67 $17,306 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,900 $4,500 $2,925 $35,100 7%



Median Monthly Rate

Median Annual Rate5



$156 $212 $172 $62,634 6%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$165 $255 $186 $67,832 7%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




K-N

n e

N e b R A s k A

$15 $22 $17 $38,896 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$18 $22 $19 $43,472 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$17 $120 $45 $11,700 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,050 $6,990 $3,390 $40,680 9%



Median Monthly Rate

Median Annual Rate5



$130 $273 $170 $62,050 8%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$135 $298 $183 $66,613 6%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




K-N

n v

N e VA D A

$15 $24 $20 $45,760 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$17 $24 $21 $47,476 4%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$58 $90 $65 $16,900 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,220 $4,945 $2,750 $33,000 6%



Median Monthly Rate

Median Annual Rate5



$155 $225 $194 $70,810 3%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$185 $267 $211 $76,833 3%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




K-N

n H

N e W h A M P s h I R e

$18 $27 $22 $49,764 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$19 $27 $24 $53,768 1%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$51 $88 $60 $15,600 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$2,150 $11,550 $3,600 $43,200 4%



Median Monthly Rate

Median Annual Rate5



$197 $315 $254 $92,710 4%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$240 $404 $269 $98,185 3%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




K-N

n J

N e W j e R s e Y

$14 $38 $19 $43,358 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$15 $38 $20 $46,812 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$70 $105 $80 $20,800 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$3,300 $6,870 $4,775 $57,300 5%



Median Monthly Rate

Median Annual Rate5



$220 $379 $277 $100,923 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$220 $420 $301 $109,865 4%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




K-N

n m

N e W M e X I C O

$15 $21 $18 $41,184 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$14 $23 $19 $42,900 4%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$18 $128 $73 $18,990 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$2,125 $5,250 $3,213 $38,550 7%



Median Monthly Rate

Median Annual Rate5



$149 $215 $177 $64,423 7%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$159 $344 $196 $71,686 7%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




K-N

n y

N e W Y O R k

$13 $30 $20 $44,616 4%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$15 $34 $21 $48,620 5%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$18 $202 $69 $17,940 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,162 $8,200 $3,255 $39,060 6%



Median Monthly Rate

Median Annual Rate5



$190 $600 $304 $110,960 4%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$195 $600 $320 $116,800 3%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




K-N

n c

N O R T h C A R O L I N A

$13 $24 $17 $38,896 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$15 $28 $18 $41,184 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$25 $69 $49 $12,740 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,000 $6,000 $2,663 $31,950 1%



Median Monthly Rate

Median Annual Rate5



$128 $354 $180 $65,700 4%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$134 $406 $195 $71,175 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




K-N

n d

N O R T h D A k O TA

$18 $22 $22 $50,061 8%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$19 $25 $22 $50,222 7%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$36 $165 $56 $14,544 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$870 $5,831 $2,790 $33,480 11%



Median Monthly Rate

Median Annual Rate5



$140 $270 $188 $68,751 11%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$150 $287 $203 $74,095 11%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




o H

O-W

O h I O

$13 $22 $18 $41,184 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$14 $22 $19 $42,328 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$40 $122 $50 $13,000 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$775 $8,250 $3,278 $39,330 10%



Median Monthly Rate

Median Annual Rate5



$118 $300 $186 $67,890 4%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$133 $350 $205 $74,825 4%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




o K

O-W

O k L A h O M A

$15 $25 $18 $40,040 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$16 $25 $18 $41,710 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$45 $60 $45 $11,700 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,250 $4,950 $2,460 $29,520 5%



Median Monthly Rate

Median Annual Rate5



$90 $172 $130 $47,450 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$90 $300 $143 $52,104 4%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




o r

O-W

O R e G O N

$17 $25 $19 $44,044 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$17 $28 $21 $46,904 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$64 $118 $97 $25,215 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,975 $6,428 $3,670 $44,040 9%



Median Monthly Rate

Median Annual Rate5



$195 $250 $215 $78,475 7%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$200 $325 $230 $83,950 6%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




P a

O-W

P e N N s Y LVA N I A

$12 $30 $19 $43,472 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$12 $30 $20 $44,616 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$30 $128 $51 $13,130 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,043 $8,490 $2,910 $34,920 8%



