138
Best State Performance
55
US Value
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Indicator
Assisted Living Supply
Compared to the 2020 Scorecard, the supply of assisted living increased by 15 percent to 55 beds per 1,000 adults 75+. This indicator shows widespread improvement with almost half (24) of states increasing performance by ten percent or more. Hawaii saw the largest increase of 54 percent relative to the last Scorecard. Minnesota has the largest supply ratio at 138, while New York has the smallest at just 20 per 1,000.
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* data not available (including concerns about data quality) or not calculated due to missing data needed for calculation.
† Data not available or not comparable in original source. AARP estimated values based on additional information (see Appendix B4 for imputation details).
Methodology
Methodology
The number of licensed assisted living and residential care units per 1,000 population ages 75+. Assisted living and residential care units are taken from two National Center for Health Statistics (NCHS) surveys. To be eligible for inclusion in these studies, a residential care community must have been licensed, registered, listed, certified, or otherwise regulated by the state to
- Provide room and board with at least two meals a day, around-the -clock on-site supervision;
- Help with personal care such as bathing and dressing or health-related services such as medication management;
- Have four or more licensed, certified, or registered beds;
- Have at least one resident currently living in the community; and
- Serve a predominantly adult population.
Excluded were residential care communities licensed to exclusively serve individuals with severe mental illness or intellectual disability/developmental disability. Nursing homes were also excluded.
Data for the current-year 2020 and reference year 2016 assisted living and residential care units are from the National Study of Long-Term Care Providers Survey.
Reference year data were not available for the District of Columbia and Iowa. The District of Columbia data did not meet confidentiality or reliability standards for NCHS. The vast majority of Iowa’s assisted living / residential care facilities were categorically ineligible for the National Study of Long-Term Care Providers (NSLTCP) due to the operational definition used in the survey.
Both 2016 and 2020 data were not available for Connecticut because the state’s licensing structure for assisted living does not permit a unit count. Connecticut has a unique method of licensing assisted living providers; NPALS therefore excludes the majority of residential care providers in the state. AARP Public Policy Institute has estimated the capacity based on data provided by state officials and a 2021 State of Connecticut Performance Audit: Oversight of Connecticut’s Assisted Living Facilities.
Because publicly reported assisted living and residential care capacity is rounded to the nearest hundred, the capacity per 1,000 people age 75+ was calculated by NCHS and reported rounded to the nearest whole number.
Population data for 2020 (current year) are from the US Census Bureau Population Estimates, 2021 vintage. Baseline 2016 population data are from the same source, 2017 vintage.
NCHS (2019, 2022). Analysis based on data from the 2016 National Survey of Residential Care Facilities and 2020 National Post-acute and Long-term Care Study (unpublished).
US Census Bureau, Annual Estimates of the Resident Population by Single Year of Age and Sex for the United States: April 1, 2020 to July 1, 2021 (Washington, DC: US Census Bureau, 2022), https://www2.census.gov/programs-surveys/popest/datasets/2020-2021/national/asrh/nc-est2021-agesex-res.csv.
US Census Bureau, Annual Estimates of the Resident Population for Selected Age Groups by Sex for the United States: April 1, 2010 to July 1, 2017 (Washington, DC: US Census Bureau, 2018), https://www.census.gov/data/tables/time-series/demo/popest/2010s-state-detail.html.
Connecticut State Performance Audit, https://wp.cga.ct.gov/apa/wp-content/cgacustom/reports/performance/PERFORMANCE_Oversight%20of%20Connecticut%E2%80%99s%20Assisted%20Living%20Facilities_20210922.pdf.