How Many Long Term Care Facilities are in the US?

11 Jan 2022
Get the lowdown on how many long-term care facilities in the US, their impact, and trends shaping them.

Long-Term Care Facilities Overview

As the US population ages, the number of individuals requiring long-term care services has increased significantly. These services are often provided in specialized facilities, designed to meet the unique needs of seniors and individuals with chronic illnesses or disabilities. This section provides an overview of the types of long-term care facilities in the US and the services they offer.

Types of Facilities

There are three primary types of long-term care facilities in the US: Adult Care Homes, Family Care Homes, and Multi-Unit Assisted Housing with Services.

  • Adult Care Homes serve seven or more adults. These facilities typically provide a variety of services in a home-like setting, including meals, personal care, and medication management.
  • Family Care Homes serve 2 to 6 adults. These smaller facilities offer a more intimate setting and often provide a higher level of personalized care.
  • Multi-Unit Assisted Housing with Services are unlicensed facilities that cater to adults not requiring 24-hour supervision. These facilities typically offer a range of supportive services, such as meals, housekeeping, and social activities.

According to recent data, more than 800,000 Americans reside in assisted living facilities, and over 1.3 million people live in nursing homes [2].

Services Offered

Long-term care facilities offer a variety of services designed to support the health and well-being of residents. These services can vary widely based on the type of facility and the needs of the individual residents. However, most long-term care facilities provide the following core services:

  • Personal Care: Assistance with activities of daily living, such as bathing, dressing, and eating.
  • Health Care: Access to medical services, including medication management, physical therapy, and ongoing health monitoring.
  • Meals: Provision of nutritious meals and assistance with eating, if necessary.
  • Social Activities: Opportunities for social interaction and engagement, such as group activities, outings, and special events.
  • Housekeeping: Regular cleaning and maintenance of the resident's living space.

These services are designed to provide a comfortable, home-like setting that encourages independence among residents, thereby offering a better quality of life for seniors.

In summary, long-term care facilities play a crucial role in serving the diverse needs of the aging population in the US. Understanding the different types of facilities and the services they provide can help individuals and their families make informed decisions about long-term care options.

Statistics on Long-Term Care Facilities

Understanding the landscape of long-term care facilities in the United States requires a close look at various statistics. These include the number of residents, distribution by state, and bed availability, among other factors. This article provides a snapshot of these key statistics.

Number of Residents

Long-term care facilities, including nursing homes, play a crucial role in providing care for a significant portion of the US population. As per data from KFF, there are approximately 1.4 million residents in certified nursing facilities in the US. However, the number of residents living in nursing facilities has seen a decrease over the years. Between 2015 and 2023, the number of residents has decreased by 12%, from 1.37 million to approximately 1.2 million [4].

Distribution by State

While the number of residents in long-term care facilities can give us a general picture of the demand for these services in the US, it's important to note that this distribution is not uniform across all states. Some states, due to a higher population or a larger elderly demographic, may have a higher demand for long-term care facilities. Unfortunately, the data on the exact distribution of these facilities by state is not provided in the available context.

Bed Availability

The capacity of long-term care facilities is often measured by bed availability. This refers to the number of beds that a facility has available for residents. While the exact numbers are not provided in the available context, it's important to note that bed availability can vary widely from one facility to another and from one state to another. Factors that can influence bed availability include the size of the facility, the level of care provided, and state regulations on facility capacity.

This data on the number of residents and bed availability in the US long-term care facilities provide insights into the scale and scope of these services. They highlight the significant role these facilities play in caring for the elderly and individuals with chronic illnesses or disabilities, and they underscore the potential challenges and considerations in ensuring adequate and quality care for all residents.

Trends in Long-Term Care Facilities

In the quest for understanding 'how many long term care facilities in the US', it's also essential to examine the trends that have been shaping these facilities. This section will delve into changes in the number of facilities, staffing levels, and private equity ownership.

Changes in Number of Facilities

The landscape of long-term care facilities in the US has seen a decrease over the past few years. According to data gathered by KFF, the number of nursing facilities certified by CMS in the US decreased by 4% between July 2015 and July 2023. The number dropped from 15,648 facilities in 2015 to 15,003 facilities in 2023.

This decrease also corresponds to a decline in the number of residents living in nursing facilities. The same report by KFF indicates a 12% decrease in residents, from 1.37 million to approximately 1.2 million, between 2015 and 2023.

Staffing Levels

Staffing levels in long-term care facilities have also followed a downward trend. The average hours of care that nursing facility residents in the US received declined by 9% between July 2015 and July 2023, with staffing levels remaining below pre-pandemic levels as of October 2023 [4].

These facilities rely on approximately 1.2 million staff members to provide care and maintain facilities. However, nursing homes have historically struggled with workforce shortages and high rates of turnover, which were further intensified during the COVID-19 pandemic [2].

Private Equity Ownership

Private equity ownership in nursing facilities has become a notable trend. An estimated 5% of nursing facilities in the US had private equity ownership in 2022. Concerns about lower quality care resulting from private equity ownership led to the Biden administration finalizing a rule in November 2023 requiring facilities to report such ownership.

These trends provide valuable insight into the evolving landscape of long-term care facilities. It's crucial for government agencies, policymakers, and healthcare providers to monitor these trends and their potential impacts on the quality of care provided to residents.

Impact of COVID-19 on Nursing Homes

The COVID-19 pandemic has had a significant impact on long-term care facilities in the United States, particularly nursing homes. These impacts range from changes in infection control practices to workforce challenges and disparities in vaccination rates.