Median Monthly Rate

Median Annual Rate5



$170 $330 $235 $85,593 4%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$182 $429 $248 $90,338 4%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




P r

O-W

P U e R T O R I C O

$13 $13 $13 $28,600 N/A

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$13 $14 $13 $30,270 N/A

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



N/A N/A N/A N/A N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$550 $2,650 $1,188 $14,250 N/A



Median Monthly Rate

Median Annual Rate5



N/A N/A N/A N/A N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



N/A N/A N/A N/A N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




r i

O-W

R h O D e I s L A N D

$19 $22 $19 $43,472 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$20 $30 $25 $57,200 5%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$53 $70 $64 $16,640 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,222 $5,200 $4,000 $48,000 4%



Median Monthly Rate

Median Annual Rate5



$205 $303 $264 $96,360 7%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$225 $343 $276 $100,740 6%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




s c

O-W

s O U T h C A R O L I N A

$12 $24 $17 $38,324 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$13 $24 $17 $38,965 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$28 $80 $46 $11,960 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,100 $5,888 $2,745 $32,940 4%



Median Monthly Rate

Median Annual Rate5



$135 $222 $175 $63,875 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$140 $252 $186 $68,054 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




s d

O-W

s O U T h D A k O TA

$17 $24 $19 $42,328 5%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$17 $24 $19 $43,472 4%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$40 $72 $60 $15,600 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,465 $5,050 $2,825 $33,900 8%



Median Monthly Rate

Median Annual Rate5



$130 $225 $169 $61,776 6%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$142 $271 $185 $67,525 7%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




t n

O-W

T e N N e s s e e

$13 $25 $17 $38,896 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$14 $28 $18 $40,040 1%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$30 $80 $49 $12,610 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,000 $6,325 $3,063 $36,750 9%



Median Monthly Rate

Median Annual Rate5



$132 $215 $166 $60,408 4%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$135 $260 $176 $64,058 3%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




O-W

t X

T e X A s

$13 $23 $18 $40,040 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$14 $25 $18 $41,070 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$12 $130 $30 $7,800 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,150 $9,000 $3,000 $36,000 5%



Median Monthly Rate

Median Annual Rate5



$80 $257 $121 $44,165 4%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$90 $335 $161 $58,765 3%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




u t

O-W

U TA h

$15 $28 $20 $46,286 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$15 $28 $21 $48,048 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$24 $67 $39 $10,140 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,775 $4,895 $2,898 $34,770 11%



Median Monthly Rate

Median Annual Rate5



$125 $207 $148 $54,020 3%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$133 $320 $175 $63,875 3%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




v t

O-W

V e R M O N T

$19 $23 $20 $45,760 1%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$20 $23 $21 $48,048 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$120 $128 $120 $31,200 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,477 $6,925 $3,030 $36,360 3%



Median Monthly Rate

Median Annual Rate5



$185 $285 $242 $88,330 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$200 $347 $262 $95,630 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




v a

O-W

V I R G I N I A

$14 $30 $17 $37,752 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$14 $30 $18 $41,184 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$43 $96 $53 $13,780 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,300 $6,500 $3,599 $43,182 5%



Median Monthly Rate

Median Annual Rate5



$140 $360 $180 $65,700 4%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$145 $380 $200 $73,000 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




w a

O-W

WA s h I N G T O N

$17 $30 $20 $45,760 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$18 $30 $22 $49,695 2%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$40 $130 $60 $15,600 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,400 $7,800 $3,988 $47,850 8%



Median Monthly Rate

Median Annual Rate5



$149 $450 $217 $79,358 4%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$155 $450 $237 $86,461 3%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




w v

O-W

W e s T V I R G I N I A

$12 $19 $14 $32,604 †

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$12 $21 $15 $33,176 1%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$40 $88 $61 $15,730 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,875 $5,203 $2,800 $33,600 9%



Median Monthly Rate

Median Annual Rate5



$135 $274 $215 $78,464 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$140 $285 $232 $84,571 6%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6





w i

O-W

W I s C O N s I N

$14 $31 $19 $42,900 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$15 $31 $21 $48,917 3%

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$20 $101 $58 $15,080 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,000 $6,528 $3,394 $40,725 7%



