Assisted living communities are a popular choice for older adults who wish to live independently but need some help with activities of daily living (ADLs), such as bathing, eating, dressing or moving from a bed to a chair. These residences vary significantly in size, accommodations, costs, amenities, care and services. With such a wide selection, it may be challenging to choose the best assisted living community for you or a loved one.
The following assisted living statistics and facts may help you make an informed decision when choosing an assisted living community.
Interesting Assisted Living Facts
Assisted living communities typically offer a homelike setting with individual apartments or rooms for residents, prepared meals and housekeeping or laundry services.
Costs of assisted living are typically based on monthly rent plus additional fees for varying levels of care, although some assisted living communities include care costs in an all-inclusive monthly rate.
Assisted living facilities range in size from small communities with 25 or fewer residents to large communities with over 100 residents.
Many assisted living communities provide 24-hour supervision, security and onsite staff.
Depending on the assisted living community, amenities offered may include scheduled transportation, events and outings, exercise and other classes, educational speakers, a cinema, a pool, a beauty salon and/or walking trails or other natural settings on the grounds.
Many senior living communities offer assisted living accommodations, care and services as part of a continuing care retirement community (CCRC) structure. CCRCs typically charge an entrance fee ranging from several thousand dollars to $1 million in addition to monthly rent. The entrance fee pays for onsite skilled nursing facility or memory care required over the course of the person’s residence.
Assisted living communities range from modest accommodations with simple amenities to luxury communities with high-end appliances in spacious apartments, patios or balconies and a broad range of amenities.
Medicare doesn’t cover assisted living costs.
Depending on the state Medicaid program, Medicaid may pay for assisted living services, and some also help cover room and board.
A majority of assisted living residents use personal finances or long-term care insurance to cover assisted living costs.
How Many Assisted Living Facilities Are There in the U.S.?
There are approximately 30,600 assisted living communities with nearly 1.2 million licensed beds in the U.S.
Of these communities, 56% are chain affiliated (part of an organization managing at least two communities).
Over 40% of these communities are independently owned.
The average assisted living community maintains 39 licensed beds.
“Overall, the supply of available beds in assisted living is greater than the demand,” says Marcy Baskin, vice president of Senior Care Authority, an elder care consulting franchise headquartered in Petaluma, California. “However, that [balance] varies regionally, [and] we expect the supply-demand ratio to change as the baby boomer population ages. The number of assisted living locations is increasing while [the number of] skilled nursing facilities (SNFs) for long-term care is decreasing. SNFs are moving more toward rehabilitation services for people needing short-term stays that are often covered by Medicare.”
Number of Assisted Living Facilities by State
According to the U.S. Census Bureau’s 2021 County Business Patterns Survey, states with the most assisted living communities include California (4,100), Washington (1,902), Florida (1,804), Texas (1,295) Wisconsin (1,272) and Oregon (1,208).
States with the fewest assisted living communities include Delaware (34), Wyoming (43), Hawaii (61), Rhode Island (61), Vermont (70) and West Virginia (77).
“To determine assisted living availability, one needs to consider not only the number of communities, but also the number of beds they provide,” says Baskin. For example, the average number of beds per community in California is 20 while the average number of beds per community in New York State is well over 100, but California is home to far more facilities than New York.
In some situations, moving to another state with more assisted living availability could make one’s housing less expensive. However, such a move requires careful consideration.
“There are important factors to consider, such as family and friends in that location,climate, geography [and the availability of] medical practitioners and services,” says Baskin. “Moving to assisted living in and of itself can be overwhelming, and moving to assisted living in an unfamiliar town or city compounds that potential hurdle.”
How Much Does Assisted Living Cost?
The national monthly median cost of assisted living in 2023 is $4,774, according to the Genworth Cost of Care survey. However, costs can vary significantly by city and state. For example, the monthly median cost of assisted living in Phoenix in 2023 is $4,217 while the monthly median cost in Washington, D.C. is $6,310 and the monthly median cost in Boise, Idaho is $3,804.
Meanwhile, costs for levels of care required by residents are typically additional line items invoiced separately from monthly rent. They have the single greatest impact on total costs of assisted living, says Baskin.
“As a loved one declines and needs more care, this [shift often] translates into higher monthly fees,” she says. Baskin recommends working with a senior advisor for help navigating the many details and costs of assisted living before entering into an agreement with a community.
How Much Does Assisted Living Cost in Each State?
Monthly assisted living costs tend to be the most expensive in the following states:
Meanwhile, monthly assisted living costs tend to be the most affordable in the following states:
How Many People Rely on Medicaid to Pay for Assisted Living?
Nearly one in five (18%) of assisted living residents relies on Medicaid to pay for daily care services provided by assisted living communities.
State Medicaid programs may pay for personal care and supportive services received in an assisted living community. However, Medicaid might not pay for room and board costs.
A minority of state Medicaid programs don’t pay for services provided by assisted living communities.
Depending on the state Medicaid program, following the death of a person in assisted living, their beneficiaries may be required to repay Medicaid for certain funds used to pay for their assisted living care and services in a process known as estate recovery.
