How Many Americans Live in Senior Housing?

Key Takeaways:

• Senior housing occupancy rates reached 84.4% in the third quarter of 2023.
• There are approximately 2.1 million residents in senior housing facilities throughout the U.S. 
• Residents aged 85 years and older make up the majority of the population in residential care communities across almost all U.S. states, with Connecticut being the sole exception to this trend.
• Non-Hispanic white residents account for the largest percentage of the population in both nursing homes (about 74%) and residential care communities (88%).
• The majority of residents in nursing homes are female, comprising about 62% of the population. This trend is also observed in residential care communities, where females represent an even higher proportion of about 70%.

In 2020, the population aged 65 and over in the U.S. reached 55.8 million, which was about 17% of the total population. This marked a significant increase from 1920, when less than 5% of the population was 65 and older. By 2030, a notable demographic shift is expected, as all baby boomers will then be older than 65. Projections indicate that by then, the older population will have risen to 73.1 million, representing 21% of the U.S. population, meaning about one in five Americans will be of retirement age.

Aging is accompanied by challenges including health issues, cognitive decline, and reduced mobility, making it difficult for many older individuals to comfortably age in place. These concerns motivate many older adults to consider moving from their homes into alternative living arrangements. Housing options for the elderly are diverse, ranging from private independent living and assisted living communities to nursing homes for those requiring significant medical care.

Senior Housing Occupancy Rates

The years 2022 and 2023 have seen an increasing trend in the demand for senior housing, coupled with a modest increase in inventory.

Among 140 major metropolitan areas surveyed by the National Investment Center for Seniors Housing & Care, Boston had the highest senior housing occupancy rate in the third quarter of 2023 at 89.8%. This was followed closely by Baltimore at 88% and Tampa at 87%. On the other hand, Houston (79.4%), Las Vegas (79.7%), and Atlanta (81%) experienced the lowest occupancy rates during this period.

Residential Care Communities

The Centers for Disease Control and Prevention (CDC) collects data on residential care communities (RCCs) across the U.S. According to the CDC, residential care communities include assisted living facilities and a range of other residential care settings, such as personal care homes, adult care homes, board care homes and adult foster care. These facilities cater to individuals who need assistance with daily living activities but do not require the intensive, skilled care provided in nursing homes.

According to the latest report released by the CDC’s National Center for Health Statistics, there were 30,600 residential care facilities across the U.S. in 2020, serving a total of 818,800 residents. 

The regional distribution of the facilities is as follows:

• Midwest: 24.5%
• Northeast: 7.8%
• South: 28%
• West: 39.7%

National Demographics for RCCs

A typical RCC resident in the U.S. is a non-Hispanic white female over the age of 85. Unfortunately, there’s a strong chance that she’s been diagnosed with a serious health condition, like high blood pressure or Alzheimer’s disease.

The makeup of RCC residents varies considerably with respect to gender, age and health concerns.

 State Demographics for RCCs

In all states, female residents account for the largest percentage of the population in RCCs. Alaska is the state with the lowest percentage of female residents, at 60.3%. On the other hand, West Virginia is the state with the highest percentage, with females accounting for 76% of all RCC residents there. 

Those who are 85 years and older account for a plurality of RCC residents in most states, with the exception of Connecticut. The percentage of residents 85 years of age and older ranges from 25.8% in Connecticut to 64% in South Dakota. 

Certain health conditions are more common among some states’ RCC residents than others:

• Alzheimer’s disease and other forms of dementia affect 59% of Alaska’s RCC residents but only 14.8% of Connecticut’s RCC residents.
• Among Connecticut’s RCCs, 23.5% of residents have diabetes, compared with a mere 10.6% of Hawaii’s RCC residents. 
• Vermont’s RCC residents have the highest incidence of depression (46.4%) and heart disease (47.4%) among all the states. Those diagnoses are far less common among RCC residents in Hawaii, where rates are only 16.5% and 19.3%, respectively.
• High blood pressure is of particular concern in Mississippi, where it affects 61.7% of residents. By contrast, only 33% of Colorado’s RCC residents are diagnosed with high blood pressure.

Read more: How Much Assisted Living Costs

Nursing Homes

Nursing homes offer services with a greater emphasis on medical care compared with most assisted living facilities or board and care homes. These services commonly encompass nursing care, round-the-clock supervision, three meals per day and overall help with daily activities. In 2020, there were 15,300 nursing homes in the U.S. serving 1,294,800 people. 

