GENWORTH FINANCIAL 2005 COST OF CARE SURVEY

Transcription

1 GENWORTH FINANCIAL 2005 COST OF CARE SURVEY MAY 2005 Nursing Homes, Assisted Living Facilities and Home Care Providers /25/05

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3 1 LETTER FROM BUCK STINSON The need for long term care is an issue that many Americans may face for themselves, a family member, or a friend. There is a heightened level of debate in Washington D.C. about the nation s long term care strategy and the dramatic funding gap that exists with today s government healthcare programs. Because of the critical nature of this topic, Genworth Financial conducted its benchmark Cost of Care study earlier this year to help raise awareness and bring more attention to this critical issue. Contacting more than 7,000 nursing homes, assisted living facilities and home care providers, the study concluded that the average cost of long term care in nursing homes, and assisted living facilities increased over The average annual cost for a private room in a nursing home rose 6% over the 2004 study to $69,400, while the average annual cost for a one-bedroom assisted living facility increased 5% to an average annual cost of $30,300. The cost of in-home care rose marginally versus the 2004 study. As the leader in the long term care insurance industry we helped pioneer over thirty years ago, Genworth Financial, by broadly accelerating its education and awareness efforts, hopes to encourage dialogue and action regarding long term care planning and help our customers realize that they have many choices about how they live as they age. By providing you with tools and information you can use, together we can help Americans make intelligent, informed long term care decisions. Sincerely, Buck Stinson President and CEO Genworth Financial Long Term Care Insurance Division

4 2 EXECUTIVE SUMMARY During March and April 2005 Genworth Financial commissioned its annual cost of care survey. The 2005 survey was conducted by CareScout by telephone in 88 separate regions in the U.S., completing surveys of more than 7,000 nursing homes, assisted living facilities, and home care providers. Nursing Homes: Medicare certified nursing homes were surveyed to determine private pay rates for private and semi-private rooms. Nationally, the average annual cost for a private room (single occupant) is $69,400 ($190/day), reflecting a 6% increase over 2004 rates ($179/day). Nationally, the average annual private room rate at a nursing home increased by $4,400 ($12/day) compared with the Genworth 2004 Survey. Alaska has the highest average annual cost, at about $201,000, for a private room, followed by New York City, New York at about $134,000. Oklahoma, Arkansas, North Dakota, Kansas, and Missouri s non-urban areas (i.e., excluding St. Louis and Kansas City), had the lowest average annual cost for a private room, costing about $44,000. The average annual cost for a semi-private room is $61,000 ($167/day), reflecting a 6% increase over 2004 rates ($158/day). Researchers also found that on average, the cost of care for a private nursing home room in urban areas across America was 12% greater than that in non-urban areas. And, in certain urban areas in California and New York, the cost of care was more than 50% greater than in non-urban areas of those states. Assisted Living Facilities: Assisted living facilities (ALFs) were surveyed to determine the rates for private one-bedroom units. All ALFs surveyed were licensed by their state as assisted living facilities or other comparable residential care facilities. Nationally, the average monthly cost for a private one-bedroom unit is $2,500 (implying a daily rate of $83/day), reflecting an average annual cost of $30,300 a 5% increase over the Genworth 2004 Survey rates ($28,800/yr.). These rates exclude any one-time community or entrance fees. Nationally, the average monthly one bedroom rate increased $1,500 per year ($125/mo.) compared with the Genworth 2004 Survey. Hawaii ($49,200 excluding community fees) and the Bridgeport area of Connecticut ($47,900 excluding community fees) have the highest annual costs for one-bedroom units in ALFs. Arkansas ($18,100 excluding community fees) has the lowest annual cost for a one-bedroom unit in an ALF. Approximately 43% of the ALFs surveyed charge a one-time fee, commonly referred to as a community or entrance fee, ranging from $75 to $8,000 with a national average one-time fee of $1,500. Home Care: Home care providers were classified into 3 types according to their certification and licensure status. The 3 provider types are: Medicare certified home care providers. These providers are also licensed. Non-certified but licensed home care providers. Non-certified and non-licensed home care providers. Researchers surveyed all 3 home health provider types, above to determine the hourly private pay rates charged to provide care by a certified Home Health Aide; also, the 2 types of non-certified providers, above, were surveyed to determine the hourly private pay rates charged to provide Homemaker services.

5 3 In reviewing Home Care rates, please note that there were two primary changes made to the 2005 survey to help improve accuracy. The certified, licensed rates do not include any charges from other (non-certified) business units of the Medicare certified provider. This improvement more strictly segregates Home Health Aid rates by provider types. Additionally, the 2005 survey does not include a Homemaker category for Medicare certified providers to more accurately account for the fact that such rates are typically charged by a related non-certified business unit. The average hourly rate for Home Health Aides was $18.58, versus $18.43 a year ago. For Homemaker services, non-certified, licensed providers had hourly rates averaging $16.82, marginally higher than $16.67 a year ago. Unlike certified home care providers, the noncertified providers offer Homemaker services and they do so at materially the same rate, on average. Nationally, non-certified but licensed providers charge $16.84 per hour while noncertified and non-licensed providers charge $16.49 per hour. METHODOLOGY CareScout, a Wellesley, Massachusetts company that specializes in eldercare provider databases and helps families select appropriate providers nationwide, conducted the survey for Genworth Financial. Carescout contacted over 20,000 providers in order to complete over 7,000 surveys of nursing homes, assisted living facilities, and home care providers in all 50 states and the District of Columbia during March and April, Genworth s study is believed to be the most comprehensive and in-depth survey of its kind. In addition to nursing homes, the Genworth survey includes assisted living facilities and 3 types of home care providers (Medicare certified and licensed providers, non-certified but licensed providers and non-certified and non-licensed providers). Regions were formed to create more accurate estimates in areas where there were large variations in costs. For example, Philadelphia and surrounding counties were separated from the rest of Pennsylvania because care was markedly more expensive than the costs across the rest of the state. This method yields more meaningful figures than providing a single average rate for every state. Nursing Homes: Researchers conducted telephone interviews among a sample of nursing homes across 88 regions created within the 50 states and the District of Columbia based on counties. Continued on next page