Median Monthly Rate

Median Annual Rate5



$135 $315 $203 $73,913 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$135 $320 $225 $82,125 5%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6




w y

W Y O M I N G

$14 $18 $16 $36,608 N/A

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate1



$15 $18 $17 $37,752 N/A

Minimum Hourly Rate

Maximum Hourly Rate

Median Hourly Rate

Median Annual Rate3



$33 $88 $57 $14,820 N/A

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



$1,800 $4,137 $3,517 $42,198 10%



Median Monthly Rate

Median Annual Rate5



$161 $206 $188 $68,620 7%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



$167 $252 $200 $72,818 6%

Minimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



O-W


m e t r o

M e T R O A R I Z O N A



Phoenix-Mesa-Scottsdale $15 $24 $22 $50,313 5%


Phoenix-Mesa-Scottsdale $72 $88 $84 $21,840 N/A

Phoenix-Mesa-Scottsdale $1,300 $6,000 $3,050 $36,600 7%



RegionMinimum

Hourly RateMaximum

Hourly RateMedian

Hourly RateMedian

Annual Rate1


RegionMinimum

Hourly RateMaximum

Hourly RateMedian

Hourly RateMedian

Annual Rate3


RegionMinimum Daily Rate

Maximum Daily Rate

Median Daily Rate

Median Annual Rate4


RegionMinimum

Monthly RateMaximum

Monthly RateMinimum

Monthly RateMedian

Annual Rate5



Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



Maximum Daily Rate

Median Daily Rate

Median Annual Rate6







M e T R O C A L I F O R N I A



Los Angeles $13 $25 $20 $44,616 2%

San Diego-Carlsbad-San Marcos $18 $22 $21 $46,904 2%

San Jose-Sunnyvale-Santa Clara $19 $27 $24 $55,484 1%

RegionMinimum

Hourly RateMaximum

Hourly RateMedian

Hourly RateMedian

Annual Rate1


RegionMinimum

Hourly RateMaximum

Hourly RateMedian

Hourly RateMedian

Annual Rate3



Maximum Daily Rate

Median Daily Rate

Median Annual Rate4

Five-year Annual Growth*

RegionMinimum

Monthly RateMaximum

Monthly RateMedian

Monthly RateMedian

Annual Rate5



Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



Maximum Daily Rate

Median Daily Rate

Median Annual Rate6






Los Angeles $11 $22 $19 $43,472 2%



Los Angeles $48 $93 $76 $19,760 N/A

San Diego-Carlsbad-San Marcos $72 $85 $80 $20,800 N/A

San Jose-Sunnyvale-Santa Clara $76 $160 $83 $21,450 N/A

Los Angeles $1,350 $8,550 $3,500 $42,000 7%

San Diego-Carlsbad-San Marcos $1,600 $5,375 $3,250 $39,000 8%

San Jose-Sunnyvale-Santa Clara $1,600 $5,500 $3,500 $42,000 7%

Los Angeles $135 $259 $185 $67,525 5%



Los Angeles $145 $375 $235 $85,593 5%



m e t r o


M e T R O F L O R I D A



Miami-Fort Lauderdale- Pompano Beach $12 $24 $16 $36,608 1%

Miami-Fort Lauderdale- Pompano Beach $35 $65 $55 $14,300 N/A

RegionMinimum

Hourly RateMaximum

Hourly RateMedian

Hourly RateMedian

Annual Rate1


RegionMinimum

Hourly RateMaximum

Hourly RateMedian

Hourly RateMedian

Annual Rate3



Maximum Daily Rate

Median Daily Rate

Median Annual Rate4


RegionMinimum

Monthly RateMaximum

Monthly RateMinimum

Monthly RateMedian

Annual Rate5



Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



Maximum Daily Rate

Median Daily Rate

Median Annual Rate6







Miami-Fort Lauderdale- Pompano Beach $800 $4,562 $1,800 $21,600 -5%



m e t r o


M e T R O G e O R G I A



Atlanta-Sandy Springs-Marietta $14 $24 $19 $42,328 2%


Atlanta-Sandy Springs-Marietta $38 $85 $55 $14,300 N/A

Atlanta-Sandy Springs-Marietta $900 $5,525 $2,750 $33,000 3%



RegionMinimum

Hourly RateMaximum

Hourly RateMedian

Hourly RateMedian

