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Long-term care statistics 2025

These stats illustrate the importance of long-term care and planning
Vanessa Ling headshot
By | Updated on Aug. 7, 2025 Medically reviewed by Scott Dershowitz, LMSW, CMC & Karen Berger, Pharm.D.
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Many Americans will need long-term care (LTC) at some point, but not everyone may understand what it really involves. Despite its potential to help many people, LTC remains an often-overlooked part of health care. Most families don’t think about it until they need it, and by then, the options and costs can be overwhelming. This article breaks down key statistics on long-term care: who needs it, how it’s delivered, what it costs, and why it matters. Whether you’re planning ahead or navigating care now, these are the numbers worth knowing.

What is long-term care?

Long-term care refers to a broad range of services that support people who can no longer fully care for themselves due to aging, illness, or disability. According to the National Institute on Aging, LTC includes both medical and non-medical care for individuals who need help with activities of daily living (ADLs), such as bathing, dressing, eating, or moving around safely. Ultimately, it’s not just about medical support, but more about helping people maintain quality of life and independence as they age.

“Long-term care is care for an individual that helps with grooming, bathing, dressing, eating, and other tasks throughout the day,” says Mary McDonald Winners, CPG, gerontologist and founder of About Senior Solutions.

Types of long-term care settings

Long-term care can be delivered in a variety of settings. Each type of LTC facility offers different levels of support and medical care: 

  • Board and care homes: Also known as residential care facilities or group homes, these are small private facilities—typically housing 20 or fewer residents. They provide personal care, meals, and around-the-clock staff supervision, but usually do not offer medical services. 
  • Assisted living facilities: These communities support residents with personal care tasks such as bathing, dressing, or medication management, but offer limited medical care. 
  • Nursing homes (skilled nursing facilities): Nursing homes provide both personal and medical care, with a strong focus on health services. Residents receive 24/7 supervision, meals, help with daily activities, and access to skilled nursing care. Many also offer rehab services like physical, occupational, and speech therapy. 
  • Continuing care retirement communities (CCRCs): Also known as life care communities, CCRCs combine independent living, assisted living, and skilled nursing care in one area. Residents can transition between levels of care as their needs change.
  • Aging in place: Aging in place refers to people who choose to remain in their own homes while receiving LTC services. Care can be provided by family members, hired caregivers, or home health aides, offering support with daily activities while maintaining independence.

LTC can also be received at a hospital, hospice facility, or palliative care facility, where the focus is more on medical care. Adult day care centers aren’t residential facilities, but they offer care and companionship during the day for older adults who need supervision or assistance. They often provide meals, recreational activities, therapeutic services, and social services.

Who needs long-term care?

  • Someone turning 65 has a 70% chance of needing some type of LTC in their future. (Office of the Assistant Secretary for Planning and Evaluation (ASPE), 2019)
  • Almost 1 in 10 (8%) of people who are 40 to 50 have a disability that could require long-term care services. (Administration of Community Living (ACL), 2025)
  • One-third of 65-year-olds may never need LTC, but 20% of 65-year-olds may need LTC for longer than five years. (ACL, 2020)
  • Almost half (48%) of older adults turning 65 will pay for LTC in their lifetime. (ASPE, 2019)
  • People with chronic diseases, such as heart disease, the leading cause of death in the United States, are more likely to need LTC. (ACL, 2025)
  • Forty percent of adults who need LTC only need it for two years, while 22% will use it between two to four years. (ASPE, 2019)

Long-term care statistics worldwide

Long-term care statistics in the U.S.