6 4 METHODOLOGY continued Within 88 individual regions, researchers polled a minimum of 10 percent of all certified and licensed nursing homes and in no region did less than 10 providers complete the survey. In many areas, the sample size was significantly larger. More than 2,000 providers completed the survey. The survey evaluated the cost of care for a private room (single occupant) and a semi-private room (two occupants) in Medicare certified nursing facilities. Medicare certified nursing homes represent more than 95% of all nursing homes in the U.S. Rates for transitional care units (typically hospital based) were not included. The daily room charge usually includes services beyond room and board such as three meals a day, laundry, sundries, basic nurse supervision, and generic-brand, non-prescription pharmaceuticals. Assisted Living Facilities: Within 88 regions surveyed, researchers polled approximately 10 percent of the licensed facilities and in no region did less than 10 facilities complete the survey. In many areas, the sample size was significantly larger. Approximately 2,000 providers completed the survey. Unlike nursing homes, there is no national, uniform regulatory protocol for assisted living facilities. As a consequence, states have instituted licensing standards that vary from state to state. CareScout s researchers interviewed assisted living facilities who were licensed according to the state licensure requirements of the state in which the assisted living facility was located. The survey evaluated the base rate, roughly the equivalent of monthly rent, for a private, onebedroom unit in an assisted living facility. Researchers also procured community / entrance fee data. The monthly rate typically includes 3 meals per day and sometimes includes basic care-related supervision. It does not typically include additional costs for care such as therapy, rehabilitation, or medication costs. Home Care: Researchers conducted telephone interviews among a sample of home care providers across 88 regions created within the 50 states and the District of Columbia based on counties. Researchers polled a minimum of 10 percent of the home care providers per region. In many areas, the sample size was significantly larger. Over 3,000 providers completed the survey. Three types of home care providers were surveyed. The 3 types are: 1. Medicare certified and licensed home care providers. 2.Non-certified but licensed home care providers. 3.Non-certified and non-licensed home care providers. Researchers surveyed all 3 home health provider types, above, to determine hourly private pay rates charged to provide care by a certified Home Health Aide. Home Health Aides provide personal care but not medical care. For example, a Home Health Aide will typically help with bathing, dressing, transferring and toileting but not with catheters or injections. Also, researchers surveyed the 2 types of non-certified providers, above, to determine hourly private pay rates charged to provide Homemaker services. Homemakers generally do not provide hands-on care; their services typically include helping with shopping, finances, cooking, running errands, transportation and/or providing companionship.

7 5 GENWORTH FINANCIAL 2005 COST OF CARE SURVEY LIST OF RATE TABLES Nursing Home Private Room Daily Rates Page 6 Nursing Home Semi-Private Room Daily Rates Page 8 Assisted Living Facility Monthly Rates for Private 1 Bedroom Page 10 Home Health - Hourly Rates for Home Health Aide Page 12 (All 3 Provider Types) Home Health - Hourly Rates for Home Health Aide Page 14 (Certified Agencies Only) Home Health - Hourly Rates for Home Health Aide Page 16 (Non-Certified but Licensed Agencies Only) Home Health - Hourly Rates for Home Health Aide Page 18 (Non-Certified but Unlicensed Agencies Only) Home Health - Hourly Rates for Homemaker Services Page 20 (Both Non-Certified Provider Types) Home Health - Hourly Rates for Homemaker Services Page 22 (Non-Certified but Licensed Agencies Only) Home Health - Hourly Rates for Homemaker Services Page 24 (Non-Certified and Unlicensed Agencies Only)

8 6 DAILY ROOM RATES FOR PRIVATE NURSING HOME ROOM Minimum Maximum Average Average State or Region Daily Rate Daily Rate Daily Rate Annual Rate AK AL AR AZ - Phoenix AZ - Rest-of-State CA - Los Angeles CA - Oakland CA - Rest-of-State CA - Sacramento CA - Santa Ana CA - San Diego CA - San Francisco CA - San Jose CO - Denver CO - Rest-of-State CT - Bridgeport CT - Rest-of-State DC - Bethesda DC - Washington DE FL - Jacksonville FL - Miami FL - Orlando FL - Rest-of-State FL - Tampa GA - Atlanta GA - Rest-of-State HI IA ID IL - Chicago IL - Rest-of-State IN - Indianapolis IN - Rest-of-State KS KY LA MA - Boston MA - Rest-of-State MD - Baltimore MD - Rest-of-State ME MI - Detroit MI - Rest-of-State MN - Minneapolis MN - Rest-of-State MO - Kansas City MO - Rest-of-State $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 200,754 $ 51,283 $ 43,701 $ 65,335 $ 72,164 $ 67,525 $ 83,585 $ 69,952 $ 76,577 $ 79,296 $ 77,946 $ 106,671 $ 77,606 $ 69,350 $ 64,072 $ 114,928 $ 102,521 $ 74,226 $ 70,985 $ 67,562 $ 60,207 $ 71,347 $ 67,890 $ 64,882 $ 77,552 $ 56,382 $ 50,870 $ 93,597 $ 48,928 $ 56,659 $ 60,685 $ 51,472 $ 60,513 $ 57,517 $ 43,920 $ 66,171 $ 44,614 $ 107,485 $ 96,612 $ 69,591 $ 63,455 $ 78,362 $ 68,722 $ 67,843 $ 67,890 $ 51,961 $ 54,002 $ 44,212 Continued on next page