Annual Rate1


RegionMinimum

Hourly RateMaximum

Hourly RateMedian

Hourly RateMedian

Annual Rate3



Maximum Daily Rate

Median Daily Rate

Median Annual Rate4


RegionMinimum

Monthly RateMaximum

Monthly RateMinimum

Monthly RateMedian

Annual Rate5



Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



Maximum Daily Rate

Median Daily Rate

Median Annual Rate6






m e t r o


M e T R O I L L I N O I s



Chicago-Naperville-Joliet $18 $29 $22 $49,192 3%


Chicago-Naperville-Joliet $48 $78 $61 $15,925 N/A

Chicago-Naperville-Joliet $1,745 $8,525 $4,160 $49,920 4%



RegionMinimum

Hourly RateMaximum

Hourly RateMedian

Hourly RateMedian

Annual Rate1


RegionMinimum

Hourly RateMaximum

Hourly RateMedian

Hourly RateMedian

Annual Rate3



Maximum Daily Rate

Median Daily Rate

Median Annual Rate4


RegionMinimum

Monthly RateMaximum

Monthly RateMinimum

Monthly RateMedian

Annual Rate5



Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



Maximum Daily Rate

Median Daily Rate

Median Annual Rate6






m e t r o


M e T R O M A s s A C h U s e T T s



Boston-Cambridge-Quincy $21 $29 $25 $57,200 4%


Boston-Cambridge-Quincy $50 $81 $61 $15,907 N/A

Boston-Cambridge-Quincy $2,150 $6,875 $4,635 $55,620 4%



RegionMinimum

Hourly RateMaximum

Hourly RateMedian

Hourly RateMedian

Annual Rate1


RegionMinimum

Hourly RateMaximum

Hourly RateMedian

Hourly RateMedian

Annual Rate3



Maximum Daily Rate

Median Daily Rate

Median Annual Rate4


RegionMinimum

Monthly RateMaximum

Monthly RateMinimum

Monthly RateMedian

Annual Rate5



Maximum Daily Rate

Median Daily Rate

Median Annual Rate6






m e t r o


Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



M e T R O M I C h I G A N



Detroit-Warren-Livonia $17 $28 $19 $43,472 1%


Detroit-Warren-Livonia $30 $96 $64 $16,640 N/A

Detroit-Warren-Livonia $788 $6,000 $3,293 $39,510 13%



RegionMinimum

Hourly RateMaximum

Hourly RateMedian

Hourly RateMedian

Annual Rate1


RegionMinimum

Hourly RateMaximum

Hourly RateMedian

Hourly RateMedian

Annual Rate3



Maximum Daily Rate

Median Daily Rate

Median Annual Rate4


RegionMinimum

Monthly RateMaximum

Monthly RateMinimum

Monthly RateMedian

Annual Rate5



Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



Maximum Daily Rate

Median Daily Rate

Median Annual Rate6






m e t r o


M e T R O M I N N e s O TA



Minneapolis-St. Paul-Bloomington $20 $28 $25 $57,200 1%


Minneapolis-St. Paul-Bloomington $56 $104 $67 $17,420 N/A

Minneapolis-St. Paul-Bloomington $700 $10,500 $3,215 $38,580 1%



RegionMinimum

Hourly RateMaximum

Hourly RateMedian

Hourly RateMedian

Annual Rate1


RegionMinimum

Hourly RateMaximum

Hourly RateMedian

Hourly RateMedian

Annual Rate3



Maximum Daily Rate

Median Daily Rate

Median Annual Rate4


RegionMinimum

Monthly RateMaximum

Monthly RateMinimum

Monthly RateMedian

Annual Rate5



Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



Maximum Daily Rate

Median Daily Rate

Median Annual Rate6






m e t r o


M e T R O M I s s O U R I



St. Louis $17 $23 $21 $47,934 4%

St. Louis $16 $23 $19 $43,472 2%

St. Louis $60 $80 $73 $19,001 N/A

St. Louis $1,228 $6,690 $2,852 $34,227 †

St. Louis $105 $192 $132 $48,326 3%

St. Louis $117 $272 $145 $52,925 2%

RegionMinimum

Hourly RateMaximum

Hourly RateMedian

Hourly RateMedian

Annual Rate1


RegionMinimum

Hourly RateMaximum

Hourly RateMedian

Hourly RateMedian

Annual Rate3



Maximum Daily Rate

Median Daily Rate

Median Annual Rate4