  • It’s estimated that by 2030, more than 20% of the U.S. population, 1 in 5 people, will be 65 and older. (ASPE, 2025)
  • The Western region of the U.S. has the most assisted living communities (41%), followed by the South (28%), Midwest (23%), and the Northeast (9%). (American Health Care Association (AHCA)/National Center for Assisted Living (NCAL))
  • An estimated 8 million people receive LTC care from nursing homes, home health agencies, assisted living communities, residential care communities, and hospice care agencies combined. 
  • In 2020, it’s estimated that 5.6 million Americans used Medicaid LTC services. (KFF, 2023)
  • Family caregivers make up around 14% of the population in the United States, with more than 37 million providing unpaid eldercare for their loved ones. (U.S. Bureau of Labor Statistics (BLS), 2023)

Long-term care statistics by facility type

Here are some statistics about LTC based on the type of facility it’s offered in:

  • In 2020, there were 15,300 nursing homes in the United States and 1.3 million Americans in them. (National Center for Health Statistics (NCHS), 2024)
  • In 2020, there were 11,400 home health agencies in the United States, with 3 million Americans receiving care from them. (NCHS, 2024)
  • There are more than 30,000 assisted living communities in the United States, with almost 1.2 million licensed beds. (AHCA/NCAL)
  • In 2022, there were more than 32,200 residential care communities in the United States, with over 1 million residents living in them. (NCHS, 2024)
  • In 2022, there were more than 5,000 adult day care centers in the United States, with about 182,000 participants on any given day. (NCHS, 2024)
  • In 2020, there were 5,200 hospice care agencies, with 1.5 million patients in them. (NCHS, 2024)
  • In 2021, almost 6 million people used Medicaid LTC services, and 3 in 4 of them were receiving care through home or community-based services. (KFF, 2024)

Long-term care demographic statistics

  • Most caregivers care for one person. Of these, almost two-thirds (66%) of eldercare providers care for a spouse or partner. (BLS, 2023)
  • People over 51 who have more LTC needs are less likely than others to have a spouse to provide care for them. (ASPE, 2023)
  • Black Americans are less likely to have a spouse as a caregiver than White and Hispanic Americans. (ASPE, 2023)
  • Black and Hispanic people are more likely than White people to experience negative consequences, such as going without a meal or clean laundry, when they don’t receive LTC. (ASPE, 2023)
  • On average, women need LTC 1.5 years longer than men. (ACL, 2020)
  • In 2022, most residential care community patients were female (67% of residents), White (92% of residents), and 85 or older (53% of residents). (NCHS, 2024)

Long-term care and health outcomes

People typically seek LTC when they need support performing their day-to-day activities, called activities of daily living (ADLs). According to the NCHS, the ADLs that residential care community residents needed the most help with were:

  • Bathing (75%)
  • Walking (71%)
  • Getting dressed (60%)
  • Getting in and out of bed or a chair (57%)
  • Going to the toilet (51%)
  • Eating (28%)

Residential care community residents may receive medical care as part of their LTC. According to the NCHS: 

  • The majority (92%) of residential care community residents have been diagnosed with at least one chronic condition in their lifetime. 
  • About half (55%) of residents had two or three chronic conditions. 
  • Only about 1 in 12 residents (8%) receiving LTC had never been diagnosed with a chronic condition. 

According to the NCHS, the most common conditions among residential care community residents in 2022 were:

Research is only now emerging to find connections between LTC facilities and how they affect care receivers’ health. One review found that, in general, home-like environments and adequate staff support better function and quality of life in people receiving LTC. 

Coronavirus 

Coronavirus (COVID-19) cases and deaths are also prevalent in long-term care facilities. 

  • As of January 5, 2025, there were more than 2.2 million confirmed COVID-19 cases in residents of nursing homes and long-term care facilities. (Centers for Medicare and Medicaid Services (CMS), 2025)
  • In January of 2022, 23% of all COVID-19 deaths in the United States were in long-term care facilities. (KFF, 2022)

