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Assisted Living 2010: Dramatic National Growth but Varying Capacity by State

by Published On: Aug 07, 2012

The assisted living field has experienced dramatic growth over the past 3 year, according to Assisted Living and Residential Care in the States in 2010, a new report from AARP. The report profiles assisted living communities and residents using data that 49 states and the District of Columbia provided to the AARP Public Policy Institute. 

Assisted Living Capacity Varies by State

All told, states provided 51,367 licensed residential care settings in 2010. Those settings had a total capacity of 1.2 million beds that year, up from 1 million beds in 2007.

The nation supplied 31 assisted living units per 1,000 residents over age 65 in 2010. Seventeen states exceeded the national average and 33 states reported units per 1,000 residents that were below that average. One state (Connecticut) did not respond to the survey.

Among the 5 highest performing states, Minnesota offered the most assisted living units (78 units) per 1,000 older state residents, followed by:

  • Oregon (62 units per 1,000 older residents).
  • Idaho (60 units).
  • Wisconsin (57 units).
  • Washington (54 units).

The District of Columbia had the fewest number of assisted living units per 1,000 residents over age 65 (7 units). Also included among the 5 lowest performing states were:

  • Louisiana (10 units per 1,000 older residents).
  • West Virginia (12 units).
  • Mississippi (13 units).
  • Nevada (14 units).

Increased Privacy

In their early years, assisted living communities often asked 2 or more residents to share a bedroom and 8 to 10 residents to share a bathroom. However, market forces, consumer preferences and some state regulations have brought increased privacy to assisted living communities. As a result, only about 3% of units were occupied by 2 unrelated individuals in 2009.

Large Facilities Serve the Most Residents

Assisted living communities come in all sizes. Small and medium facilities of 4 to 25 units dominate the market but serve a relatively small percentage of assisted living residents. In 2010:

  • Large facilities made up 35% of all facilities but housed 81% of the residents. 
  • Small and medium-sized facilities outnumbered large facilities but housed only 19% of residents. 

For-Profit Ownership

Most assisted living communities are privately owned by for-profit owners. In 2010:

  • About 82% of facilities were privately owned for profit. The remaining 18% were nonprofit or owned by state, city or local governments. 
  • About 38% of facilities were chain-affiliated.

Older Females Predominate

The typical assisted living resident is female (70%), age 85 and older (54%), and receiving assistance with activities of daily living (74%). In 2010:

  • Only 10% of residents were younger than 65. 
  • Approximately one-third of residents (33%) had been living in the facility for less than a year. Thirty-six percent of residents had lived in the community for 1 to 3 years and 31% had been in residence for more than 3 years. 
  • More than a third (37%) of residents had 3 or more limitations in activities of daily living. Almost half (42%) had Alzheimer’s or another dementia. 
  • Approximately 1 in 5 assisted living residents (19%) received Medicaid assistance. A third (31%) of Medicaid recipients were younger than 65. 


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