RegionMinimum

Monthly RateMaximum

Monthly RateMinimum

Monthly RateMedian

Annual Rate5



Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



Maximum Daily Rate

Median Daily Rate

Median Annual Rate6






m e t r o



M e T R O N e VA D A



Las vegas-Paradise $17 $23 $20 $45,142 2%


Las vegas-Paradise $60 $90 $60 $15,600 N/A

Las vegas-Paradise $1,220 $4,945 $2,550 $30,600 5%



RegionMinimum

Hourly RateMaximum

Hourly RateMedian

Hourly RateMedian

Annual Rate1


RegionMinimum

Hourly RateMaximum

Hourly RateMedian

Hourly RateMedian

Annual Rate3



Maximum Daily Rate

Median Daily Rate

Median Annual Rate4



Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



Maximum Daily Rate

Median Daily Rate

Median Annual Rate6






m e t r o

RegionMinimum

Monthly RateMaximum

Monthly RateMinimum

Monthly RateMedian

Annual Rate5



M e T R O N e W Y O R k



New york $15 $38 $20 $44,616 2%

New york $13 $38 $19 $43,472 3%

New york $25 $200 $79 $20,605 N/A

New york $1,162 $7,980 $4,300 $51,600 7%

New york $225 $600 $325 $118,625 4%

New york $240 $600 $344 $125,651 4%

RegionMinimum

Hourly RateMaximum

Hourly RateMedian

Hourly RateMedian

Annual Rate1


RegionMinimum

Hourly RateMaximum

Hourly RateMedian

Hourly RateMedian

Annual Rate3



Maximum Daily Rate

Median Daily Rate

Median Annual Rate4


RegionMinimum

Monthly RateMaximum

Monthly RateMinimum

Monthly RateMedian

Annual Rate5



Maximum Daily Rate

Median Daily Rate

Median Annual Rate6



Maximum Daily Rate

Median Daily Rate

Median Annual Rate6






m e t r o


M e T R O P e N N s LY VA N I A



Philadelphia-Camden-Wilmington $15 $27 $20 $45,760 2%


Philadelphia-Camden-Wilmington $65 $92 $71 $18,460 N/A

Philadelphia-Camden-Wilmington $1,800 $6,585 $4,245 $50,940 7%



RegionMinimum

Hourly RateMaximum

Hourly RateMedian

Hourly RateMedian

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M e T R O T e X A s



Dallas-Fort Worth-Arlington $15 $24 $18 $41,070 2%

Houston-Sugar Land-Baytown $17 $23 $19 $42,900 3%

San Antonio $15 $20 $17 $38,324 2%

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San Antonio $15 $19 $17 $37,752 3%

Dallas-Fort Worth-Arlington $35 $75 $40 $10,400 N/A

Houston-Sugar Land-Baytown $30 $53 $35 $9,100 N/A

San Antonio $30 $40 $34 $8,840 N/A

Dallas-Fort Worth-Arlington $1,150 $6,075 $2,998 $35,970 3%

Houston-Sugar Land-Baytown $1,400 $5,713 $3,200 $38,400 5%

San Antonio $1,500 $5,380 $3,460 $41,520 11%

Dallas-Fort Worth-Arlington $104 $164 $127 $46,173 †


San Antonio $95 $152 $129 $46,903 2%



San Antonio $150 $260 $181 $65,930 4%

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M e T R O WA s h I N G T O N



Seattle-Tacoma-Bellevue $22 $30 $25 $57,772 4%


Seattle-Tacoma-Bellevue $40 $130 $60 $15,600 N/A

Seattle-Tacoma-Bellevue $1,750 $7,800 $4,000 $48,000 6%



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D ATA TA b L e e N D N O T e s(FOR NON-DATA TAbLe eND NOTes, see PAGe 91)

1 Homemaker Services annual rates are based on 44 hours/week multiplied by 52 weeks.2 Represents the compound annual growth rate based on Genworth Cost of Care Survey data from 2005-2010.3 Home Health Aide Services annual rates are based on 44 hours/week multiplied by 52 weeks.4 Adult Day Health Care annual rates are based on 5 days/week multiplied by 52 weeks.5 Assisted Living Faciliy annual rates are based on monthly rate multiplied by 12 months.6 Nursing Home annual rates are based on daily rates, multiplied by 365 days.