Hospitalizations, ER visits, and deaths

  • Every day, about 1 in 43 nursing home residents gets an infection associated with their medical care. (Healthcare-Associated Infections (HAIs), 2024)
  • According to Pennsylvania Patient Safety Reporting System (PA-PSRS) data, skin and soft tissue infections were the most common (37%) infections from LTC facilities, followed by urinary tract infections (31%), and respiratory tract infections (26%). (Patient Safety Journal, 2024)
  • Compared to people living in nursing homes and assisted living facilities, people in their own homes and community LTC facilities were about four and six times, respectively, less likely to be infected with respiratory syncytial virus (RSV). (The Journal of Infectious Diseases, 2024)
  • For people with dementia, life expectancy after entering a nursing home ranges from two and eight years, depending on age at diagnosis. (BMJ, 2025)
  • Falls, trauma, or fractures were the most frequent problems of nursing home residents treated in the emergency department from 2015 to 2016. (Journal of the American Geriatrics Society, 2020)

Elder abuse

Unfortunately, elder abuse sometimes occurs in nursing homes.

  • Globally, about 1 in 6 people aged 60 years or older have experienced some form of elder abuse in a community setting. (WHO, 2024)
  • Two-thirds of long-term care staff around the world reportedly committed elder abuse in the past year. (WHO, 2024)
  • About 1 in 10 older adults experience some form of elder abuse. (Cureus, 2021)
  • Physical abuse is the most common (29%) form of elder abuse in nursing homes, followed by resident-to-resident abuse (22%). (Cureus, 2021)
  • Forty-four percent of nursing home residents report being abused and 95% have either been neglected or seen another resident be neglected. (Cureus, 2021)

If you suspect elder abuse or neglect, you can report it through the resources found on the National Center on Elder Abuse’s (NCOA’s) website.

The cost of long-term care

Here are some key facts about the cost of LTC in the United States:

  • In our 2024 long-term care survey, more than half of the respondents (56%) mistakenly believed that the cost of an assisted living facility was less than $4,000 per month. 
  • Actually, roughly 1 in 5 Americans turning 65 will face more than $200,000 in LTC costs. (ASPE, 2025)
  • While most people receiving LTC may only need it for a short amount of time, almost 1 in 4 older adults (24%) get more than 2 years of paid LTC. (ASPE, 2019)

Knowing the potential cost of LTC is a critical step in planning ahead. This table shows how the cost of long-term care services in 2024 increased compared to the year before, based on a survey by Genworth/CareScout.

Long-term care costs are increasing
Year Cost Monthly cost Annual cost
Homemaker services 2024 $33 per hour $5,280* $75,504†
2023 $30 per hour $4,800* $57,600**
Home health aide 2024 $34 per hour $5,440* $77,792†
2023 $33 per hour $5,280* $63,360**
Adult day health care 2024 $100 per day $2,000* $26,000†
2023 $95 per day $1,900* $22,800**
Assisted living community 2024 $179 per day* $5,900 $70,800†
2023 $178 per day* $5,350 $64,200**
Semi-private room in a nursing home facility 2024 $309 per day* $9,277 $111,325†
2023 $289 per day* $8,669 $104,028**
Private room in a nursing home facility 2024 $355 per day* $10,646 $127,750†
2023 $324 per day* $9,733 $116,796**
* Calculated based on a 40-hour work week with four weeks in a month, five working days in a week; ** Calculated based on monthly cost; † As reported by Genworth/CareScout, 2025

Long-term care coverage and payment options

Paying for LTC can be a financial burden that many Americans don’t plan for. In our SingleCare long-term care survey, 1 in 3 respondents (33%) said they haven’t considered how they’ll pay for LTC if needed. 

According to the ASPE, families typically cover about half of long-term care costs out of pocket. While some expenses may be partially covered by insurance, Medicare, or Medicaid, coverage depends heavily on the type of care, the setting, and the details of an individual’s plan. 

