CMS nursing-home cost-report rates by state

A state comparison calculated only from 13,523 public federal cost reports. Rates stay in their source unit: dollars per resident-day.

This is not a price list. Each rate is net patient revenue divided by resident-days, straight from the federal CMS Skilled Nursing Facility Cost Report. It combines Medicare, Medicaid, and private-pay revenue, so payer mix materially affects the result. Do not multiply it into a monthly quote.

Median all-payer rate, ranked by state

Median across 13,523 reporting facilities: $330/resident-day. States with fewer than five matched reports are omitted.

#	State	CMS $/resident-day	Reporting facilities
1	Alaska	$798	8
2	Oregon	$550	111
3	Hawaii	$477	32
4	California	$443	1,022
5	Washington	$430	183
6	District of Columbia	$425	12
7	Nevada	$418	53
8	West Virginia	$418	103
9	North Dakota	$398	48
10	Vermont	$398	32
11	Utah	$396	87
12	New York	$392	527
13	Arizona	$391	129
14	Minnesota	$391	276
15	Maryland	$389	206
16	Idaho	$380	71
17	New Hampshire	$379	67
18	Wyoming	$378	22
19	New Mexico	$376	63
20	Wisconsin	$373	301
21	Delaware	$371	36
22	Connecticut	$369	186
23	New Jersey	$368	328
24	Maine	$358	59
25	Massachusetts	$358	334
26	Indiana	$350	501
27	Michigan	$346	394
28	North Carolina	$346	393
29	Virginia	$341	262
30	Colorado	$338	201
31	Florida	$329	666
32	Rhode Island	$328	68
33	Nebraska	$322	160
34	Pennsylvania	$322	617
35	Montana	$320	39
36	Mississippi	$313	171
37	Arkansas	$312	205
38	Tennessee	$312	282
39	Kentucky	$306	252
40	Ohio	$303	899
41	Kansas	$300	252
42	South Dakota	$300	67
43	Alabama	$299	212
44	South Carolina	$293	178
45	Iowa	$292	366
46	Illinois	$291	621
47	Louisiana	$285	254
48	Georgia	$279	315
49	Oklahoma	$250	267
50	Texas	$247	1,129
51	Missouri	$230	456

Source: CMS Skilled Nursing Facility Cost Report (FY2023), analyzed by Senior Care Record Map. A higher accounting rate is not evidence of better care. Use the linked state and facility pages to inspect CMS quality and enforcement records separately.

Common questions

Is the CMS rate what a resident pays?

No. It is net patient revenue divided by resident-days across Medicare, Medicaid, and private pay. It is useful for comparing facility accounting patterns, but it is not a private-pay quote and should not be multiplied into a monthly consumer price.

Does Medicare or Medicaid pay for a nursing home?

Medicare covers only a short skilled-rehab stay after a qualifying hospital admission (up to 100 days, with cost-sharing after day 20) — not long-term custodial care. Medicaid is the largest payer of long-term nursing-home care for those who meet state income and asset limits. See our full cost guide for how coverage works.

Where do these numbers come from?

Each facility's rate is total net patient revenue divided by total resident-days in the public CMS Skilled Nursing Facility Cost Report. Senior Care Record Map calculates each state median from facilities with a matched report and publishes states with at least five reporting facilities.

Read the safety record behind the rate

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