9 7 DAILY ROOM RATES FOR PRIVATE NURSING HOME ROOM Minimum Maximum Average Average State or Region Daily Rate Daily Rate Daily Rate Annual Rate MO - St. Louis MS MT NC - Charlotte NC - Rest-of-State ND NE NH NJ - New York NJ - Rest-of-State NM NV - Las Vegas NV - Rest-of-State NYC NY - Buffalo, Rochester, Syracuse NY - New York, Newark, Edison (Not NYC) NY - Rest-of-State OH OK OR - Portland OR - Rest-of-State PA - Philadelphia PA - Rest-of-State RI SC SD TN TX - Austin TX - Dallas TX - Houston TX - Rest-of-State TX - San Antonio UT VA - Rest-of-State VT WA - Rest-of-State WA - Seattle WI WV WY National $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 45,844 $ 51,472 $ 50,965 $ 60,240 $ 57,933 $ 43,815 $ 48,822 $ 83,267 $ 92,568 $ 93,075 $ 54,257 $ 66,686 $ 64,503 $ 133,663 $ 86,917 $ 115,716 $ 88,461 $ 64,043 $ 42,431 $ 63,565 $ 60,827 $ 84,837 $ 74,288 $ 84,333 $ 52,089 $ 48,081 $ 58,280 $ 51,801 $ 53,958 $ 66,295 $ 48,720 $ 53,381 $ 55,097 $ 56,593 $ 74,387 $ 73,872 $ 80,756 $ 66,536 $ 60,667 $ 56,750 $ 69,422

10 8 DAILY ROOM RATES FOR SEMI-PRIVATE NURSING HOME ROOM Minimum Maximum Average Average State or Region Daily Rate Daily Rate Daily Rate Annual Rate AK AL AR AZ - Phoenix AZ - Rest-of-State CA - Los Angeles CA - Oakland CA - Rest-of-State CA - Sacramento CA - Santa Ana CA - San Diego CA - San Francisco CA - San Jose CO - Denver CO - Rest-of-State CT - Bridgeport CT - Rest-of-State DC - Bethesda DC - Washington DE FL - Jacksonville FL - Miami FL - Orlando FL - Rest-of-State FL - Tampa GA - Atlanta GA - Rest-of-State HI IA ID IL - Chicago IL - Rest-of-State IN - Indianapolis IN - Rest-of-State KS KY LA MA - Boston MA - Rest-of-State MD - Baltimore MD - Rest-of-State ME MI - Detroit MI - Rest-of-State MN - Minneapolis MN - Rest-of-State MO - Kansas City MO - Rest-of-State $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 189,986 $ 48,957 $ 39,029 $ 55,089 $ 54,973 $ 54,385 $ 64,733 $ 58,210 $ 57,305 $ 62,900 $ 58,572 $ 81,001 $ 64,167 $ 60,554 $ 53,137 $ 108,544 $ 93,429 $ 67,726 $ 65,328 $ 63,583 $ 55,597 $ 64,047 $ 59,469 $ 58,466 $ 60,499 $ 51,502 $ 48,640 $ 86,917 $ 42,442 $ 54,232 $ 50,699 $ 42,968 $ 43,603 $ 50,976 $ 40,354 $ 57,663 $ 38,701 $ 94,641 $ 89,297 $ 64,174 $ 55,918 $ 70,514 $ 60,287 $ 62,090 $ 53,243 $ 46,121 $ 44,950 $ 40,646 Continued on next page

11 9 DAILY ROOM RATES FOR SEMI-PRIVATE NURSING HOME ROOM Minimum Maximum Average Average State or Region Daily Rate Daily Rate Daily Rate Annual Rate MO - St. Louis MS MT NC - Charlotte NC - Rest-of-State ND NE NH NJ - New York NJ - Rest-of-State NM NV - Las Vegas NV - Rest-of-State NYC NY - Buffalo, Rochester, Syracuse NY - New York, Newark, Edison (Not NYC) NY - Rest-of-State OH OK OR - Portland OR - Rest-of-State PA - Philadelphia PA - Rest-of-State RI SC SD TN TX - Austin TX - Dallas TX - Houston TX - Rest-of-State TX - San Antonio UT VA - Rest-of-State VT WA - Rest-of-State WA - Seattle WI WV WY National $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 42,377 $ 49,366 $ 48,399 $ 55,130 $ 54,349 $ 40,683 $ 43,307 $ 76,515 $ 83,760 $ 85,045 $ 48,206 $ 58,181 $ 58,104 $ 129,283 $ 84,096 $ 111,781 $ 83,238 $ 55,907 $ 36,909 $ 57,148 $ 57,097 $ 75,088 $ 66,255 $ 70,317 $ 47,757 $ 46,859 $ 51,450 $ 40,515 $ 39,238 $ 42,851 $ 34,620 $ 36,095 $ 46,129 $ 52,253 $ 71,832 $ 68,766 $ 71,222 $ 59,813 $ 57,809 $ 50,209 $ 61,116

