Nursing Home Statistics

For those in need of long-term care or assistance with their daily needs, moving into a skilled nursing facility, nursing home, or other residential care community may be necessary. Families seeking help to care for their loved ones have to weigh several factors when picking one of these facilities, which can vary significantly by size and may be quite costly.

While some seniors may be able to live safely on their own or move in with friends or family, others may rely on a senior living facility to provide long-term care services. Some facilities are limited in scope, offering only housing and cleaning, while others offer more comprehensive personal care, such as specialized medical services.

Key Takeaways:

• Over the past eight years, the number of residents living in nursing facilities decreased by 12%, from nearly 1.4 million in mid-2015 to 1.2 million in mid-2023.
• From July 2015 to July 2023, the average number of hours the typical nursing care resident received per day fell from more than 4.1 hours to less than 3.8 hours.
• The number of certified nursing facilities has declined steadily by year from more than 15,600 in July 2015 to just over 15,000 in July 2023.
• There were nearly 1.4 million workers employed by nursing care facilities as of May 2023.
• In 2020, more than 62% of nursing home residents were women.

Nursing Home Statistics

While the number of nursing homes and residents living in such facilities has steadily declined over the past two decades, the COVID-19 pandemic drove these numbers down further. As of May 2024, more than 171,000 nursing home residents have died from COVID-19.

As of 2023, there were fewer nursing homes than at any other point in the past nearly 30 years.

While the declines have dampened the growth of the nursing facility market, revenues for these facilities are expected to rise in the coming years as the senior population in the U.S. grows.

The costs for these homes are also significantly supported by government benefits. More than 6 in 10 nursing home residents were Medicaid recipients in 2020.

Types of Residential Care Facilities

For seniors seeking long-term care, there are several options for housing and care depending on their needs.

Nursing homes: Provide a wide range of personal and medical services, typically including nursing care, 24-hour supervision, meals, and rehabilitation services in some cases. These facilities, sometimes called skilled nursing facilities, are typically licensed and inspected and may be better suited for people with chronic or physical or mental health conditions.

While they may be described interchangeably, skilled nursing facilities may be separate from nursing homes, as they include care administered by trained registered nurses under a doctor’s supervision.

Board and care homes: Also called residential care facilities, these are typically smaller homes where residents receive personal care and meals but not nursing and medical care.

Assisted living facilities: Can offer residents help with their daily personal care but typically not to the same extent as nursing homes.

Continuing care retirement communities: Offer tiered services where residents can move from independent housing to assisted living and skilled nursing care facilities depending on their needs.

Nursing Home Populations

Since the turn of the century, the number of residents in certified nursing homes has declined significantly, falling from 1.48 million in 2000 to 1.37 million in 2015 to just 1.2 million in 2023. The nursing home population has been further driven down in recent years, with more than 171,000 nursing home deaths attributed to COVID-19.

The declining number of people living in nursing homes reflects a trend of more people opting to receive care in home- and community-based settings rather than institutional settings. People are instead relying on personal home aides, which can cost significantly less than paying for a private or even semiprivate room at a nursing home.

The decline also bucks overall population trends in the U.S. While fewer people have entered nursing homes, the share of Americans ages 65 and older has grown from 12.3% in 2000 to 17.1% in 2022.

Nursing Home Residents by State

California and New York had the most nursing homes in 2023, with nearly 100,000 apiece, while Alaska was the only state with fewer than 1,000 in 2023.

Certified Nursing Home Facilities by Year

As the number of people living in nursing homes has declined by year, so has the number of facilities certified as nursing homes.

In 2000, the U.S. had nearly 17,000 nursing homes. In 2023, that number had fallen to 15,000.¹ The American Health Care Association and National Center for Assisted Living have attributed the decline, in part, to labor shortages, with nursing homes losing skilled workers during the pandemic.

Nursing Home Resident Demographics

The largest share of nursing home residents by age are those 85 and older, who made up nearly 33% of residents in 2020.⁶ Among roughly 1.3 million nursing home users, the next largest groups were ages 75 to 84 (27%) and 65 to 74 (22%).

Nearly half of nursing home residents (46%) were diagnosed with Alzheimer’s disease or another form of dementia, a reflection of these patients’ need for more around-the-clock care than other seniors.

