Where Your $9,277/Month Nursing Home Payment Goes
Quick Answer
The national median nursing home cost is $9,277/month ($111,325/year) for a semi-private room, yet certified nursing assistants providing most hands-on care earn a median of just $19/hour ($39,530/year). Industry estimates suggest staffing consumes 30-40% of costs, real estate 20-25%, food and supplies 15-20%, administration 10-15%, and profit/reinvestment 5-15%.
You get a bill. $9,277 per month. $111,325 per year. Your parent is receiving care, so the facility must be using this money efficiently, right? Wrong. Or at least, not in the way you'd hope. At Kinporch, we took verified cost and wage data from the Bureau of Labor Statistics, the 2024 Genworth Cost of Care Survey, and publicly available Medicare reimbursement data to map where your money actually goes. What we found should alarm you: certified nursing assistants — the people providing the majority of hands-on care — earn a median of $19/hour, while you're paying $9,277/month. The gap between what families pay and what frontline workers earn is the central problem in American senior care.
The Cost Reality: $9,277/Month Is Now the National Median
According to the 2024 Genworth Cost of Care Survey — which compiled data from 140,000+ senior care providers with 15,000+ completed surveys — the national median for nursing home care in a semi-private room is $9,277/month, or $111,325/year. This is up 7% from 2023, following a trend of consistent increases.
| Year | Monthly Cost | Annual Cost | Year-over-Year Change |
|---|---|---|---|
| 2021 | $7,908 | $94,900 | Baseline |
| 2023 | $8,669 | $104,025 | +9.6% |
| 2024 | $9,277 | $111,325 | +7% |
A private room costs even more: $10,646/month ($127,750/year), up 9% from the prior year. But here's the critical question: where does that money go? Use the Kinporch cost calculator to see how costs compare in your area.
The Wage Reality: CNAs Earn $19/Hour
According to the U.S. Bureau of Labor Statistics' May 2024 survey, the median wage for nursing assistants (CNAs) is $39,530 per year — or roughly $19/hour. The bottom 10% earn under $15/hour (under $31,390/year), while the top 10% earn over $24/hour (over $50,000/year). Home health aides earn even less: a median of $34,900/year, or $16.80/hour.
Nursing facilities typically employ more CNAs than any other role. CNAs provide the majority of direct care — bathing, toileting, mobility assistance, wound care observation. They're frontline. They're underpaid. According to BLS data, CNAs in nursing homes earn less than construction workers (median $50,320), electricians (median $56,900), and even retail managers (median $38,680) — yet nursing home care is physically demanding, emotionally taxing, and involves handling bodily fluids, preventing falls, and providing emotional support to dying residents.
The Cost Breakdown: Where $9,277 Goes
While the Genworth survey produced the $9,277 figure, it doesn't provide a detailed per-facility cost breakdown. However, we can reference industry estimates and the best available data.
Staffing (estimated 30-40% of costs): A nursing facility must employ CNAs at $19/hour median (total cost per CNA typically $23,000-$26,000 annually with taxes and benefits), LPNs at $48,070/year median, and RNs at $77,560/year median, plus nurse management and administrative staff. Industry observers estimate staffing consumes 30-40% of operating costs.
Real estate and facility operations (estimated 20-25%): This includes mortgage or lease payments, property taxes, utilities, building maintenance, and liability insurance — varying dramatically based on ownership structure and local costs.
Food, supplies, and operations (estimated 15-20%): Food service, medical supplies, laundry, cleaning, office supplies, and technology. Administrative overhead (estimated 10-15%): Executive leadership, accounting, compliance, marketing, and legal services. Profit/reinvestment (estimated 5-15%): For-profit facilities typically target 10-15% operating margins. Nonprofit facilities reinvest surpluses into improvements.
What the Data Actually Tells Us
Here's what we can say with certainty. CNAs earn $19/hour median while facility charges reach $9,277/month. That's a massive gap. Even if a CNA works 40 hours per week caring for 8-12 residents, the math doesn't add up to $9,277/month per resident going primarily to frontline care.
Industry observers estimate staffing costs at 30-40% of revenue. If we take 35% of $9,277, that's about $3,247/month per resident across all staff. The remaining 60-70% covers real estate, food, supplies, administration, insurance, compliance, and profit. These are substantial legitimate costs, but the breakdown varies by facility. Without facility-specific financial data, we cannot claim exact percentages — but the gap between what families pay and what workers earn is significant and worth questioning.
The Critical Question: Why Are Wages So Low?
The industry claim is that Medicaid reimbursement doesn't support higher wages. But your private-pay $9,277/month isn't going to Medicaid — it's going to a facility that could theoretically allocate more to direct care staff. Most don't. This is why checking CMS staffing data and asking facilities directly about wages is so important.
What This Means When You're Evaluating a Facility
Ask directly: "What do you pay CNAs per hour?" If they won't answer, that's a red flag. Facilities paying competitive wages ($22-$25/hour) are often willing to say so. Ask: "What's your CNA-to-resident ratio?" Better-staffed facilities maintain 1 CNA per 6-8 residents; understaffed ones run 1 per 12-15. Ask: "What percentage of your residents are Medicaid vs. private-pay?" And check staffing turnover — if a facility has 50%+ annual CNA turnover, staff are leaving because pay and conditions are poor. See our guide on questions to ask when touring a facility.
Assisted Living vs. Nursing Home Costs
According to the 2024 Genworth survey, assisted living costs a national median of $5,900/month ($70,800/year), up 10% from 2023. Assisted living provides less skilled nursing care — residents need help with daily living activities but not 24-hour skilled nursing. This explains the lower cost, though the same wage gap exists. Read our complete assisted living cost guide for details.
How Kinporch Helps You Compare
Kinporch's directory includes 59,346+ verified facilities with direct links to CMS quality ratings and staffing data, publicly available inspection records and deficiency history, and no referral fees. When you compare facilities, don't focus only on cost. Compare cost against CMS staffing ratios and quality ratings. A facility charging $9,277/month with excellent staffing and low deficiencies is different from one charging the same with poor staffing and chronic violations.
Related reading:
- How Much Does Assisted Living Cost? 2026 Guide
- Senior Care Costs by State: Complete 2026 Breakdown
- How to Pay for Nursing Home Care in 2026
Compare nursing home costs and quality on Kinporch — with CMS data, staffing ratios, and no referral fees for 59,346+ facilities nationwide.
Kinporch Editorial Team
The Kinporch Editorial Team researches and writes evidence-based guides to help families navigate senior care decisions. Our content is reviewed for accuracy and informed by CMS data covering 59,000+ facilities nationwide.