12 10 MONTHLY RATES FOR ASSISTED LIVING FACILITY- PRIVATE 1 BEDROOM State or Region AK AL AR AZ - Phoenix AZ - Rest-of-State CA - Los Angeles CA - Oakland CA - Rest-of-State CA - Sacramento CA - Santa Ana CA - San Diego CA - San Francisco CA - San Jose CO - Denver CO - Rest-of-State CT - Bridgeport CT - Rest-of-State DC - Bethesda DC - Washington DE FL - Jacksonville FL - Miami FL - Orlando FL - Rest-of-State FL - Tampa GA - Atlanta GA - Rest-of-State HI IA ID IL - Chicago IL - Rest-of-State IN - Indianapolis IN - Rest-of-State KS KY LA MA - Boston MA - Rest-of-State MD - Baltimore MD - Rest-of-State ME MI - Detroit MI - Rest-of-State MN - Minneapolis MN - Rest-of-State MO - Kansas City MO - Rest-of-State Continued on next page Minimum Maximum Average Average Monthly Rate Monthly Rate Monthly Rate Annual Rate $ $ $ $1, $1, $ $ $1, $1, $1, $ 1, $2, $ $ $1, $2, $1, $1, $1, $1, $ $ $1, $1, $1, $1, $ 1, $3, $1, $ $ 1, $1, $1, $ $1, $ 1, $1, $2, $1, $1, $ $1, $ $ $ 1, $ $1, $ $6, $3, $2, $3, $3, $ 7, $4, $4, $3, $5, $5, $6, $6, $4, $3, $6, $4, $4, $4, $3, $4, $5, $3, $2, $ 3, $3, $2, $6, $2, $4, $5, $6, $3, $3, $3, $3, $3, $ 5, $4, $3, $3, $5, $3, $3, $4, $4, $4, $3, $3, $1, $ 1, $2, $2, $3, $2, $2, $2, $ 2, $ 2, $ 3, $2, $ 2, $2, $ 3, $ 2, $ 3, $ 2, $2, $2, $2, $2, $2, $2, $ 2, $1, $ 4, $ 2, $ 2, $ 3, $2, $2, $ 2, $2, $2, $2, $ 3, $3, $2, $1, $3, $2, $1, $2, $2, $2, $ 2, $ 45,636 $ 21,687 $ 18,147 $ 26,723 $ 28,760 $ 39,490 $ 31,239 $ 30,571 $ 28,508 $ 32,293 $ 32,858 $ 37,585 $ 31,064 $ 29,642 $ 27,065 $ 47,892 $ 34,512 $ 39,597 $ 33,299 $ 34,669 $ 27,415 $ 27,954 $ 29,171 $ 29,118 $ 26,951 $ 27,410 $ 22,164 $ 49,230 $ 24,233 $ 27,565 $ 37,432 $ 34,733 $ 26,951 $ 25,951 $ 28,725 $ 25,189 $ 25,321 $ 47,341 $ 39,539 $ 32,512 $ 22,376 $ 43,681 $ 35,122 $ 18,888 $ 24,883 $ 29,187 $ 29,673 $ 25,552

13 11 MONTHLY RATES FOR ASSISTED LIVING FACILITY- PRIVATE 1 BEDROOM State or Region MO - St. Louis MS MT NC - Charlotte NC - Rest-of-State ND NE NH NJ - New York NJ - Rest-of-State NM NV - Las Vegas NV - Rest-of-State NYC NY - Buffalo, Rochester, Syracuse NY - New York, Newark, Edison (Not NYC) NY - Rest-of-State OH OK OR - Portland OR - Rest-of-State PA - Philadelphia PA - Rest-of-State RI SC SD TN TX - Austin TX - Dallas TX - Houston TX - Rest-of-State TX - San Antonio UT VA - Rest-of-State VT WA - Rest-of-State WA - Seattle WI WV WY National Minimum Maximum Average Average Monthly Rate Monthly Rate Monthly Rate Annual Rate $ $ $1, $2, $1, $ $1, $1, $2, $2, $ $1, $1, $ $ $1, $ $ $ $1, $1, $2, $ $1, $ $1, $ $2, $ $ $1, $ $1, $ $ 1, $ 1, $1, $1, $1, $1, $ $3, $3, $3, $5, $3, $2, $5, $5, $ 4, $4, $3, $3, $2, $5, $3, $4, $5, $4, $4, $3, $3, $4, $6, $4, $ 3, $2, $3, $3, $4, $3, $4, $3, $2, $ 3, $3, $4, $4, $ 3, $2, $2, $ 7, $2, $2, $2, $ 2, $2, $1, $2, $2, $3, $3, $2, $2, $1, $3, $2, $ 2, $2, $2, $ 2, $2, $2, $3, $1, $ 3, $2, $1, $ 2, $2, $2, $1, $ 2, $2, $ 1, $2, $2, $2, $ 2, $ 2, $ 1, $ 2, $ 2, $ 30,493 $ 24,368 $ 25,646 $ 34,219 $ 29,909 $ 19,726 $ 31,116 $ 35,334 $ 47,046 $ 40,334 $ 26,640 $ 27,704 $ 23,122 $ 42,326 $ 27,714 $ 31,822 $ 26,730 $ 25,575 $ 25,863 $ 29,349 $ 28,884 $ 39,471 $ 23,803 $ 37,313 $ 24,197 $ 23,151 $ 25,311 $ 35,984 $ 30,957 $ 21,397 $ 29,009 $ 24,947 $ 21,776 $ 28,278 $ 29,238 $ 29,145 $ 33,750 $ 29,905 $ 21,849 $ 24,447 $ 30,265

