What it costs to keep her at home, against what assisted living costs here

Every family arrives at this question and almost nobody answers it in public, because the honest answer often is she can stay at home for less — and a site paid a placement fee loses money by saying so. This page says it, shows the arithmetic, and names every figure it does not have.

The short version for Nevada. The published median for a caregiver at home is $37 an hour; the published median for assisted living is $6,241 a month, all in (CareScout (Genworth) Cost of Care Survey, 2025). Divide one into the other and you get the number this whole page is about: at about 39 hours a week, the caregiver alone costs what the entire assisted-living bill costs.

And that comparison flatters staying at home, so read it carefully. The assisted-living figure buys the room, the food, the utilities, the activities and staff on the premises at night. The home-care figure buys the caregiver and nothing else — underneath it she is still paying her mortgage or rent, her heating and her groceries, exactly as she is today. Below the crossover, home is usually cheaper and it is not close. Above it, home is more expensive than the number suggests, not less.

Where in Nevada changes the answer more than most families expect: the crossover runs from about 39 hours a week in Carson City to about 65 in rural Nevada, because assisted living and caregiver wages do not move together from one town to the next.

Build the stack

Pick where she lives and how much of each thing she needs. Every figure below is a published median with its source attached, and anything modeled rather than measured is marked est. and shows the number it was modeled from. Nothing you type here is sent anywhere.

Where does she live?

Care at home, per month, in Nevada as a whole
What she needs	How much	A month
A caregiver at home Help with bathing, dressing, meals and company — what the survey calls home care and Medicare calls custodial care. The survey's own monthly figure assumes 44 hours a week. What to ask about this	hours a week	—
Adult day services A staffed day program with a meal and transport, so she is not alone and you can work. Usually the cheapest hour-for-hour care there is. What to ask about this	days a week	—
A nurse visiting at home Wound care, injections, monitoring an unstable condition. Ask about Medicare first — if she is homebound and needs it intermittently, this line is very often $0. What to ask about this	hours a week	—
At least		the lines above, and nothing else

Also needed — and no survey prices these, so they are not in the total

Meals delivered the federal meal program under the Older Americans Act comes first — there is no fee and no means test, only a suggested donation — what this costs and who pays
Housekeeping and laundry some of this is bundled into a home-care visit you are already paying for — ask before you hire it separately — what this costs and who pays
A medical alert pendant a monthly fee for a monitored one, nothing per month for an unmonitored one that rings a list of family phones — what this costs and who pays
Getting to appointments volunteer driver programs are free or nearly free in most counties, and ADA paratransit is capped by law at twice the regular fare — what this costs and who pays
Changes to the house grab bars and a ramp are a one-off, not a monthly bill — and home-modification help, USDA Section 504 grants and weatherization money exist — what this costs and who pays
Someone to manage all of it the free public agency for her county does a version of this at no charge; a private care manager bills by the hour — what this costs and who pays

Against moving, in Nevada as a whole
Assisted living, all in	$6,241 Nevada-wide median
A nursing home, semi-private room	$11,786 Nevada-wide median

At about 39 hours a week of home care, the caregiver alone costs what the whole assisted-living bill costs in Nevada as a whole — and she is still paying her own rent, heating and groceries underneath it.

What the survey publishes

Region	Caregiver, an hour	Assisted living	Nursing, semi-private	Crossover, hours a week
Carson City	$39	$6,615	$11,558	39
Las Vegas	$35	$5,875	$12,167	39
Reno	$39	$6,893	about $13,017 est.	41
rural Nevada	$25	$6,990	$10,646	65
Nevada, all of it	$37	$6,241	$11,786	39

CareScout (Genworth) Cost of Care Survey, 2025 — 211,985 long-term-care providers surveyed, July–November 2025. Two services are missing from this table on purpose. adult day services ($80 a day) and nurse visiting at home ($100 an hour) are published for Nevada as a whole and not region by region, so there is no rural Nevada figure or Carson City figure for either — only Nevada's. On the stack above they are marked as Nevada's, or modeled for your region from Nevada's and marked est. The last column is ours, and it is the one to read: the hours of home care a week that cost what the whole assisted-living bill costs. Assisted living per month, converted to a week, divided by the hourly home-care rate — arithmetic on two measured medians, not a model, and you can redo it from the columns to its left. Figures marked est. are estimates, not survey results. The survey didn't publish that service for this region, so we took the figure it does publish for the wider area and scaled it by how far this region's assisted-living median sits from the same wider figure. It is arithmetic on two published numbers, not a measurement, and we show the number it was built from so you can judge it.

Who pays for any of this

Medicare does not pay for long-term care. That is not our summary of it; it is the heading Medicare itself puts on the page, over the words “Not Covered. You pay all costs” — and nearly every line on the stack above is one of its examples (Medicare, Long-term care). The claim stays here with the arithmetic it changes; what each payer does cover, what no survey prices at all, and the one figure nobody publishes are the same in every state, so they are written once: who pays for senior care.