The average total cost for a nursing home is higher than you might think - way higher.

According to industry data, the average cost of a nursing home residence according to Genworth's 2018 cost of care study, is $8,121 a month for a private room, and $7,148 a month for a semi-private room.

Both figures represent total costs for nursing home care on a monthly basis, including room, board, fees, and ancillary expenses charged by a nursing home (also called a skilled nursing facility.)

The factors that matter when calculating the total cost of a nursing home stay rarely vary. The top of that list includes the quality and location of the nursing home residence, how long the stay will be the nursing home care recipient, and the number and quality of specific senior home care services required by the recipient and his or her family.

Those extra charges could be for a wide menu of services, including physical therapy, memory care, prescription drug purchase and/or delivery, special meals based on dietary needs, and other critical services a nursing home resident may need.

That's why an all-inclusive nursing home care rate is advisable for seniors and their families. It gives you a total cost estimate and you may get discounts on key services for paying for an all-inclusive senior care center plan.

It's also worth noting that nursing home care on all levels outpaces the U.S. rate of inflation, by an average of 3%-to-6% annual cost growth rate for nursing homes versus the current U.S. inflation rate of 1.8% through July, 2019.

Put that calculating factor into play and the expected cost of annual nursing home care for a semi-private room rises to $120,008 and the cost of a private room soars to $134,896 in 2028, according to Genworth.

Here's how Genworth breaks down average nursing home care costs on a daily, monthly, and annual basis:

 

Daily 

Monthly 

 

Yearly 

Private Room

$275

$8,365

 

$100,375

Semi-Private Room

$245

$7,441

 

$89,297

Location Really Matters

While all of the above factors are important, the location may be the biggest when calculating senior home care in the U.S. in 2019.

For example, the state you reside in can add or subtract the total average monthly nursing home cost in a significant way.

For example, the average monthly cost for a nursing home residential experience in Oklahoma in 2018 stood at $5,293. Compare that to a cost of over $29,000 for Alaska for the same private room. Alaska is, however, a major outlier, given its relatively remote geographical location and a lack of nursing home options. For instance, Connecticut clocks in second among the most expensive U.S. states for nursing home care, at $13,733.

For a deeper dive, here's a state-by-state list of nursing home costs, as of 2018.

State Total Monthly Cost for Private Room

Highest States by Average Monthly Cost

    Alaska - $29,291

    Connecticut - $13,733

    Hawaii - $13,657

    Massachusetts - $12,775

    New York - $12,189

    No. Dakota - $11,690

    New Jersey - $11,863

    Delaware - $10,950

    Hampshire - $11,102

    Virginia - $11,072

    Lowest States by Average Monthly Cost

      Alabama - $6,661

      Texas - $6,540

      Iowa - $6,479

      Utah - $7,604

      Illinois - $6,753

      Arkansas - $5,986

      Kansas - $5,865

      Missouri - $5,543

      Louisiana - $5,542 

      Oklahoma - $5,293

      Comparative Costs

      With the costs of nursing home care so high - even for a semi-private room - U.S. seniors and their families may want to set their sights lower and pay a more affordable rate of senior home care or assisted living care even if that means foregoing the nursing home care experience.

      For example assisted-living costs, using the same metrics as Genworth uses for its nursing home pricing estimates, comes in at about half the cost of nursing home care.

      In 2018, for example, Genworth pegs the cost of assisted living on a nationwide basis as follows:

      Daily - $132

      Monthly - $4,000

      Yearly - $48,000

      There are two ways of looking at the costs of nursing home care versus assisted living.

      • First, you're getting more comprehensive care, including 24-hour medical services, from a nursing home.
      • Second, you're paying significantly less for assisted-living care, which costs approximately 50% less (depending on where you live) compared to nursing home care. If you're a senior with a family able to pitch in for care needs, the price difference is hard to ignore, as most Americans can hardly afford $8,000 or even $6,000 a month for full-time nursing home care.

      Home-based senior care has a quality of life advantage built into the equation, as most seniors, if health allows, would rather stay in the comfort and safety of their own home than have to live in a nursing home or even spend time at an assisted care center.