14 12 HOURLY RATES FOR HOME HEALTH AIDE (All 3 Provider Types) Minimum Maximum Average State or Region Hourly Rate Hourly Rate Hourly Rate AK AL AR AZ - Phoenix AZ - Rest-of-State CA - Los Angeles CA - Oakland CA - Rest-of-State CA - Sacramento CA - Santa Ana CA - San Diego CA - San Francisco CA - San Jose CO - Denver CO - Rest-of-State CT - Bridgeport CT - Rest-of-State DC - Bethesda DC - Washington DE FL - Jacksonville FL - Miami FL - Orlando FL - Rest-of-State FL - Tampa GA - Atlanta GA - Rest-of-State HI IA ID IL - Chicago IL - Rest-of-State IN - Indianapolis IN - Rest-of-State KS KY LA MA - Boston MA - Rest-of-State MD - Baltimore MD - Rest-of-State ME MI - Detroit MI - Rest-of-State MN - Minneapolis MN - Rest-of-State MO - Kansas City MO - Rest-of-State $ 6.10 $ $ $ $ $ $ $ $ 6.50 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $23.16 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Continued on next page

15 13 HOURLY RATES FOR HOME HEALTH AIDE (All 3 Provider Types) Minimum Maximum Average State or Region Hourly Rate Hourly Rate Hourly Rate MO - St. Louis MS MT NC - Charlotte NC - Rest-of-State ND NE NH NJ - New York NJ - Rest-of-State NM NV - Las Vegas NV - Rest-of-State NYC NY - Buffalo, Rochester, Syracuse NY - New York, Newark, Edison (Not NYC) NY - Rest-of-State OH OK OR - Portland OR - Rest-of-State PA - Philadelphia PA - Rest-of-State RI SC SD TN TX - Austin TX - Dallas TX - Houston TX - Rest-of-State TX - San Antonio UT VA - Rest-of-State VT WA - Rest-of-State WA - Seattle WI WV WY National $ $ 9.00 $ $ $ $ 9.00 $ $ 8.50 $ $ 7.50 $ 9.00 $ $ $ 7.50 $ 7.50 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 22.43

16 14 HOURLY RATES FOR HOME HEALTH AIDE (Certified Agencies Only) Minimum Maximum Average State or Region Hourly Rate Hourly Rate Hourly Rate AK AL AR AZ - Phoenix AZ - Rest-of-State CA - Los Angeles CA - Oakland CA - Rest-of-State CA - Sacramento CA - Santa Ana CA - San Diego CA - San Francisco CA - San Jose CO - Denver CO - Rest-of-State CT - Bridgeport CT - Rest-of-State DC - Bethesda DC - Washington DE FL - Jacksonville FL - Miami FL - Orlando FL - Rest-of-State FL - Tampa GA - Atlanta GA - Rest-of-State HI IA ID IL - Chicago IL - Rest-of-State IN - Indianapolis IN - Rest-of-State KS KY LA MA - Boston MA - Rest-of-State MD - Baltimore MD - Rest-of-State ME MI - Detroit MI - Rest-of-State MN - Minneapolis MN - Rest-of-State MO - Kansas City MO - Rest-of-State $ $ 6.10 $ $ $ $ $ $ 6.50 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Continued on next page

17 15 HOURLY RATES FOR HOME HEALTH AIDE (Certified Agencies Only) Minimum Maximum Average State or Region Hourly Rate Hourly Rate Hourly Rate MO - St. Louis MS MT NC - Charlotte NC - Rest-of-State ND NE NH NJ - New York NJ - Rest-of-State NM NV - Las Vegas NV - Rest-of-State NYC NY - Buffalo, Rochester, Syracuse NY - New York, Newark, Edison (Not NYC) NY - Rest-of-State OH OK OR - Portland OR - Rest-of-State PA - Philadelphia PA - Rest-of-State RI SC SD TN TX - Austin TX - Dallas TX - Houston TX - Rest-of-State TX - San Antonio UT VA - Rest-of-State VT WA - Rest-of-State WA - Seattle WI WV WY National $ $ $ 9.00 $ $ $ $ 8.50 $ $ 7.50 $ $ $ 7.50 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $19.98 $ $19.38 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 30.96

18 16 HOURLY RATES FOR HOME HEALTH AIDE (Non-Certified but Licensed Agencies Only) Minimum Maximum Average State or Region Hourly Rate Hourly Rate Hourly Rate AK AL AR AZ - Phoenix AZ - Rest-of-State CA - Los Angeles CA - Oakland CA - Rest-of-State CA - Sacramento CA - Santa Ana CA - San Diego CA - San Francisco CA - San Jose CO - Denver CO - Rest-of-State CT - Bridgeport CT - Rest-of-State DC - Bethesda DC - Washington DE FL - Jacksonville FL - Miami FL - Orlando FL - Rest-of-State FL - Tampa GA - Atlanta GA - Rest-of-State HI IA ID IL - Chicago IL - Rest-of-State IN - Indianapolis IN - Rest-of-State KS KY LA MA - Boston MA - Rest-of-State MD - Baltimore MD - Rest-of-State ME MI - Detroit MI - Rest-of-State MN - Minneapolis MN - Rest-of-State MO - Kansas City MO - Rest-of-State $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $19.13 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $16.00 $ Continued on next page