Nursing home residents were also predominantly white and women. Nearly 74% of residents in 2020 identified as non-Hispanic white, followed by 16% identifying as Black. And while women and men make up more even shares of the overall U.S. population, more than 62% of nursing home residents were women in 2020.

Nursing Home Employment

There were nearly 1.4 million workers employed by nursing care facilities as of May 2023.

The largest portion of these workers were home health and personal care aides, with more than 509,000 people employed in these positions.

The median hourly pay for nursing facility workers was $20.25, below the median wage for all jobs nationally ($23.11 per hour). The typical pay for aides and nursing assistants was even lower at just $18.06 per hour.

Pay for skilled nurses at these facilities was significantly higher, with registered nurses receiving a median pay of more than $38 per hour.

Nursing Home Market Outlook

While the declining number of people at nursing homes coupled with the COVID-19 pandemic dampened the market for skilled nursing facilities in the U.S., the market remains robust with a value of $179 billion in 2022.

But as the share of Americans ages 65 and older has risen, the market for nursing facilities is projected to grow at a compound annual growth rate (CAGR) of 3.43% from 2023 to 2030. The prevalence of chronic diseases, including heart conditions, dementia, and Alzheimer’s disease, is also expected to contribute to the demand for such facilities.

Still, the hit to the market and declining use of skilled nursing facilities caused by the pandemic may have lasting impacts on the market for nursing facilities as more people turn to at-home care.

FAQ

What percentage of people end up in a nursing home?

While there have been upward of 1.2 million people living in nursing homes for decades, relatively few people out of the overall U.S. population rely on these facilities. In 2020, there were less than 1.1 million people ages 65 and older living in nursing facilities, accounting for about 2% of the population of Americans in that group.

How many nursing homes are there in the U.S.?

As of July 2023, there were 15,003 certified nursing homes in the U.S., down from nearly 17,000 facilities in 2000.

Who is most likely to be in a nursing home?

Women are more likely than men to live in nursing homes, with women making up nearly 62% of nursing home residents in 2020.⁶ Nursing home residents are also likely to suffer from a chronic health condition — nearly half of residents in 2020 were diagnosed with dementia or Alzheimer’s disease, while nearly 3 in 4 residents had high blood pressure or hypertension.

What percentage of those over the age of 85 live in a nursing home?

People ages 85 and older make up the largest share of nursing home residents, representing nearly one-third of the nursing home population in 2020.

Sources

Chidambaram, P., & Burns, A. “A Look at Nursing Facility Characteristics Between 2015 and 2023.” KFF. Evaluated June 4, 2024.

“NAICS 623100 - Nursing Care Facilities (Skilled Nursing Facilities).” U.S. Bureau of Labor Statistics. Evaluated June 4, 2024.

”COVID-19 Nursing Home Data.” Centers for Medicare & Medicaid Services. Evaluated June 4, 2024.

“Table 92. Nursing homes, beds, residents, and occupancy rates, by state: United States, selected years 1995–2016.” U.S. Centers for Disease Control and Prevention, National Center of Health Statistics. Evaluated June 4, 2024.

“U.S. Skilled Nursing Facility Market Size, Share & Trends Analysis Report By Ownership (For-profit, Non-profit, Government), By Type (Freestanding, Hospital), And Segment Forecasts, 2023 - 2030.” Grand View Research. Evaluated June 4, 2024.

“Data from the 2020 National Post-acute and Long-term Care Study.” U.S. Centers for Disease Control and Prevention, National Center of Health Statistics. Evaluated June 4, 2024.

“Long-Term Care Facilities: Assisted Living, Nursing Homes, and Other Residential Care.” National Institute on Aging. Evaluated June 4, 2024.

“What's the difference between a skilled nursing facility and a nursing home?” United Healthcare. Evaluated June 4, 2024.

“Population ages 65 and above for the United States.” Federal Reserve Bank of St. Louis. Evaluated June 4, 2024.

“New Report Finds Access To Nursing Home Care A Growing Crisis.” American Health Care Association and National Center for Assisted Living. Evaluated June 4, 2024.

“May 2023 National Occupational Employment and Wage Estimates.” U.S. Bureau of Labor Statistics. Evaluated June 4, 2024.

“Population Pyramid: Population by Age and Sex.” U.S. Census Bureau. Evaluated June 4, 2024.