RANKINGS • May 3, 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
Browse by Pillar
All 51 States Ranked
Lower rank = better| Rank | State | Grade | Composite | Afford. | Quality | Staffing | Access | Medicaid | |
|---|---|---|---|---|---|---|---|---|---|
| #1 | North Dakota | A | 61.2 | 88 | 48 | 34 | 66 | 70 | View → |
| #2 | District of Columbia | A | 56.5 | 55 | 47 | 53 | 50 | 85 | View → |
| #3 | Kansas | A | 56.3 | 87 | 45 | 24 | 54 | 70 | View → |
| #4 | Nebraska | A | 55.9 | 85 | 46 | 26 | 49 | 70 | View → |
| #5 | Minnesota | A | 55.7 | 70 | 46 | 32 | 50 | 85 | View → |
| #6 | Missouri | A | 55.6 | 100 | 45 | 9 | 46 | 70 | View → |
| #7 | Arkansas | A | 55.4 | 94 | 53 | 20 | 27 | 70 | View → |
| #8 | Iowa | A | 54.9 | 84 | 47 | 20 | 52 | 70 | View → |
| #9 | South Dakota | A | 54.2 | 90 | 45 | 22 | 52 | 55 | View → |
| #10 | Kentucky | B | 53.7 | 89 | 49 | 24 | 26 | 70 | View → |
| #11 | Oklahoma | B | 53.1 | 94 | 46 | 15 | 30 | 70 | View → |
| #12 | Utah | B | 53.1 | 87 | 44 | 31 | 23 | 70 | View → |
| #13 | Louisiana | B | 53.0 | 94 | 46 | 14 | 32 | 70 | View → |
| #14 | Wisconsin | B | 52.5 | 78 | 45 | 30 | 34 | 70 | View → |
| #15 | Arizona | C | 52.1 | 86 | 45 | 25 | 10 | 85 | View → |
| #16 | Indiana | C | 51.9 | 84 | 46 | 17 | 38 | 70 | View → |
| #17 | Alabama | C | 51.5 | 93 | 46 | 20 | 16 | 70 | View → |
| #18 | California | C | 51.5 | 63 | 46 | 32 | 35 | 85 | View → |
| #19 | Ohio | C | 51.2 | 82 | 45 | 16 | 38 | 70 | View → |
| #20 | Montana | C | 50.8 | 83 | 46 | 26 | 19 | 70 | View → |
| #21 | New York | C | 50.3 | 62 | 44 | 16 | 52 | 85 | View → |
| #22 | North Carolina | C | 50.3 | 86 | 47 | 17 | 21 | 70 | View → |
| #23 | Illinois | C | 50.2 | 85 | 44 | 13 | 32 | 70 | View → |
| #24 | Nevada | C | 50.2 | 78 | 50 | 34 | 7 | 70 | View → |
| #25 | Pennsylvania | C | 50.2 | 75 | 44 | 22 | 37 | 70 | View → |
| #26 | Maine | C | 50.1 | 62 | 45 | 34 | 24 | 85 | View → |
| #27 | Idaho | C | 49.9 | 82 | 43 | 26 | 19 | 70 | View → |
| #28 | Texas | C | 49.5 | 96 | 45 | 8 | 31 | 55 | View → |
| #29 | Vermont | C | 49.5 | 62 | 46 | 30 | 24 | 85 | View → |
| #30 | Colorado | C | 49.3 | 76 | 44 | 19 | 20 | 85 | View → |
| #31 | New Mexico | C | 49.3 | 80 | 42 | 13 | 22 | 85 | View → |
| #32 | Michigan | C | 49.2 | 78 | 45 | 24 | 20 | 70 | View → |
| #33 | Mississippi | C | 49.1 | 88 | 44 | 26 | 32 | 40 | View → |
| #34 | Washington | C | 49.1 | 61 | 46 | 33 | 20 | 85 | View → |
| #35 | Georgia | C | 48.7 | 89 | 45 | 12 | 16 | 70 | View → |
| #36 | Rhode Island | C | 48.7 | 61 | 48 | 18 | 33 | 85 | View → |
| #37 | Oregon | D | 48.5 | 56 | 46 | 41 | 14 | 85 | View → |
| #38 | South Carolina | D | 48.3 | 88 | 48 | 19 | 14 | 55 | View → |
| #39 | Massachusetts | D | 48.2 | 53 | 48 | 19 | 42 | 85 | View → |
| #40 | Virginia | D | 48.0 | 79 | 45 | 19 | 18 | 70 | View → |
| #41 | West Virginia | D | 48.0 | 75 | 46 | 17 | 27 | 70 | View → |
| #42 | Tennessee | D | 47.4 | 85 | 46 | 19 | 17 | 55 | View → |
| #43 | Hawaii | D | 47.2 | 55 | 49 | 49 | 6 | 70 | View → |
| #44 | Alaska | D | 47.1 | 0 | 42 | 100 | 25 | 85 | View → |
| #45 | Delaware | D | 46.8 | 59 | 42 | 37 | 24 | 70 | View → |
| #46 | Connecticut | F | 46.5 | 58 | 43 | 20 | 31 | 85 | View → |
| #47 | Maryland | F | 45.3 | 67 | 46 | 22 | 15 | 70 | View → |
| #48 | New Hampshire | F | 44.9 | 63 | 45 | 21 | 21 | 70 | View → |
| #49 | Florida | F | 44.6 | 80 | 46 | 20 | 4 | 55 | View → |
| #50 | New Jersey | F | 44.3 | 59 | 44 | 20 | 26 | 70 | View → |
| #51 | Wyoming | F | 42.3 | 82 | 47 | 22 | 22 | 15 | View → |
All pillar scores are 0–100. Composite is a weighted average: Affordability 25%, Quality 25%, Staffing 20%, Access 15%, Medicaid 15%. Letter grades assigned by rank position (top 10 = A, next 11 = B, etc.). Read methodology →