19 17 HOURLY RATES FOR HOME HEALTH AIDE (Non-Certified but Licensed Agencies Only) Minimum Maximum Average State or Region Hourly Rate Hourly Rate Hourly Rate MO - St. Louis MS MT NC - Charlotte NC - Rest-of-State ND NE NH NJ - New York NJ - Rest-of-State NM NV - Las Vegas NV - Rest-of-State NYC NY - Buffalo, Rochester, Syracuse NY - New York, Newark, Edison (Not NYC) NY - Rest-of-State OH OK OR - Portland OR - Rest-of-State PA - Philadelphia PA - Rest-of-State RI SC SD TN TX - Austin TX - Dallas TX - Houston TX - Rest-of-State TX - San Antonio UT VA - Rest-of-State VT WA - Rest-of-State WA - Seattle WI WV WY National $ $ $ $ $ $ $ 9.00 $ $ 9.00 $ 7.50 $ 9.00 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 18.58

20 18 HOURLY RATES FOR HOME HEALTH AIDE (Non-Certified but Unlicensed Agencies) Minimum Maximum Average State or Region Hourly Rate Hourly Rate Hourly Rate AK AL AR AZ - Phoenix AZ - Rest-of-State CA - Los Angeles CA - Oakland CA - Rest-of-State CA - Sacramento CA - Santa Ana CA - San Diego CA - San Francisco CA - San Jose CO - Denver CO - Rest-of-State CT - Bridgeport CT - Rest-of-State DC - Bethesda DC - Washington DE FL - Jacksonville FL - Miami FL - Orlando FL - Rest-of-State FL - Tampa GA - Atlanta GA - Rest-of-State HI IA ID IL - Chicago IL - Rest-of-State IN - Indianapolis IN - Rest-of-State KS KY LA MA - Boston MA - Rest-of-State MD - Baltimore MD - Rest-of-State ME MI - Detroit MI - Rest-of-State MN - Minneapolis MN - Rest-of-State MO - Kansas City MO - Rest-of-State $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $18.00 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Continued on next page

21 19 HOURLY RATES FOR HOME HEALTH AIDE (Non-Certified but Unlicensed Agencies) Minimum Maximum Average State or Region Hourly Rate Hourly Rate Hourly Rate MO - St. Louis MS MT NC - Charlotte NC - Rest-of-State ND NE NH NJ - New York NJ - Rest-of-State NM NV - Las Vegas NV - Rest-of-State NYC NY - Buffalo, Rochester, Syracuse NY - New York, Newark, Edison (Not NYC) NY - Rest-of-State OH OK OR - Portland OR - Rest-of-State PA - Philadelphia PA - Rest-of-State RI SC SD TN TX - Austin TX - Dallas TX - Houston TX - Rest-of-State TX - San Antonio UT VA - Rest-of-State VT WA - Rest-of-State WA - Seattle WI WV WY National $ $ $ $ $ $ NA NA $ $ $ $ $ $ $ NA $ $ $ $ $ $ NA NA $ $ $ $ $ $ $ NA $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ NA NA $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ NA $ 17.58

22 20 HOURLY RATES FOR HOMEMAKER SERVICES (Both Non-Certified Provider Types) Minimum Maximum Average State or Region Hourly Rate Hourly Rate Hourly Rate AK AL AR AZ - Phoenix AZ - Rest-of-State CA - Los Angeles CA - Oakland CA - Rest-of-State CA - Sacramento CA - Santa Ana CA - San Diego CA - San Francisco CA - San Jose CO - Denver CO - Rest-of-State CT - Bridgeport CT - Rest-of-State DC - Bethesda DC - Washington DE FL - Jacksonville FL - Miami FL - Orlando FL - Rest-of-State FL - Tampa GA - Atlanta GA - Rest-of-State HI IA ID IL - Chicago IL - Rest-of-State IN - Indianapolis IN - Rest-of-State KS KY LA MA - Boston MA - Rest-of-State MD - Baltimore MD - Rest-of-State ME MI - Detroit MI - Rest-of-State MN - Minneapolis MN - Rest-of-State MO - Kansas City MO - Rest-of-State $ $ 9.00 $ $ $ $ $ $ $ $ $ $ 7.50 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Continued on next page

23 21 HOURLY RATES FOR HOMEMAKER SERVICES (Both Non-Certified Provider Types) Minimum Maximum Average State or Region Hourly Rate Hourly Rate Hourly Rate MO - St. Louis MS MT NC - Charlotte NC - Rest-of-State ND NE NH NJ - New York NJ - Rest-of-State NM NV - Las Vegas NV - Rest-of-State NYC NY - Buffalo, Rochester, Syracuse NY - New York, Newark, Edison (Not NYC) NY - Rest-of-State OH OK OR - Portland OR - Rest-of-State PA - Philadelphia PA - Rest-of-State RI SC SD TN TX - Austin TX - Dallas TX - Houston TX - Rest-of-State TX - San Antonio UT VA - Rest-of-State VT WA - Rest-of-State WA - Seattle WI WV WY National $ 6.90 $ $ $ $ $ $ 8.25 $ $ 9.59 $ $ 8.50 $ $ $ $ 7.50 $ 6.90 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 16.66

