Senior woman and caregiver outdoors on a walk with walker in park, talking and laughing
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Arizona is the best state for long-term care cost, access and quality of care, according to a recent ValuePenguin study.

Using data from the U.S. Bureau of Labor Statistics, the U.S. Census Bureau County Business Patterns and the Centers for Medicare & Medicaid Services, ValuePenguin ranked Arizona, Idaho and Missouri as tops for long-term care, whereas Washington, DC, ranked last, despite noting that high-quality care is available in the nation’s capital. 

Arizona ranked in the top 10 for several quality metrics, including ranking among the top five for its density of assisted living communities.

The nation’s capital ranked lowest for its lower density of long-term care facilities and medical professionals than most states. It also is among the most expensive for healthcare — the average annual cost for an assisted living community is $83,730, ValuePenguin said. 

Wyoming and New Hampshire follow Washington, DC, in the ranking of worst states for long-term care. Although care generally is affordable in Wyoming — the average annual cost for assisted living is $50,025 — it ranks among the lowest states for access to care and quality of care, the study found. New Hampshire consistently ranks lowest for cost, access and quality of care, ValuePenguin said.

Overall, the study found that just 16 states provide four or more nurse staffing hours daily per resident in long-term care facilities. Pandemic-induced staffing shortages add additional challenges for long-term care facilities, according to the study authors. 

When it comes to cost, Washington, DC, ranked highest for assisted living community costs, followed by Alaska, where the average annual cost is $81,690, and Rhode Island, at $81,915 annually. Meanwhile, in Washington state, where home healthcare aide wages are highest, at $36,120, assisted living communities cost an average of $72,000 annually, ranking the state among the top 10 most expensive for assisted living.

On the other hand, Missouri was among the most affordable states. There, the average annual cost for an assisted living community is $36,000, ValuePenguin said. The Dakotas follow Missouri in affordability — assisted living annual average costs in South Dakota were $40,200, and they were $40,695 in North Dakota. 

Meanwhile, home healthcare aides make just $28,900 per year in South Dakota, ranking it 27 lowest for wages, whereas North Dakota aides earned among the highest annual wages, at $34,150.