The Best (and Worst) States for Senior Care
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For many seniors, retirement is an opportunity to start fresh–whether that means moving closer to family, joining a new community, or simply enjoying a change of pace. However, the quality and accessibility of senior care can vary significantly from one state to another, with some offering strong support and others falling short. Our nationwide retirement survey found that healthcare and medical costs are the biggest financial worry for 15% of retirees, making it crucial to understand which states provide the best care infrastructure.
Key Insights
Hawaii is the best state for senior care, thanks to high-quality nursing homes, a low risk of social isolation and pristine air and water quality.
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Louisiana is the worst state for senior care, burdened by poor-quality nursing homes, senior poverty, and pollution.
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Utah seniors have the lowest risk of social isolation, reflecting strong community and family support.
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Mississippi ranks last for healthcare system performance, with the 6th-highest rate of preventable hospitalizations and limited access to timely care.
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Colorado has the nation’s lowest rate of preventable hospital discharges, 766 per 100K seniors, showing excellent access to primary care.
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The Retirement Living Research Team analyzed all 50 U.S. states using the latest federal and nonprofit data, ranking them based on healthcare access, community support, and physical environment. This report highlights where seniors thrive and where they face challenges. Read our full methodology below.
Senior Care Report: How States Measure Up
Our senior care report provides a clear look at how each state supports its aging population. Ranks are calculated using 17 weighted factors, measuring healthcare quality, access, community support, and overall senior living conditions. Whether you’re planning a cross-country move or staying in your current home, the key is matching your personal priorities with what each state offers best.
The Best States for Senior Care
The five states below rank at the top of our list for the best senior care. These states lead the country in providing healthcare support and favorable environments for older adults.
1. Hawaii
Hawaii stands out as the nation’s gold standard for senior care. The state ranks first overall for quality of nursing homes, second overall for healthcare system performance, and has the third-lowest rate of preventable hospitalizations, 813 per 100,000 seniors. Hawaii also has below-average social isolation risks for seniors and one of the lowest food insecurity rates in the country at 5.2%
It shouldn’t be surprising that Hawaii also earns high marks for its environment, ranking second in the category. Residents enjoy abundant walkable communities and parks that encourage activities and socialization, along with America’s cleanest air and water. Add comfortable weather year-round, a laid-back culture, and some of the most spectacular natural beauty on earth, and it’s easy to see why Hawaii is such an attractive option for healthy, happy senior living.
2. Minnesota
Seniors have it good in Minnesota, where healthcare accessibility sets the state apart. With the third-highest rate of geriatric doctors per 100,000 residents over 65, specialized care for senior citizens is easier to access. The state also ranks fifth nationally for nursing home quality, ensuring excellent options for long-term care when needed. Community support for seniors is also above average. Only 3.4% of adults 60 or older are food insecure, the second-lowest rate in the country.
Despite its cold winters, Minnesota offers a superior environment for older adults. In addition to the state’s famed number of lakes, Minnesota ranks third for park access, meaning seniors have an abundance of green spaces to enjoy.
3. Utah
Utah offers seniors a relatively safe and inexpensive place to live, ranking fourth nationally for healthcare accessibility. The state leads the nation with the highest percentage of Medicare recipients who passed away in a hospice facility, showing that affordable and compassionate end-of-life care is widely available. Utah also has the lowest risk of social isolation for seniors in the U.S., and the fifth-lowest rate of senior poverty at 8.2%.
The environment in Utah is also conducive to healthy senior living. Utah ranks in the top 20 for drinking water quality as well as walkability. Home to some of the country’s most celebrated national parks, Utah makes a good choice for seniors who love the outdoors.
4. New Hampshire
There is no better state in the country when it comes to community support for seniors than New Hampshire. The state has the second-lowest risk of social isolation in the U.S. It also has some of the lowest levels of senior poverty (7.6%) and food insecurity (3.5%), ranking third for both factors. New Hampshire also provides exceptional healthcare for seniors, with its state healthcare system ranking third in the country for overall performance.
New Hampshire seniors can breathe easily with the country’s third-lowest level of air pollution. That makes it even more appealing to get out and explore the state’s quaint villages and stunning scenery.
5. Colorado
Seniors enjoy a mile-high quality of life in Colorado, with access to some of the nation’s best senior healthcare. Colorado has the lowest level of preventable hospitalizations for older adults and ranks in the top 10 for its patient-to-geriatric-doctor ratio and overall state healthcare system performance. Colorado also ranks among the top 10 in the country for having some of the lowest rates of senior poverty (9.2%) and risk of social isolation.
Colorado provides lots of incentives to stay active in retirement, with some of the lowest levels of air pollution and highest concentrations of public parks in the U.S. Once you factor in the state’s breathtaking Rocky Mountain scenery, it’s easy to see why Colorado is a breath of fresh air for many senior citizens.
The Worst States for Senior Care
On the other side of our list are the states that fall the shortest when it comes to senior care. Food insecurity and poverty disproportionately affect seniors in these struggling states. These five states all earned the lowest possible overall letter grade of F due to poor performance in our key evaluation categories.
