The Metlife Mature Market Institute has released its annual survey of the cost of long-term care services, including nursing homes, assisted living facilities, adult day programs, and home care. And the news is not good. On average, provider costs rose far faster than the rate of inflation. The only exceptions were home care services, where costs were unchanged from 2010 to 2011.

On average, nursing home costs rose from $229 a day for a private room in a nursing home to $239, or more than $87,000 per year. Adult day program costs rose from $67 to $70. And the average monthly cost of assisted living rose by 5.6 percent from $3,293 to $3,477, or about $42,000 annually. Keep in mind, these are costs to consumers who pay out of their own pocket or with long-term care insurance benefits. Medicaid normally pays far less.   

While assisted living facilities costs rose faster over the past year than nursing homes, they remain far less expensive–only half the cost on average. For dementia care, a private room in a skilled nursing facility costs $92,000 on average while a unit in an assisted living facility costs about $55,000.

However, consumers need to be very careful about assisted living costs, which can often jump substantially if residents need additional care. For instance, a facility will add, on average, $307 per month for helping a resident bathe, an extra $530 a month for other personal care such as toileting, transferring, or incontinence care, and an extra $370 per month to help manage medications.

Adult day programs remain a relative bargain at just $70-a-day. Yet, they remain underused.

Just as important as national averages is the wide variation of costs around the country. In Alaska, for example, a nursing home costs costs a staggering $655-a-day for a private room, while the cost in rural Louisiana was $141-a-day.

Similarly, home health aides cost only about $9-an-hour in Louisiana but more than twice as much, or $19, in New Hampshire.

Even as the costs of care continue to rise, the nation remains unable to figure out how to pay for these services. Americans don’t save–fewer than of those 65 and older have financial assets of $55,000 or more and only about 7 million have private long-term care insurance.  And, of course, the CLASS Act, the attempt to create a national long-term care insurance program, has been abandoned by the Obama Administration. As a result, these paid services are simply out of reach for many, who have little choice but to rely on relatives and friends. 

The MetLife report is just the latest evidence that our system of long-term care is broken for all but the well off.