Infection Control Practices

Historically, nursing homes have had poor infection control practices, which contributed to the rapid spread of COVID-19 within these facilities. Issues such as inadequate and unavailable testing, lack of personal protective equipment (PPE), and delayed or inadequate isolation and quarantine measures further facilitated the spread of the virus. In response to the pandemic, many nursing homes have had to update and improve their infection control practices, introducing new protocols and training to ensure the safety and health of both residents and staff.

Workforce Challenges

Nursing homes rely on approximately 1.2 million staff members to provide care and maintain facilities. However, the sector has historically struggled with workforce shortages and high rates of turnover, challenges that were further intensified during the COVID-19 pandemic. As the pandemic unfolded, many facilities faced staff shortages due to illness, quarantine measures, and fear of infection. These shortages put added pressure on the remaining staff, potentially impacting the quality of care.

Vaccination Rates

Vaccination has been a critical tool in the fight against COVID-19, particularly in long-term care facilities with vulnerable populations. However, vaccination rates among nursing home residents and staff have varied. Factors such as organizational characteristics and race and ethnicity have influenced vaccination coverage. For instance, nonprofit and nonchain facilities had higher vaccination rates, while Black residents had lower vaccination rates. Despite these disparities, the introduction and prioritization of vaccines in nursing homes have significantly reduced the impact of COVID-19 [2].

In conclusion, the COVID-19 pandemic has significantly impacted nursing homes, presenting challenges in infection control, staffing, and vaccination. As the situation evolves, it is crucial for these facilities to continue adapting their practices and policies to protect the health and wellbeing of their residents and staff.

Disparities in Long-Term Care

In the landscape of long-term care facilities in the US, the presence of disparities has become increasingly evident, particularly in light of the COVID-19 pandemic. These disparities range from the impact of the virus on specific demographic groups to differences in vaccination rates among various populations.

COVID-19 Impact Disparities

COVID-19 has had a profound impact on long-term care facilities across the United States, but it's important to note that this impact has not been evenly distributed. Disparities in COVID-19 cases and deaths have been observed among nursing home residents. According to the NCBI Bookshelf, nursing homes serving a higher percentage of non-White residents experienced more COVID-19 cases and deaths.

However, as the pandemic progressed, the impact of COVID-19 shifted to nursing homes with more White residents, depending on the prevalence of the virus in different regions. This illustrates the shifting nature of the pandemic and the existence of disparities within the scope of long-term care facilities.

Vaccination Disparities

On the subject of COVID-19 vaccinations, disparities are also present. Vaccination rates have varied among nursing home residents and staff, with certain factors influencing vaccination coverage. For instance, organizational characteristics had a role to play, with nonprofit and nonchain facilities having higher vaccination rates.

Race and ethnicity also played a part in these disparities. Black residents, for instance, had lower vaccination rates. However, the introduction of vaccines and prioritization of their distribution in nursing homes significantly reduced the impact of COVID-19, according to the NCBI Bookshelf.

These disparities highlight the importance of equitable healthcare practices and policies, especially in the context of long-term care. They underline the need for ongoing efforts to ensure that all residents and staff in these facilities have equal access to necessary care and preventative measures, such as vaccinations. This is an essential step in providing quality care to all residents, regardless of their race, ethnicity, or the organizational characteristics of the facility they reside in.

Financing Long-Term Care

Considering the number of people needing long-term care in the United States, it's crucial to understand the various financing options available. These options are primarily provided by Medicaid, Medicare Part A, and private payment arrangements.

Medicaid Coverage

Medicaid plays a significant role in financing long-term care. It covers the cost of nursing home care for the majority of residents. As of 2020, over 1.3 million people in the United States live in nursing homes, with Medicaid being the primary payer for many of them.

Notably, Medicaid's coverage for long-term care is a critical resource for those who cannot afford the high cost of nursing home care. However, eligibility for Medicaid varies by state, and individuals must meet income and asset limits to qualify.

Medicare Part A Coverage

While Medicaid covers a large portion of long-term care residents, Medicare Part A is the primary payer for a smaller percentage of nursing home residents. Medicare Part A covers short-term stays for skilled nursing or rehabilitation services following a hospital stay.

It's important to note that while Medicare Part A does provide some coverage for nursing home care, it does not cover long-term stays. This coverage is limited to a specific number of days and is contingent on the resident having had a recent hospital stay of at least three days.

Private Payment Options

For individuals who do not qualify for Medicaid or Medicare coverage, private payment options are available. These include out-of-pocket payments or long-term care insurance.

Long-term care insurance is a private payment option that individuals can purchase to help cover the costs of long-term care, including nursing home care. These policies typically cover services not covered by Medicare, such as assistance with daily living activities.

However, the cost of long-term care insurance can be prohibitive for many individuals, and policies often come with limitations and exclusions. Therefore, it's important for individuals to carefully review any insurance policy before purchase.

In conclusion, Medicaid, Medicare Part A, and private payment options each offer different solutions for financing long-term care. Understanding the details of these options can help individuals and families plan for future long-term care needs.

References

[1]: https://forltc.org/types-of-longterm-care

[2]: https://www.ncbi.nlm.nih.gov/books/NBK584647/

[3]: https://www.asccare.com/types-long-term-care-services/

[4]: https://www.kff.org/medicaid/issue-brief/a-look-at-nursing-facility-characteristics/

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