50. Louisiana
Seniors face significant challenges living in Louisiana, which ranks last for senior care. That starts with the state’s healthcare system, which has some of the worst health outcomes in the country. Louisiana has the lowest-quality nursing homes in the U.S. and has the third-highest rate of preventable hospitalizations. Geriatric doctors are scarce, with only 22 registered geriatric clinicians per 100,000 adults aged 65 or older. Community support is equally lacking, as Louisiana has the highest rate of food insecurity among seniors in the country at around 14%, along with the third-highest senior poverty rate, 1,943 per 100,000 seniors.
The physical environment is another drawback for seniors in Louisiana. Air quality falls below average, while access to parks is limited throughout the state. Louisiana also has the second-worst drinking water in the U.S., which poses a significant health and safety risk for all residents, but particularly for seniors.
49. Mississippi
Access to healthcare is a genuine concern for seniors in Mississippi, with the state ranking dead last for its healthcare system performance. Mississippi also has the highest rates of senior poverty (15.8%) and social isolation in the nation, which poses both safety and quality-of-life challenges. On top of that, the state invests just $29 per senior in Older Americans Act funding, offering limited support for services like meals, transportation, and caregiver assistance.
Green spaces are few and far between in Mississippi, which ranks last overall for park accessibility. While the state’s environmental scores are notably higher than in other categories, Mississippi’s overall score for the category still falls below the national average.
48. West Virginia
West Virginia ranks last in the U.S. for access to healthcare for seniors. The state has the most preventable hospitalizations in the country, 2,470 per 100,000 seniors. It also ranks second to last for nursing home quality, indicating that finding acceptable assisted living options may be difficult when needed. Community support proves equally inadequate, as West Virginia has the third-highest rate of food-insecure seniors in the U.S. at 11.5%. Loneliness is also a major concern in the state, which ranks in the top 10 for the highest risk of social isolation for seniors.
Despite its natural beauty, West Virginia’s seniors also face a few environmental challenges. West Virginia has the country’s ninth-most polluted drinking water and also ranks low for walkability, thanks to a primarily rural population.
47. Oklahoma
Oklahoma leaves a lot to be desired for senior citizens, especially when it comes to healthcare. The state’s healthcare system is the third-worst rated in the country. It may also be difficult for seniors to find a doctor in Oklahoma, which has only 23.3 geriatric physicians for every 100,000 seniors. Social health presents additional challenges, as Oklahoma has among the highest risks of social isolation for older adults in the U.S. The state also spends just $26 per senior through the Older Americans Act, leaving vital programs like meals and senior centers underfunded.
While Oklahoma ranks highly for walkability, the state has the second-worst water quality in the country, has high levels of air pollution, and has few public parks.
46. Kentucky
High rates of preventable hospitalizations for older adults are just one of several healthcare concerns for seniors in Kentucky. The state finished near the bottom for every factor in our healthcare access category, indicating that high-quality senior care may be hard to come by. Around 13% of seniors in Kentucky live below the poverty line, and seniors here are also very vulnerable to being alone.
Kentucky earned substantially higher scores in the physical environment category, ranking among the top 15 in the country for walkability. However, Kentucky still has worse-than-average air pollution and access to parks.
See Where Your State Ranks
There are, of course, 40 other states in the U.S. In the table below, you can see how every state scored in each of our evaluation categories in our 2025 senior care study.
How to Use These Senior Care Rankings
Where you want to spend your golden years is up to you. If top-tier healthcare is your priority, Hawaii and Minnesota should be at the top of your list. If you value outdoor recreation, Utah or Colorado might be better fits.
Start by identifying your non-negotiables. Are you managing chronic health conditions that require specialized care? Focus on states with high healthcare scores. Worried about feeling isolated in retirement? Prioritize states with strong community support rates. Love spending time outdoors? Paying attention to environmental scores becomes crucial.
Once you’ve narrowed down your choices, explore specific communities using our seniors housing search tools. Finding the best option takes time and a little legwork, but the payoff is a place where you can retire stress-free.
Methodology
To determine the best and worst states for senior care, the Retirement Living Research Team compared all U.S. states across three weighted categories, equaling 100 points.
Healthcare access (50 points): Nursing Home Quality (Sept-Nov 2024 CMS Care Compare Five-Star Rating System); Preventable Hospitalizations; (2023: CMS Mapping Medicare Disparities Tool); Geriatric Clinicians (Sept 2024: CMS National Plan and Provider Enumeration System); Hospice Care (2022: NHPCO Facts and Figures Report); State Health System Performance (2025: The Commonwealth Fund Fund Scorecard on State Health System Performance).
Social and community factors (30 points): Senior Poverty (2023: Census Bureau American Community Survey); Senior Food Insecurity (2022: Feeding America Report Series); Community Support Expenditures (2021: Administration for Community Living State Program Reports); Risk of Social Isolation Among Seniors (2019-2023: Census Bureau American Community Survey).
Physical environment (20 points): Drinking Water Violations (2023: EPA Safe Drinking Water Information System via ECHO); Air Pollution Particles (2021-2023: EPA); Access to Parks (2025: City Health Dashboard); Walk Score (2025: Walk Score).