What Elder Care Index is
Elder Care Index is an independent editorial publication that compiles publicly-available data on long-term elder care: Medicaid eligibility rules, HCBS waiver programs, nursing home quality scores, care costs, and state-by-state program performance. Our goal is to help families make better-informed decisions by surfacing the same data professional researchers use, presented in a comparable format.
What Elder Care Index is not
We are not a licensed Medicaid planner, elder law attorney, financial advisor, insurance broker, or government agency. We do not determine eligibility, file applications, represent clients before any state Medicaid agency, sell insurance, or collect commissions on care placements. Reading this site does not establish an attorney-client, advisory, agency, or fiduciary relationship.
Editorial analysis is not personal advice
The state Medicaid pages, rankings, guides, and cost data published on this site present general editorial analysis based on publicly-available federal and state sources. Our content does not consider your specific income, assets, household composition, health status, prior asset transfers, family circumstances, or applicable state policy nuances.
Decisions about Medicaid eligibility planning — including whether to spend down, gift assets, establish a Miller Trust or pooled income trust, transfer a home, purchase an annuity, or apply for nursing home Medicaid — should involve a qualified elder law attorney or a state-certified Medicaid planner in your jurisdiction. Mistakes can trigger multi-year ineligibility periods or estate recovery against your home.
Look-back, transfer penalties, and estate recovery
Federal Medicaid rules impose a 60-month (5-year) look-back on asset transfers prior to a long-term care Medicaid application. Gifts, below-market sales, and certain trust transfers within that window can create a penalty period of ineligibility, often calculated against the state's average monthly nursing home cost. Estate recovery rules — under which a state may seek repayment from a deceased recipient's estate — vary materially by state and are continuously updated.
If you are within five years of needing long-term care, or if you are considering moving assets, get qualified legal advice before any transfer. Generic guidance on this site cannot substitute for individualized counsel.
Source data limitations
Per-state Medicaid eligibility data is compiled from Medicaid.gov, KFF state Medicaid profiles, HHS ASPE poverty guidelines, and individual state Medicaid agency publications. Our methodology page documents the full source list, refresh cadence, and known state-specific exceptions (Wisconsin Section 1115 waiver, California Medi-Cal asset limit elimination, Alaska/Hawaii FPL adjustments, and others).
State Medicaid rules change continuously through legislative action, waiver amendments, and administrative decisions. While we make reasonable efforts to keep our coverage current and date-stamp every state page, there may be a delay between a state policy change and our update. Always confirm current eligibility thresholds and program rules with your state Medicaid agency before applying.
Care quality scores
Nursing home quality scores presented on Elder Care Index are derived from CMS Nursing Home Compare data. State averages mask substantial facility-level variation: a state with a low average score may still contain excellent facilities, and vice versa. Always check specific facility ratings on Medicare Care Compare before choosing a provider.
Cost estimates
Per-state cost estimates (nursing home, assisted living, memory care, home health, adult day care) are sourced from the Genworth Cost of Care Survey and presented as state median values. Actual costs vary substantially by metro area, facility, level of care, and time. Use the figures on this site as planning estimates, not as quotes.
Corrections
If you find an error in our data — an outdated income limit, a misclassified waiver, an incorrect estate recovery characterization, or any other factual issue — please contact us with the page URL, the specific data point, and a primary source link. We verify and correct issues promptly.
If a decision matters, get qualified help. Long-term care Medicaid decisions can have five- and six-figure consequences for your family's finances and your eligibility timing. The cost of a one-time consultation with a qualified elder law attorney or certified Medicaid planner in your state is small relative to the cost of a wrong move based on general editorial reading. We strongly encourage that step for every meaningful decision.