Elder Care Index Browse All States
RANKINGS • November 11, 2026

State Elder Care Rankings (2026)

All 50 states plus DC ranked across five pillars: affordability, quality, staffing, access, and Medicaid support. Composite score determines each state's letter grade.

Top 3 States Overall

#1 A

Utah

Composite 89.0
#2 A

Washington

Composite 78.7
#3 A

Hawaii

Composite 76.7

Browse by Pillar

Most AffordableHighest QualityBest StaffingBest AccessBest Medicaid Coverage

All 51 States Ranked

Lower rank = better
Rank State Grade Composite Afford. Quality Staffing Access Medicaid
#1 Utah A 89.0 100 87 57 27 17 View →
#2range 2–4 Washington A 78.7 55 73 59 24 60 View →
#3range 2–10 Hawaii A 76.7 66 91 99 2 25 View →
#4range 3–6 Delaware A 76.0 63 68 65 31 33 View →
#5range 3–9 Idaho A 73.8 82 76 36 20 40 View →
#6range 5–9 Maryland A 73.2 87 63 50 28 28 View →
#7range 4–9 Wisconsin A 72.8 69 51 51 36 60 View →
#8range 2–10 Minnesota A 72.5 73 42 63 62 33 View →
#9range 7–15 Arizona B 69.4 97 70 39 10 36 View →
#10range 2–25 District of Columbia B 67.7 0 77 100 84 62 View →
#11range 8–24 Illinois B 64.1 88 31 30 58 76 View →
#12range 10–18 Nebraska B 63.9 91 44 32 62 26 View →
#13range 10–25 Nevada B 63.6 92 50 66 3 42 View →
#14range 11–21 Michigan B 63.4 69 48 40 27 66 View →
#15range 9–24 North Dakota B 62.8 98 39 51 66 9 View →
#16range 12–18 Pennsylvania B 62.8 59 54 38 58 32 View →
#17range 11–19 Indiana B 62.8 70 63 28 52 22 View →
#18range 11–24 California B 62.2 33 58 55 49 51 View →
#19range 14–23 Kansas B 60.9 86 44 35 56 25 View →
#20range 15–24 Ohio B 60.2 67 67 22 50 25 View →
#21range 12–26 New York B 60.1 36 48 38 70 65 View →
#22range 15–24 Virginia B 59.8 84 59 30 24 31 View →
#23range 16–26 Iowa B 58.8 79 53 36 55 10 View →
#24range 14–27 Texas B 58.4 100 53 6 48 44 View →
#25range 19–26 Colorado C 57.9 74 63 33 25 25 View →
#26range 20–27 Wyoming C 56.4 98 51 38 20 20 View →
#27range 24–28 Connecticut C 54.8 55 44 45 51 31 View →
#28range 27–33 South Dakota C 49.2 100 39 32 52 5 View →
#29range 27–33 Florida C 49.0 77 54 39 6 33 View →
#30range 28–33 New Mexico C 48.2 67 53 14 29 51 View →
#31range 27–34 Oregon C 48.2 31 57 58 11 60 View →
#32range 29–32 New Hampshire C 47.6 54 43 40 22 53 View →
#33range 30–35 New Jersey C 44.8 41 48 42 44 25 View →
#34range 33–35 North Carolina C 42.3 70 48 24 24 27 View →
#35range 33–37 South Carolina D 40.5 87 41 28 12 29 View →
#36range 32–41 Missouri D 38.0 100 25 2 70 54 View →
#37range 35–39 Arkansas D 37.3 62 51 17 48 8 View →
#38range 36–40 Kentucky D 35.9 65 40 40 40 2 View →
#39range 36–45 Alaska D 30.9 0 57 84 24 37 View →
#40range 39–42 Tennessee D 30.8 63 49 22 26 5 View →
#41range 38–45 Maine F 29.6 6 55 59 24 38 View →
#42range 40–46 West Virginia F 27.3 29 56 34 39 1 View →
#43range 42–45 Montana F 25.1 50 36 33 18 20 View →
#44range 40–46 Georgia F 25.0 81 28 16 22 26 View →
#45range 42–47 Massachusetts F 24.0 16 35 42 59 25 View →
#46range 41–48 Alabama F 22.8 75 31 29 27 0 View →
#47range 42–49 Mississippi F 21.5 71 14 36 38 33 View →
#48range 46–49 Vermont F 19.6 29 36 33 24 25 View →
#49range 48–50 Oklahoma F 14.9 84 20 5 44 19 View →
#50range 48–50 Rhode Island F 14.5 0 39 42 46 34 View →
#51 Louisiana F 0.0 54 15 16 53 0 View →
Index version 2.0 (November 2026). Pillar scores are 0–100. The composite combines the five pillars at Affordability 25%, Quality 25%, Staffing 20%, Access 15%, Medicaid 15%, scaled so 50 is the average state. Letter grades reflect distance from the average state, not a fixed quota. "Range" shows where a state lands when the weights shift by up to five points. Read methodology →