Female caregiver greets older couple at door

A new study judging quality and access to elder care ranked all 50 states and named Iowa the top state in the country. 

The study evaluated states on a scale of 100 based on a variety of factors, such as the number of nursing homes per 100,000 residents, occupancy rates, cost of residency and the percentage of nursing homes with no deficiencies. 

Iowa topped the list with a score of 70.67. Iowa was not a leading state in the individual categories, but was consistently in the top third of each category. Around 10% of Iowa homes had no deficiencies, which was well above the national average of 6%. 

Despite a top-five occupancy rate, California was the bottom-ranked state, with an 18.61 rating. This was partially because of its high cost. Private nursing home rooms in the state cost more than $12,000 per month, among the highest in the nation. The state also has the 2nd most deficiencies per facility on average.

Providing insight into nursing home care in the US is only growing more important as the population ages, said SonderCare CEO Kyle Sobko. 

“This data provides a clear insight into which states currently offer the best access to elderly care and outlines the factors contributing to this,” Sobko stated. 

Rural Southern and Great Plains states consistently received high scores in the study. The top 10, in order, were:

  • Iowa
  • Oklahoma
  • Missouri
  • Louisiana
  • South Dakota
  • Kansas
  • Montana
  • North Carolina
  • Wisconsin
  • Nebraska

Among more populous states, Texas, Pennsylvania, and Illinois ranked highest, at 11th, 15th and 16th, respectively. 

Sobko noted that there were some notable outliers in the SonderCare study.

“The most surprising finding from this study is that Alaska ranks overwhelmingly as the most expensive state for elderly care, both semi-private and private,” he said. “The cost of a room in a private nursing home in Alaska is $31,512 per month, this is more than $16,300 more than the second most expensive state, Connecticut.”

Those costs helped drag Alaska down to a ranking of 46th, rounding out a bottom five that also included the 2nd most expensive state, Connecticut, as well as West Virginia, Hawaii, and California. East coast states made up nine of the bottom 15.