24 22 HOURLY RATES FOR HOMEMAKER SERVICES (Non-Certified but Licensed Agencies) Minimum Maximum Average State or Region Hourly Rate Hourly Rate Hourly Rate AK AL AR AZ - Phoenix AZ - Rest-of-State CA - Los Angeles CA - Oakland CA - Rest-of-State CA - Sacramento CA - Santa Ana CA - San Diego CA - San Francisco CA - San Jose CO - Denver CO - Rest-of-State CT - Bridgeport CT - Rest-of-State DC - Bethesda DC - Washington DE FL - Jacksonville FL - Miami FL - Orlando FL - Rest-of-State FL - Tampa GA - Atlanta GA - Rest-of-State HI IA ID IL - Chicago IL - Rest-of-State IN - Indianapolis IN - Rest-of-State KS KY LA MA - Boston MA - Rest-of-State MD - Baltimore MD - Rest-of-State ME MI - Detroit MI - Rest-of-State MN - Minneapolis MN - Rest-of-State MO - Kansas City MO - Rest-of-State $ $ 9.00 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $15.00 $ $ $19.00 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Continued on next page

25 23 HOURLY RATES FOR HOMEMAKER SERVICES (Non-Certified but Licensed Agencies) Minimum Maximum Average State or Region Hourly Rate Hourly Rate Hourly Rate MO - St. Louis MS MT NC - Charlotte NC - Rest-of-State ND NE NH NJ - New York NJ - Rest-of-State NM NV - Las Vegas NV - Rest-of-State NYC NY - Buffalo, Rochester, Syracuse NY - New York, Newark, Edison (Not NYC) NY - Rest-of-State OH OK OR - Portland OR - Rest-of-State PA - Philadelphia PA - Rest-of-State RI SC SD TN TX - Austin TX - Dallas TX - Houston TX - Rest-of-State TX - San Antonio UT VA - Rest-of-State VT WA - Rest-of-State WA - Seattle WI WV WY National $ $ $ $ $ $ $ 8.25 $ 9.59 $ 8.50 $ $ $ $ 7.50 $ 8.25 $19.00 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 16.82

26 24 HOURLY RATES FOR HOMEMAKER SERVICES (Non-Certified and Unlicensed Agencies) Minimum Maximum Average State or Region Hourly Rate Hourly Rate Hourly Rate AK AL AR AZ - Phoenix AZ - Rest-of-State CA - Los Angeles CA - Oakland CA - Rest-of-State CA - Sacramento CA - Santa Ana CA - San Diego CA - San Francisco CA - San Jose CO - Denver CO - Rest-of-State CT - Bridgeport CT - Rest-of-State DC - Bethesda DC - Washington DE FL - Jacksonville FL - Miami FL - Orlando FL - Rest-of-State FL - Tampa GA - Atlanta GA - Rest-of-State HI IA ID IL - Chicago IL - Rest-of-State IN - Indianapolis IN - Rest-of-State KS KY LA MA - Boston MA - Rest-of-State MD - Baltimore MD - Rest-of-State ME MI - Detroit MI - Rest-of-State MN - Minneapolis MN - Rest-of-State MO - Kansas City MO - Rest-of-State $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ 7.50 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Continued on next page

27 25 HOURLY RATES FOR HOMEMAKER SERVICES (Non-Certified and Unlicensed Agencies) Minimum Maximum Average State or Region Hourly Rate Hourly Rate Hourly Rate MO - St. Louis MS MT NC - Charlotte NC - Rest-of-State ND NE NH NJ - New York NJ - Rest-of-State NM NV - Las Vegas NV - Rest-of-State NYC NY - Buffalo, Rochester, Syracuse NY - New York, Newark, Edison (Not NYC) NY - Rest-of-State OH OK OR - Portland OR - Rest-of-State PA - Philadelphia PA - Rest-of-State RI SC SD TN TX - Austin TX - Dallas TX - Houston TX - Rest-of-State TX - San Antonio UT VA - Rest-of-State VT WA - Rest-of-State WA - Seattle WI WV WY National $ $ 6.90 $ $ $ $ $ $ NA NA $ $ $ 9.50 $ $ $ $ NA $ 6.90 $ $ $ $ $ $ NA NA $ $ $ $ $ NA $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ NA NA $ $ $ $ $ $ $ $ $ $ $ $ $ $ NA $ 16.48

28 26 GENWORTH FINANCIAL 2005 COST OF CARE SURVEY LIST OF REGIONS Regional Definition with Average Daily Rates for Nursing Home Private Rooms and Semi-Private Rooms Page 27 Map of Regions with Nursing Home Private Daily Room Rate Comparison Page 31 Map of Regions with Nursing Home Semi-Private Daily Room Rate Comparison Page 32