The regional distribution of nursing homes is as follows:

• Midwest: 32.7%
• Northeast: 16.5%
• South: 35.3%
• West: 15.5%

 Nursing Home Demographics

Again, the majority of Americans in nursing home facilities are non-Hispanic whites (73.6%), and about 62.2% of all residents are female. However, ages skew slightly younger in nursing homes, with a much higher percentage of residents under 75 residing in nursing homes (39.9%) than in residential care facilities (19.2%).

The National Center for Health Statistics report offers demographic data on nursing homes at the national level. Some key statistics are presented in the charts below. 

Senior Housing and COVID-19

The COVID-19 pandemic led to a decline in occupancy rates in senior community homes and a consequent drop in revenue for the sector. In 2020, occupancy rates in retirement centers reached a 16-year low. Furthermore, the pandemic caused a staffing crisis in senior housing facilities due to workforce restrictions and challenges in finding qualified workers.

Research indicates that age is a key factor in determining the severity and mortality rates of COVID-19, with older patients experiencing higher risks. As the virus spread, healthcare facilities — including hospitals, assisted living facilities and nursing homes — were advised to limit all nonessential visits. This measure effectively slowed down the spread of the virus but also led to negative side effects. Elderly residents in nursing homes faced increased isolation and reduced physical activity, and the absence of visitors impacted their psychosocial well-being. 

However, improved access to COVID-19 vaccines in the latter half of 2021 marked a turning point, and vaccination spurred a recovery in demand for senior care facilities. As a result, in 2022, assisted living facilities saw an increase in occupancy to 80.7%, a 6.8% rise from its lowest point of 73.9% occupancy in the second quarter of 2021. That improved occupancy rate, however, remained below the 84.6% occupancy rate that assisted living facilities enjoyed prior to the pandemic. Similarly, nursing care occupancy in 2022 rose to 80%, a 6% increase from its lowest occupancy rate of 74% in the first quarter of 2021, but still not reaching its 86.6% rate from before the pandemic.

FAQs

What is the number of assisted living facilities in the U.S.?

The latest data from the CDC’s National Center for Health Statistics indicates that in 2020, the U.S. was home to 30,600 residential care facilities, commonly known as assisted living facilities.

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

According to the CDC’s National Center for Health Statistics, there were 15,300 nursing homes in the U.S. in 2020. 

What is the most frequently diagnosed health condition among nursing home residents?

High blood pressure/hypertension is the most frequently diagnosed health condition among nursing home residents. Approximately 74% of nursing home residents were diagnosed with this condition in 2020. 

Which U.S. city has the highest occupancy rate in the senior housing sector?

During the third quarter of 2023, Boston recorded the highest occupancy rate in the senior housing sector, reaching almost 90%.

Sources

1. Pearson et al. “The Forgotten Middle: Many Middle-Income Seniors Will Have Insufficient Resources For Housing And Health Care.” Health Affairs. Evaluated Dec. 26, 2023.

2. Mills et al. “COVID-19 in older adults: clinical, psychosocial, and public health considerations.” JCI Insight. Evaluated Dec. 26, 2023.

3. Caplan Z. “2020 Census: 1 in 6 People in the United States Were 65 and Over.” U.S. Census Bureau. Evaluated Dec. 27, 2023. 

4. Vespa et al. “Demographic Turning Points for the United States: Population Projections for 2020 to 2060.” U.S. Census Bureau. Evaluated Dec. 27, 2023. 

5. AEW. “State of Seniors Housing: The Investment Opportunity.” AEW. Evaluated Dec. 27, 2023. 

6. National Investment Center for Seniors Housing & Care. “Senior Housing Occupancy Rate Increases for Ninth Consecutive Quarter.” National Investment Center for Seniors Housing & Care. Evaluated Dec. 28, 2023.

7. NIC MAP Vision. “Senior Housing Market Fundamentals.” NIC MAP Vision. Evaluated Dec. 28, 2023.

8. Sengupta et al. “Variation in Residential Care Community Resident Characteristics, by Size of Community: United States, 2014.” Centers for Disease Control and Prevention. Evaluated Dec. 28, 2023.

9. Khatutsky et al. “Residential Care Communities and Their Residents in 2010: A National Portrait.” Centers for Disease Control and Prevention. Evaluated Dec. 29, 2023. 

10. National Center for Health Statistics. “National Post-acute and Long-term Care Survey.” Centers for Disease Control and Prevention. Evaluated Dec. 29, 2023.

11. National Institute on Aging. “Long-Term Care Facilities: Assisted Living, Nursing Homes, and Other Residential Care.” National Institute on Aging. Evaluated Dec. 29, 2023.12. National Investment Center for Seniors Housing & Care. “Record Senior Housing Demand in 2022 Supported Strong Occupancy Rate Gains.” National Investment Center for Seniors Housing & Care. Evaluated Dec. 29, 2023.