Texas Tops the List for Nursing Home Facilities
When examining the total count of certified nursing facilities, Texas holds the top position, often reporting over 1,300 locations. This is a significant figure, and while Texas is the second-most populous state, its large number of facilities is not solely determined by population. Geographic size and a large rural population also play a role, as a greater land area can require a more distributed network of care facilities to serve residents across the state.
Other States with a High Concentration of Nursing Homes
While Texas leads the pack, other states also have a high number of facilities, primarily due to their large populations. California, the nation's most populous state, is consistently ranked second. Ohio and Illinois often follow, rounding out the top tier of states with the most nursing facilities. Comparing these states highlights how a large number of senior citizens in a given area drives demand for long-term care services.
Factors Influencing the State-by-State Breakdown
Several complex factors influence the number of nursing homes in any given state. It's not as simple as population size alone. Here's a breakdown of what determines the supply of these facilities.
Population Demographics
- Senior Population Size: The most direct factor is the total number of residents aged 65 and older. States with a larger senior population will naturally have a higher demand for nursing home care.
- Urban vs. Rural Population: Large rural areas, like those found in Texas, may require more numerous, smaller facilities to be accessible to a wider population, whereas densely populated urban areas might have fewer but larger facilities.
- Health and Longevity: Regional differences in health trends and life expectancy can also influence the need for long-term care.
Economic and Regulatory Factors
- Medicaid Reimbursement Rates: States with more favorable Medicaid reimbursement rates for long-term care services may see a greater supply of nursing homes, as it becomes more financially viable for providers.
- State Regulations: Different state-level regulations regarding licensing, construction, and staffing can influence the ease of opening and operating a nursing home.
- Competition from Other Care Options: The availability of alternative care options, such as assisted living facilities, home health care, and family-based care, can impact the demand for and supply of traditional nursing homes.
Nursing Home Supply vs. Number of Residents
It's important to distinguish between the number of facilities and the number of residents. While Texas has the most facilities, other states, like California and New York, often have the highest number of actual nursing home residents. This can be attributed to factors like higher occupancy rates and larger average facility size in these states. The size and capacity of each facility are just as important as the total count. For example, a state might have fewer nursing homes but significantly more beds overall if its facilities are larger.
State-by-State Comparison of Certified Facilities
| Rank | State | Number of Facilities (approx. 2024-2025) | Notable Factor |
|---|---|---|---|
| 1 | Texas | 1,300+ | Large population and geographic area |
| 2 | California | 1,200+ | Highest total population |
| 3 | Ohio | 900+ | Significant older adult population |
| 4 | Florida | 700+ | High percentage of senior citizens |
| 5 | Illinois | 700+ | Densely populated urban centers |
| 6 | Pennsylvania | 700+ | Large senior population |
| 7 | New York | 600+ | Large population centers |
| 8 | Indiana | 500+ | Steady demand for long-term care |
| 9 | Missouri | 500+ | Regional demographic needs |
| 10 | Iowa | 400+ | High proportion of older residents |
How to Find and Research Nursing Home Options
For families searching for a nursing home, focusing on the total number of facilities in a state is less important than researching the quality of specific locations. Authoritative resources can provide detailed information on individual nursing homes, including health inspection ratings, staffing levels, and quality of care measures. A great resource for this is the Centers for Medicare & Medicaid Services (CMS) website, which offers its own five-star rating system. You can explore the data for yourself at the CMS Five-Star Quality Rating System.
When conducting research, consider the following steps:
- Check CMS Ratings: Use the official government website to review star ratings, inspection reports, and complaint histories.
- Read Resident Reviews: Look for resident and family testimonials on review sites and advocacy group forums.
- Visit Prospective Facilities: Schedule in-person or virtual tours to evaluate the environment, staff, and resident engagement.
- Consider Location and Cost: Evaluate the facility's proximity to family and friends, and ensure its costs align with your budget and insurance coverage.
Conclusion
In conclusion, Texas has the highest number of nursing homes in the U.S., a fact primarily driven by its large, geographically widespread population. However, the total count is just one piece of a much larger puzzle. For those seeking long-term care, a comprehensive evaluation of quality, resident satisfaction, and individual needs is far more crucial than simply focusing on which state has the highest number of nursing homes. Leveraging the right resources and performing thorough due diligence will lead to the best possible outcome for senior care.
