The Midwest can lay claim to offering the most long-term care options at the lowest cost, according to the results of a survey by Genworth Financial (NYSE: GNW), while the Northeast and West Coast states generally offer fewer affordable alternatives. These are among the key findings of a national cost of care survey released by Richmond, Va.-based Genworth in late April.

The most comprehensive study of its kind, Genworth’s 2009 Cost of Care Survey covers more than 14,000 nursing homes, assisted living facilities, and home health and adult day health care providers in 331 regions across America.

Since 2004, Genworth has surveyed the cost of long-term care across the U.S. to provide Americans with a clear understanding of the cost of care in their part of the country. “In 2009, we expanded the scope and depth of our annual Cost of Care Survey to help American families answer the question, 'What's the cost and availability of long-term care in my local community?’" says Buck Stinson, president of insurance products at Genworth Financial.

“Two-thirds of people over age 65 will need long-term care in their lifetimes,” adds Stinson. “Such local information is invaluable to families and their trusted advisors in mapping out a financial security strategy to cover the growing cost of this vital care.”

New to the 2009 survey is the Genworth Choice & Affordability Index. This tool identifies regions where nursing home care choices are both numerous and most affordable in proportion to the area’s population of persons age 65 and older, thereby creating an index of the best places in the U.S. for nursing home care.

The Choice & Affordability Index does not measure or reflect the long-term care services capacity, such as the number of beds available in a region or the quality of care. Instead, it reflects the number of facilities in the region in proportion to the population age 65 and older along with the cost of care in that area.

Full results of Genworth's 2009 Cost of Care Survey, including the Choice & Affordability Index, an interactive map of the cost of care in all 50 states and 331 geographic regions, and other useful tools and information is available online at Genworth.com/CostofCare.

Genworth's Choice & Affordability Index highlights the great disparity nationwide between regions with many alternatives for affordable nursing home care and those with more limited options.

According to the Choice & Affordability Index, the top 10 states for nursing home care availability and choice include: (1) Iowa, (2) South Dakota, (3) Kansas, (4) Nebraska, (5) North Dakota, (6) Oklahoma, (7) Missouri, (8) Arkansas, (9) Wyoming, (10) Louisiana.

While nursing home and assisted living costs have risen sharply over the past five years, home care costs have remained relatively flat. Genworth data shows that 74% of initial claims are for long-term care services received in the home. The hourly private pay rate for a non-Medicare certified, state licensed home health aide is $18.50. Since 2005, the cost for this type of care has increased at an annual rate of 2%.

The cost of care in a nursing home or assisted living facility continues to rise at a rate nearly twice that of the median annual inflation rate of 2.3% over the same period of time, measured using the core Consumer Price Index (which excludes food and fuel) reported by the U.S. Bureau of Labor Statistics.

The annual cost for a private nursing home room is $74,208, or $203 per day, representing an increase of 4% annually since 2005. At this rate, the cost is expected to exceed $270,000 a year in 30 years, when the nation’s youngest baby boomers will be in their mid-70s. According to the Centers for Disease Control and Prevention, more than 76% of nursing home residents are 75 years of age or older.

The annual cost for a one-bedroom unit in an assisted living facility is $33,903, excluding any one-time community or entrance fees, a 5% increase annually since 2005. The cost for this type of care is forecast to exceed $220,000 in 40 years, when the youngest baby boomers will be in their mid-80s. The average age of residents in assisted living facilities was 85 in 2006, as reported by the National Center for Assisted Living.

There are approximately 4,000 adult day health care centers in the U.S., according to the National Adult Day Services Association. The daily cost for this type of care is $53.59 nationally, or $12,862 per year, assuming five days per week of care.

"While countless American families have seen the value of their homes and investment portfolios dwindle during the current economic downturn, the cost of long-term care continues to rise,” according to Stinson of Genworth.

“This environment creates significant financial planning challenges for individuals' long-term care needs. For individuals who had planned to tap their hard-earned nest egg to cover future long-term care costs, this may no longer be a viable option,” adds Stinson.

A trusted advisor, financial planner or insurance specialist can help families talk about and evaluate their options.