“Since assisted living is generally a private pay [industry], it’s typical for low- to middle-income families who don’t have long-term care insurance to lack the financial means to pay for assisted living, which creates a greater demand for Medicaid assistance,” explains Baskin.
Medicaid is administered by each state, and each state’s regulations vary. “In some states, there are few options [available] for Medicaid covered assisted living costs, which forces someone needing care to move to a skilled nursing facility (which is more commonly covered by Medicaid),” says Baskin.
Medicaid Usage for Assisted Living by State
States where the highest percentage of residents rely on Medicaid are listed below.
States where the lowest percentage of residents rely on Medicaid include:
How Many People Live in Assisted Living Facilities?
Over 800,000 older adults in the U.S. reside in an assisted living facility.
Half of assisted living residents (50%) are at least 85 years old.
About 70% of assisted living residents are female.
About 30% of assisted living residents are male.
When searching for an assisted living community, it’s important to ask about the staff-to-resident ratio, advises Baskin.
“Care needs and state regulations are the primary drivers of staffing ratios,” she explains. “For example, an assisted living facility where residents mostly need help with ADLs like bathing, grooming and dressing may have higher staffing ratios (fewer staff available to support more residents) than a community that serves higher acuity residents with services like memory care.”
How Long Do People Stay in Assisted Living?
The median length stay for someone in assisted living is around 22 months.
Over half (60%) of assisted living residents eventually move from an assisted living community to a skilled nursing facility.
Around one-third of people at least 65 years old may never need assisted living or care in a skilled nursing facility.
One in five people will need long-term care support for longer than five years as they age.
The typical resident lives in an assisted living community for two to three years, many of whom then move to a skilled nursing facility. Communities may also discharge a resident because they:
Move back home
Require a hospital stay
Face financial problems that lead to an inability to pay for assisted living
Choose to move to another assisted living facility
“Occasionally someone moves home if they run out of funds or the family decides to provide or hire care at home,” says Baskin. However, in-home care provided by private agencies is expensive.
“The cost of 24/7 home health care provided by a licensed in-home care agency can be significantly higher than assisted living,” says Baskin. “If someone does move home, families often need to supplement hire care (by physically providing care themselves) to reduce costs.”
Average Age of Assisted Living Residents
Around half of assisted living residents in the U.S. are at least 85 years old.
Just over 30% of residents are between 75 and 84 years old.
About 13% of residents are between 65 and 74 years old.
Just 6% of residents are younger than 65 years old.
“Care provided in assisted living is based on an assessment of an individual’s needs,” says Baskin. “While many conditions are characteristic of adults in their eighties (and older), someone with a dementia diagnosis, for example, could be considerably younger than the typical resident in their eighties.”
A younger person in assisted living may have a physically debilitating disease, such as Parkinson’s disease or multiple sclerosis, requiring assistance with many ADLs. “We’re seeing more people in their seventies requiring assisted living or memory care than in the past,” adds Baskin.
Assisted Living Resident Demographics
Regionally speaking, western states are home to the most assisted living communities (40%), followed by the south (28%), the midwest (22%) and the northeast (8%).
Assisted Living Residents by Gender
The majority of assisted living residents are female, at least 85 years old and non-Hispanic white.
About 70% of assisted living residents are women.
About 30% of assisted living residents are men.
Health Conditions in Assisted Living
Four in 10 assisted living residents are diagnosed with Alzheimer’s disease or another form of dementia.
Three in 10 assisted living residents have heart disease.
Nearly 30% of assisted living residents have depression.
Over 15% of assisted living residents have diabetes.
Nearly half of all residents have hypertension (high blood pressure).
Nearly 65% of residents require assistance with bathing.
About 50% need help with walking or locomotion (moving from one place to another).
Almost 49% of residents require help with getting dressed.
Over 40% need help using the bathroom safely.
Over a third of residents (34%) need help transferring in and out of bed.
Over 20% need help with eating.
“Developers and investors continue to pour money into assisted living [communities], so the number of locations and beds are increasing every day,” says Baskin. “The main issue is affordability, which is the major barrier to finding assisted living for many families.”
The life-changing decision to transition to assisted living is complex, says Baskin. “The emotional, physical, financial and even spiritual toll it can take on an older adult (as well as their family) isn’t a small challenge,” she adds.
At the same time, moving to an assisted living community can mitigate other challenges many older adults face as they age, such as feelings of loneliness and isolation and an increased risk of falls and other injuries, says Baskin.
“As an adult child, relative or friend of someone requiring assistance and support, it’s good to be armed with facts, as well as compassion for the difficulty someone might face when navigating this significant transition,” she adds.
Continuing care retirement communities FAQs. Pennsylvania Insurance Department. Accessed 9/29/2023.
Facts & figures. National Center for Assisted Living. Accessed 9/29/2023.
North American Industry Classification System. U.S. Census Bureau. Accessed 10/23/2023.
2021 cost of care survey. Genworth. Accessed 9/29/2023.
Medicaid. National Center for Assisted Living. Accessed 9/29/2023.
How much care will you need? LongTermCare.gov. Accessed 9/29/2023.
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