The Current Number of Assisted Living Facilities
Recent data from authoritative sources provides a clear picture of the assisted living landscape in the United States. According to the National Center for Assisted Living (NCAL), part of the American Health Care Association (AHCA), there are approximately 32,231 assisted living communities nationwide. These communities offer a combined total of nearly 1.2 million licensed beds to accommodate residents.
The number of facilities can vary slightly across different data sources depending on the criteria used for classification. For example, some market research firms might track slightly different figures, but the general consensus is that the number of facilities exceeds 30,000. For instance, Definitive Healthcare reported over 32,000 active Assisted Living Facilities (ALFs) as of April 2025, and the CDC's 2022 survey data also reported 32,231 licensed residential care communities. This consistency across major reports solidifies the approximate count.
Assisted Living Facilities by Region
While the national number is helpful, the distribution of assisted living facilities is far from uniform. Factors like population density and state regulations cause significant regional variations. According to AHCA/NCAL data, the regional distribution is heavily weighted toward the West and South:
- West: 40.8% of assisted living communities.
- South: 28.0% of assisted living communities.
- Midwest: 22.6% of assisted living communities.
- Northeast: 8.6% of assisted living communities.
States with warmer climates and lower costs of living, particularly in the Sun Belt, have become magnets for retirees, driving higher concentrations of facilities. This means seniors in some states, like California, Florida, and Texas, may have more options to choose from than those in states with smaller or less concentrated aging populations.
Factors Driving Industry Growth
The steady increase in the number of assisted living facilities is driven by several key demographic and social trends:
- Aging Baby Boomer Population: The large baby boomer generation is reaching retirement age, creating a surge in demand for senior housing and care services.
- Increased Life Expectancy: People are living longer, increasing the number of individuals who will eventually require some form of long-term care.
- Evolving Senior Preferences: Older adults today often seek options that offer a blend of independence and support, preferring the community-focused, less clinical environment of assisted living over traditional nursing homes.
- Chronic Health Conditions: A significant portion of assisted living residents have chronic conditions such as high blood pressure, Alzheimer's, or other forms of dementia, requiring supportive services that can be managed within an assisted living setting.
Assisted Living vs. Other Care Options
Understanding the role of assisted living is clearer when compared to other senior care choices. Assisted living serves as a middle ground between complete independence and round-the-clock skilled nursing care.
| Feature | Assisted Living | Nursing Home | Home Care |
|---|---|---|---|
| Level of Care | Assistance with daily living activities (ADLs) like bathing, dressing, and medication management. | 24/7 skilled nursing care for complex medical needs. | Care provided in the senior's own home; can be part-time or full-time. |
| Environment | Apartment-style living in a residential, community-based setting. | Clinical, institutional setting, often with shared rooms. | Senior's own home, providing comfort and familiarity. |
| Cost | Typically lower than nursing homes but higher than part-time home care. Averages vary by location. | Significantly higher due to constant medical supervision and care. | Can vary widely depending on the number of hours and level of care required. Full-time care can be more expensive than assisted living. |
| Independence | Encourages independence while providing a supportive structure. | Less independence due to higher medical needs and constant supervision. | Maximizes independence by allowing seniors to remain in their own homes. |
Choosing the Right Assisted Living Facility
With thousands of facilities available, selecting the right one can be overwhelming. Here are key steps to guide your decision:
- Assess Current and Future Needs: Determine what level of assistance is required now and consider potential future needs. Some facilities offer a continuum of care, including memory care.
- Consider Location and Proximity: Choose a location that is convenient for family visits and close to medical providers and other amenities.
- Tour and Evaluate: During visits, pay attention to the cleanliness, atmosphere, amenities, and overall environment. Observe how staff members interact with residents.
- Ask In-depth Questions: Inquire about staff-to-resident ratios, staff training, resident rights, meal options, and activity calendars.
- Understand Costs and Contracts: Carefully review the pricing structure, including monthly fees and potential additional charges. Clarify payment options, including any potential for Medicaid waivers or veterans' benefits.
Regulation of Assisted Living Facilities
Assisted living facilities are unique in that their oversight is primarily at the state level, not federal, which can lead to a patchwork of different regulations across the country. States are responsible for licensing, inspections, and enforcing standards for operations and staffing. In contrast, nursing homes are subject to federal oversight from the Centers for Medicare & Medicaid Services (CMS) due to their provision of skilled medical care. Families should research the specific state regulations where they are considering a facility to understand the standards for care, staffing, and resident rights.
Conclusion
The assisted living industry is a vast and growing part of the senior care landscape, with more than 32,000 facilities nationwide addressing the needs of a diverse and aging population. While the sheer number of options can seem daunting, a clear understanding of the industry's statistics, regional variations, and guiding factors can help families make informed decisions. By researching facilities thoroughly and understanding the nuances between assisted living and other care models, you can find the right fit to promote independence and well-being for yourself or a loved one. For more information on national statistics and facts, you can visit the National Center for Assisted Living (NCAL) statistics page.
The Assisted Living Workforce
The operation of these facilities relies on a dedicated workforce. As of early 2023, the assisted living workforce comprised approximately 478,500 employees. However, the industry faces significant challenges with staffing shortages and high turnover rates, which can impact the quality of care. The ongoing growth in demand means attracting and retaining skilled caregivers will remain a critical focus for the industry in the coming years.