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M e T h O D O L O G Y

CareScout has conducted the Genworth Cost of Care Survey annually since 2004. Located in Waltham, Massachusetts, CareScout has specialized in helping families find long term

care providers nationwide since 1997.

This year, CareScout – now part of the Genworth Financial family of companies, contacted more than 60,000 providers to complete nearly 13,000 surveys of nursing homes, assisted living facilities, adult day health facilities and home care providers. Potential respondents were selected randomly from the CareScout nationwide database of providers in each category of long term care services. Survey respondents representing all 50 states, the District of Columbia and Puerto Rico were contacted by phone during January, February and March of 2010. Survey respondents were informed that survey data provided would be included in the Genworth 2010 Cost of Care Survey results. Survey questions varied, based on the type of care provider.

Considered the most comprehensive survey of its kind, the Genworth Cost of Care Survey is the first to publish costs for all 384 U.S. Metropolitan Statistical Areas (MSA). MSA definitions are established by the Office of Management and Budget and include approximately 84 percent of the U.S. population. The survey also includes some counties outside of the MSA regions. To create accurate historical trends for this

expanded scope, CareScout recast the base data from the 2005 survey into the current region structure. As a result, CareScout is able to report a five-year compound annual growth rate for each region.

Home Care (HC)Surveyors completed nearly 2,700 interviews with licensed home health care providers representing approximately 17 percent of home care agencies. The agencies surveyed provide home health care and homemaker services where a skilled nurse does not need to be present. A home health aide will typically help with bathing, dressing, transferring and toileting, but not with catheters or injections. Most of these agencies also provide homemaker services that typically include assistance with shopping, finances, cooking, errands and transportation. Homemaker services may also be employed for the purpose of providing companionship.

Annual rates are based on 44 hours of care per week, multiplied by 52 weeks. Where a rate range was provided, the midpoint was used. The survey excludes weekend and holiday rates.



Adult Day Health Care (ADH)Across 436 regions, surveyors polled more than 34 percent of adult day health care facilities, re-sulting in more than 1,300 completed surveys. ADH is designed to meet the needs of adults who are functionally and/or severely cognitively impaired. Programs are intended to be structured and comprehensive, and to 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 live more independently in the community. These services may also be used to provide relief for family caregivers.

ADH facility rates are structured in a variety of ways: some charge by the hour, some by the half-day and others for the full day, regardless of utilization. All rates used in Genworth’s survey were extrapolated to a daily (6-8 hours) rate.

ADH facility rates may be subsidized by the government or the community. A government subsidy is based on the individual’s ability to pay. However, a community subsidy is available to individuals regardless of their income level. This survey captures the full private pay rates, or where applicable, the community subsidy rates. This survey does not capture the government subsidy rates.

Annual rates are based on the daily rate multiplied by five days per week, and then multiplied by 52 weeks.

Assisted Living Facilities (ALF)Across 436 regions, surveyors polled more than 12 percent of licensed assisted living facilities, resulting in more than 5,300 completed surveys.

Unlike nursing homes, there is no uniform regulatory standard for assisted living facilities. As a consequence, states have instituted licensing standards that vary from state to state. The assisted living facilities polled were licensed according to the licensure requirements of the state in which the assisted living facility was located.

Currently, there are more than 70 different names or designations for facilities licensed as some form of an assisted care facility. Generally, only about 50 percent of these care facilities use the term “assisted living facility” as a part of their formal name or licensure designation. For example, some facilities may be identified as “residential care facilities.” Because of variations in licensing requirements by state,

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both small group homes and large multi-service facilities qualified as assisted living facilities for the purposes of this study.

Surveyors collected the monthly, private pay base rates for single occupancy of a one-bedroom unit in an assisted living facility. They also determined whether the facility charges a non-refundable community or entrance fee. This survey shows that approximately 33 percent of assisted living facilities charge a one-time non-refundable fee.

In some cases, a facility will charge extra for health-related services (e.g. using “care level” gradations). The published monthly rates for this survey do not include these additional health-related costs. Many assisted living facilities charge a monthly rate that is within a range based on the level of care needed by the resident. The monthly fee typically includes rent, meals and housekeeping.

Where a rate range was provided, CareScout calculated and used the average of the high and low range rates.

Annual rates are based on the monthly fee multiplied by 12 months.

Nursing Homes (NH)Across 436 regions, surveyors polled more than 22 percent of certified and licensed nursing homes, resulting in more than 3,600 completed surveys.