      Base costs for home care do come in much lower than a nursing home or even assisted-living care, but there are plenty of add-ons and caveats that can add to the cost of home-based senior care.

      Let's start with basic costs for home care, which is usually priced out at an hourly rate for agency-based care.

      According to PayingforSeniorCare.com, hourly rates vary for senior-based home health care, from $21 to $28 an hour depending on where you live and services you require.

      You may have to add more dollars to the home care budget if the care provided goes beyond basic daily living needs, which include meal preparation, medication help, companionship, hygiene assistance, and occasional licensed medical care. Anything beyond that, like paying for dementia care or other services related to a serious injury or illness, and be prepared to pay a higher rate for senior home care.

      The good news is that you can bring in a trusted private caretaker into your home for up to 30% lower in prices and fees.

      If that sounds like a viable option, make sure to thoroughly vet any private caretaker and ask for references. Any red flags on that front and be ready to pull the plug - any discount on home health care services aren't worth the trouble if you have a problematic private home care service provider under your roof.

      Additionally, don't count on Medicare for full nursing home care financial help. Uncle Sam may help pay for short-term medical care at a nursing home, but usually does not pay the freight for traditional nursing home stays.

      Is Nursing Home Care Tax Deductible?

      The short answer is yes, nursing home care and most professional senior care costs can be tax-deductible as legitimate medical expenses. That said, the IRS has (naturally) certain conditions where it's allowed, as follows:

      You can deduct the full cost of nursing home care if you or your spouse or dependent resides in a nursing home care for medical/health care reasons. In that scenario, you can deduct the whole cost of nursing home care, including room, board, and meals.

      The IRS is prickly about seniors opting for nursing home care for non-medical reasons and doesn't allow for deductions for seniors who reside in a nursing home for personal reasons (i.e., they like the environment and the facility, and are there for reasons other than health issues.)

      That "medical versus personal" area is a gray one in the eyes of the IRS, so it's best to work with a trusted accountant or tax specialist to make sure you're making the correct call when listing a nursing home expense as a deduction on your taxes.

      Tips on Choosing the Perfect Nursing Home 

      Now that you're more aware of the cost of a nursing home, what are the best action steps to take to choose the right one for yourself or for a loved one?

      These strategies always stand the test of time and should help you land the best care facility for your unique needs.

      Ask Your Doctor or Better Yet, Your Nurse

      If you or a family member has a close relationship with their physicians or have spent time in a hospital and care clinic, take advantage of that proximity to knowledge and ask a doctor, nurse or clinician for their "top votes" for nursing home care centers near you.

      Know Going in What Your Priorities Are

      What matters to you in a nursing home selection process is a big issue and needs to be prioritized. If it's the location to family, quality of the facility (i.e. cleanliness or access to regular medical care), good meals, or access to favored religious services, that matter, then say so upfront when you're visiting a home and vetting it.

      Use the Community Grapevine

      Ask your friends, neighbors and co-workers if they have any tips or inside knowledge on local nursing homes. Social media, the Better Business Bureau, and even local law enforcement or community centers are a good place to go fishing for solid nursing home information.

      Visit the Center and Ask Other Families and Residents Staying There

      Besides asking for references, which should a be a staple when you're vetting a nursing home, ask residents and their families what they like and don't like about the facility. Anyone who spends regular time at a nursing home should be a great source of information and red flags concerning that facility. So make sure to ask around when you're on site.

      Read Your Contract Thoroughly 

      Once you've made up your mind and are ready to sign on the dotted line, don't do so until you've read the nursing home contract line. Have a trusted attorney do the same thing. If any issues stand out, make sure to clear the air with the nursing homeowner or manager before signing the document.

      It's never too late - or too early - to plan and invest for the retirement you deserve. Get more information and a free trial subscription toTheStreet's Retirement Dailyto learn more about saving for and living in retirement. Got questions about money, retirement and/or investments? EmailRobert.Powell@TheStreet.com.