Get ready for some sticker shock at cost of Tri-Cities elder care

Remember the numbers recently used to illustrate the contrast between the emergence of GenZ and the Tri-Cities Baby Boomers on the front porch of old age? A 2018 study by Genworth Financial Inc. adds another level of context – and some sticker shock – to current and future costs challenges as the local population ages.

$120 a day for home health aide services; $100 a day for adult day care; $130 a day for assisted living. Nursing home costs head toward $100,000 a year.

According to the study, Johnson City Metropolitan Statistical Area (MSA) elders who are in semi-private nursing home care are now paying a median cost of $76,833 a year. In a decade, when the local elderly population will balloon, the median cost is expected to be to $103,257 a year.

In the Kingsport-Bristol area, the current median price for a semi-private nursing home room is $73,000, and it’s expected to increase to $98,106 in 2028.

Of course, nursing home care is at the top of the elder care cost pyramid. Some elders live at home or with family caregivers. Others contract for homemaker services, home health aides and assisted living. And the use of and need for adult day care is growing just as fast as the aging population.

Current estimates show 18 Tri-Cities residents a day are turning 70. Census data show there are about 45,000 who are 75 or older. And, there’s a projection that the 75+ group will increase by 36% in the coming decade. The bottom line is the Tri-Cities is five or six years ahead of the national aging trend – a tsunami that will impose many new challenges as well as providing additional opportunities for some elders. But many of those opportunities are muted by the reality of aging and the cost that come with it. Some elders continue to be active and living at home. Many are in or rejoining the labor force. The opportunity and needs level is a highly individual condition.

The cost of elder care comes with some sticker shocks. Long-term health care insurance is available, but it’s expensive and out of reach for many nearing old age. As pointed out in many studies, few age groups are even saving enough for retirement much less worrying about long-term elder care.

Here’s a local look at this facet of the Tri-Cities aging story


Folks in the Kingsport-Bristol Metropolitan Statistical Area (MSA) who use Homemaker Services or a Home Health Aide are paying a median daily cost of $119 for those services that make it possible for them to live in their own homes by having someone to take care of household cores they can’t manage. Things like cleaning house, cooking meals or running areas.

Those services and folks who make it possible for the elderly to live at home run $122 a day in the Johnson City MSA.


Adult Day Care gives caregivers a break that in concept is similar to Child Day Care. Centers may provide health care services, therapeutic services, and social activities. In the Johnson City MSA, the median tab is $50 a day. It’s $96 a day in Kingsport-Bristol.


The cost of aging begins to increase when assisted living facilities come into the picture. Assisted living is not an alternative to a nursing home. It’s an intermediate level of long-term care that offers personal and health services for elders. The median cost in Kingsport-Bristol is $137 a day and $127 a day in the Johnson City metro area


The cost goes up substantially when nursing home care is involved. Residents at these facilities need a higher level of supervision and care than what assisted living facilities can offer. Services include personal care, room, and board, supervision of medications, therapists and rehab as well as skilled nursing care on a 24-hour basis.

Semi-private rooms in the Johnson City metro have a median price of $211 a day while it $226 a day for a private room.

The median for a semi-private room in Kingsport-Bristol is $200 a day and $210 a day for a private room.

Here’s how Genworth thinks the median price for those items will cost in 2028. The median is the number where half is higher, and half is lower.


Homemaker services and home health aide services are expected to increase to $160 a day.

Adult day care increased from $96 a day to $129.

Assisted living increases to $184 from $137.

Semi-private nursing cost increase to $269 a day and a private room goes up to $282.


Homemaker service $164 a day. Home health aides $171 a day.

Adult Daycare $67 a day.

Assisted living facilities $171 a day.

Nursing home semi-private room $284 and $304 for a private room.

For 15 years, Genworth has developed the Cost of Care Survey to help families understand the costs of varying types of care across the U.S. Since 2004, the Cost of Care survey has become the foundation for long-term care planning. The 2018 survey, conducted by Carescout®, covering  449 regions is based on data collected from more than 15,500 completed surveys.

According to the report, the annual median cost of care now ranges from $18,720 for adult care services to $100,375 for a private nursing home room. Since 2017, assisted living facilities increased the most at 6.67%, followed by a semi-private nursing home room at 4.1%.



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