29 27 GENWORTH FINANCIAL COST OF CARE SURVEY 2005 LIST OF REGIONS State or Region Counties Territory ID Nursing Home Nursing Home Private Room Semi-Private Average Room Average Daily Rate Daily Rate AK AL AR AZ - Phoenix AZ - Rest-of-State CA - Los Angeles CA - Oakland CA - Rest-of-State CA - Sacramento CA - San Diego CA - San Francisco CA - San Jose CA - Santa Ana CO - Denver CO - Rest-of-State CT - Bridgeport CT - Rest-of-State DC - Bethesda DC - Washington DE FL - Jacksonville FL - Miami FL - Orlando FL - Rest-of-State FL - Tampa GA - Atlanta GA - Rest-of-State Maricopa, Pinal All remaining counties Los Angeles Alameda, Contra Costa All remaining counties El Dorado, Yolo, Placer, Sacramento San Diego Marin, San Mateo, San Francisco Santa Clara, San Benito Orange Jefferson, Park, Clear Creek, Adams, Gilpin, Douglas, Denver, Elbert, Broomfield All remaining counties Fairfield All remaining counties Frederick, Montgomery Charles County, Prince Georges and Calvert County in MD; All remaining counties in DC; Manassas City, Warren, Stafford, Spotsylvania, Fairfax, Manassas Park City, Fairfax City, Prince William, Clarke, Fredricksburg City, Falls Church City, Loudoun, Fauquier, Alexandria City Counties in VA. All remaining counties Baker, Clay, St Johns, Nassau, Duval Miami-Dade, Broward, Palm Beach Osceola, Seminole, Orange, Lake All remaining counties Hillsborough, Pasco, Hernando, Pinellas Haralson, Newton, Walton, Lamar, Fulton, Barrow, Pickens, DeKalb, Bartow, Gwinnett, Butts, Coweta, Paulding, Cherokee, Jasper, Clayton, Meriwether, Cobb, Douglas, Spalding, Forsyth, Carroll, Henry, Dawson, Rockdale, Pike, Fayette, and Heard All remaining counties 87 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Continued on next page

30 28 GENWORTH FINANCIAL COST OF CARE SURVEY 2005 LIST OF REGIONS Nursing Home Nursing Home State or Region Counties Territory ID Private Room Semi-Private Average Room Average Daily Rate Daily Rate HI 88 $ $ IA 51 $ $ ID 72 $ $ IL - Chicago Will, McHenry, DuPage, Cook, 42 $ $ Kane, Kendall, Grundy, DeKalb IL - Rest-of-State All remaining counties 43 $ $ IN - Indianapolis Brown, Shelby, Hendricks, Marion, 40 $ $ Johnson, Hamilton, Hancock, Morgan, Boone, Putnam IN - Rest-of-State All remaining counties 37 $ $ KS (excluding portions of 57 $ $ state within MO-Kansas City region) KY 38 $ $ LA 47 $ $ MA - Boston Essex, Norfolk, Suffolk, Middlesex, 2 $ $ Plymouth MA - Rest-of-State All remaining counties 7 $ $ MD - Baltimore Baltimore city, Harford, Anne 17 $ $ Arundel, Queen Annes, Baltimore, Howard, Carroll MD - Rest-of-State All remaining counties 15 $ $ ME 1 $ $ MI - Detroit Livingston, Lapeer, Oakland, 34 $ $ St Clair, Wayne, Macomb MI - Rest-of-State All remaining counties 36 $ $ MN - Minneapolis Washington, Carver, Ramsey, Isanti, 52 $ $ Hennepin, Scott, Wright, Anoka, Sherburne, Dakota, Chisago MN - Rest-of-State All remaining counties 50 $ $ MO - Kansas City Wyandotte, Miami, Johnson, 53 $ $ Franklin, Leavenworth, Linn Counties in KS; Bates, Cass, Lafayette, Clinton, Jackson, Ray, Clay, Platte, and Caldwell Counties in MO MO - Rest-of-State All remaining counties 49 $ $ MO - St. Louis St Charles, Crawford, Washington, 46 $ $ Warren, Lincoln, Jefferson, St Louis, St Louis city, Franklin MS 44 $ $ MT 68 $ $ NC - Charlotte Anson, Cabarrus, Mecklenburg, 26 $ $ Gaston, Union NC - Rest-of-State All remaining counties 23 $ $ ND 63 $ $ Continued on next page

31 29 GENWORTH FINANCIAL COST OF CARE SURVEY 2005 LIST OF REGIONS State or Region Counties Territory ID Nursing Home Nursing Home Private Room Semi-Private Average Room Average Daily Rate Daily Rate NE NH NJ - New York NJ - Rest-of-State NM NV - Las Vegas NV - Rest-of-State NY - Buffalo- Rochester -Syracuse NY - Newark - Edison (Not NYC) NY - Rest-of-State NYC OH OK OR - Portland OR - Rest-of-State PA - Philadelphia PA - Rest-of-State RI SC SD TN TX - Austin TX - Dallas TX - Houston TX - Rest-of-State Bergen, Union, Hunterdon, Monmouth, Somerset, Morris, Sussex, Middlesex, Passaic, Hudson, Ocean, Essex All remaining counties Clark All remaining counties Oswego, Niagara, Onondaga, Orleans, Monroe, Erie, Wayne, Livingston, Ontario, Madison Kings, Westchester, Rockland, Putnam, Queens, Bronx, Richmond, Nassau, Suffolk All remaining counties New York Columbia, Washington, Multnomah, Clackamas, Yamhill Counties in OR; Clark, Skamania Counties in WA All remaining counties New Castle County in DE; Cecil County in MD; Gloucester, Salem, Burlington, Camden Counties in NJ; Philadelphia, Delaware, Bucks, Montgomery, Chester Counties in PA All remaining counties Bastrop, Caldwell, Williamson, Hays, Travis Ellis, Tarrant, Wise, Delta, Kaufman, Collin, Dallas, Rockwall, Johnson, Parker, Hunt, Denton Liberty, Austin, San Jacinto, Montgomery, Chambers, Waller, Brazoria, Harris, Galveston, Fort Bend All remaining counties 60 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Continued on next page