Surveyors collected the daily rates for private rooms (single occupancy) and semi-private rooms (double occupancy) in Medicare-certified nursing facilities. Medicare-certified nursing homes represent more than 90 percent of all nursing homes in the U.S. The daily room charge usually includes services beyond rent such as three meals a day, laundry, sundries, basic nurse supervision and generic non-prescription pharmaceuticals.

Annual rates are based on the daily fee multiplied by 365 days.

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e N D N O T e s(FOR DATA TAbLe eND NOTes, see PAGe 87)

1 U.S. Department of Health and Human Services National Clearinghouse for Long Term Care Information, 10/22/08.2 America Talks: Protecting Our Families’ Futures, an Age Wave/Harris Interactive Study sponsored by the Genworth Financial

companies, January 2010. The survey was conducted online by Harris Interactive among 2,939 U.S. consumers between January 12 and 15, 2010. The sample is representative of the entire U.S. population of consumers ages 18 and over on the basis of age, gender, race, income, education and region.

3 Percentage increase represents the compound annual inflation rate for surveys conducted from 2005 to 2010.4 Ibid5 Genworth began collecting Adult Day Health Care data in 2008; data is not yet available to determine a five-year compound

annual growth rate.6 Over the last decade, ALFs have continued to adapt to the wide range of care needs presented by our growing elder

population. As the range of services becomes broader, so does the range of monthly costs. In 2010, our aggregated survey results use the average of these ranges. We feel this average is the most reliable indicator of the true cost of assisted living care in the surveyed regions. Given this change in methodology, a comparison to survey results from five years would overstate the compound annual growth rate. However, we do not see any indication in the base data that the growth rate for ALF care would be dramatically different from the 4.5 percent compound annual growth rate for nursing homes.

7 Percentage increase represents the compound annual inflation rate for surveys conducted from 2005 to 2010.8 Ibid9 Ibid10 U.S. Department of Health and Human Services National Clearinghouse for Long Term Care Information, 10/22/08.11 Genworth Financial companies Long Term Care Claims Experience Data, December 1974 through 6/30/09.

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About CAreSCoutHeadquartered in Waltham, Massachusetts, CareScout helps Americans across the United States find quality care providers for their long term care needs. As an objective source for this provider information, CareScout, now part of the Genworth Financial family of companies, developed the nation’s first quality-of-care ratings system for certified nursing homes and home care providers. Large employers, risk underwriters and families rely on CareScout’s proprietary ratings system, the CareScout network and its database of more than 90,000 providers including nursing homes, assisted living facilities and home care agencies to help find and arrange the most appropriate care for loved ones. For more information, visit carescout.com.

About Genworth FinAnCiAl

Genworth Financial, Inc. (NYSE:GNW) is a leading Fortune 500 global financial security company. Genworth employs approximately 6,000 people with a presence in more than 25 countries. Its products and services help meet the investment, protection, retirement and lifestyle needs of more than 15 million customers.

Genworth operates through three segments: Retirement and Protection, U.S. Mortgage Insurance and International. Its products and services are offered through financial intermediaries, advisors, independent distributors and sales specialists.

Genworth Financial, which traces its roots back to 1871, became a public company in 2004 and is headquartered in Richmond, Virginia. For more information, visit Genworth.com.

From time to time, Genworth releases important information via postings on its corporate Web site. Accordingly, investors and other interested parties are encouraged to enroll to receive automatic e-mail alerts and Really Simple Syndication (RSS) feeds regarding new postings. Enrollment information is found under the “Investors” section of Genworth.com.

Insurance and annuity products:• Are not deposits. • Are not insured by the FDIC or any other federal government agency.• May decrease in value. • Are not guaranteed by the bank or its affiliates.

Visit genworth.com/CostofCare to:• compare costs across locations• calculate future costs of care• get more information about the Cost of Care Survey

©2005-2010 Genworth Financial, Inc. and National Eldercare Referral Systems, LLC (CareScout). All rights reserved. Genworth, Genworth Financial and the Genworth logo are registered service marks of Genworth Financial, Inc.

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Alzheimer’s Association and Genworth Financial, Inc. have entered into a strategic relationship that permits Genworth’s use of the Association’s trademarks and/or logos. The use of the Alzheimer’s Association logo does not constitute an endorsement of the Company’s products and services.

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