The following are some other statistics to consider about how Americans pay for long-term care:

  • In total, there was more than $467 billion spent on LTC in 2021. Seventy-one percent of LTC spending was by public programs such as Medicaid, Medicare, federal assistance, and state programs. Twenty-nine percent of LTC costs were paid privately, by consumers out of pocket, private insurance, or other private sources of funding. (Congressional Research Service (CRS), 2023)
  • Americans spent almost $64 billion in out-of-pocket costs for LTC services and support. (CRS, 2023)
  • Medicaid users who receive LTC services spend eight times more on medical care (about $41,000 per person) than those who don’t use LTC (about $5,300 per person). (KFF, 2024)
  • Although only 6% of Medicaid enrollees use LTC services, this small group accounts for more than a third (34%) of total Medicaid spending. (KFF, 2024)
  • Medicaid paid for more than half (61%) of the LTC services paid out in 2022. About 17% of all LTC costs in 2022 were paid out of pocket. (KFF, 2024)
Medicare and long-term care coverage

Medicare covers up to 100 days of skilled nursing facility care following a qualifying hospital stay. It also covers some home health services for nursing care and therapy, up to 28 hours per week.

One option is long-term care insurance, a policy specifically designed to help cover these expenses. However, not many people have LTC insurance. Despite the rising cost of LTC, only about 1 in 10 respondents (11%) in our survey said they purchased long-term care insurance. In 2023, premiums for long-term care insurance ranged from $900 to $7,225 per year, depending on the type of policy, age of the person covered, and how many people are covered by the policy. According to KFF, out of the 7.1 million people who paid for long-term care insurance, there were only 80,000 claims filed in 2021.

Preparing for long-term care

Being prepared for long-term care is important for all seniors. There are several ways to do this, but the reality is that most don’t plan for it. In our long-term care survey, only 17% of respondents said they had started planning by having conversations, researching options, or purchasing long-term care insurance.

Planning early can offer more flexibility, better choices, and significant financial savings down the line. Here are a few key steps to consider:

  • Develop a financial plan: Thinking ahead financially is one of the most important parts of long-term care planning. Start by evaluating your income, assets, and potential expenses. 
  • Consider the type of care you may need: It’s impossible to predict exactly what type of care you’ll need, but understanding your options is important. Research different care settings, such as home care, assisted living, or nursing homes, and compare their costs.
  • Review your Medicare and health insurance benefits: While Medicare doesn’t cover all long-term care, some services like short-term home health care or skilled nursing after hospitalization may. Review your plan to be familiar with what’s covered and when.
  • Determine how you’ll pay for care: Long-term care can be expensive. Most people rely on a mix of private funds, Medicaid, or long-term care insurance. Knowing your options can help prevent financial strain later on.
  • Consider long-term care insurance: Purchasing LTC insurance can help protect your finances if you need extended care in the future. Premiums vary based on age, health, and policy features, so the earlier you buy, the better.
  • Create an advance care plan: Advance care planning ensures your medical and financial wishes are followed if you become unable to make decisions. This may include advance directives, a healthcare proxy (medical power of attorney), a living will, and a financial power of attorney.
  • Talk with your family: Open conversations with loved ones can make a big difference. They should understand your wishes and may also be involved in your future care or financial planning.
Resources for finding a long-term care facility, provided by the National Institute on Aging:

Long-term care reform

Millions of Americans will need long-term care, but the current LTC system might not be accessible to everyone. Many families face steep out-of-pocket expenses, limited coverage from Medicare or Medicaid, and a heavy reliance on unpaid family caregivers. Without reforming the LTC system, these barriers will only grow, leaving older adults with fewer options for safe, high-quality elder care.

Some organizations are working to change that. The American Health Care Association and the National Center for Assisted Living (AHCA/NCAL) are advocating for access to high-quality, person-centered care across all types of communities. Their focus includes promoting independence, integrating new technologies, and improving accountability in care settings.

Globally, the WHO is driving long-term care reform through initiatives like the Global Strategy and Action Plan on Ageing and Health and the United Nations Decade of Healthy Ageing (2021–2030). These efforts aim to expand access to long-term care for older adults and others with ongoing LTC needs. 

In the United States, the ASPE’s Office of Behavioral Health, Disability, and Aging Policy is guiding federal, state, and Medicare initiatives to improve LTC access and affordability. Through research and policy modeling, this federal office helps inform decisions that can shape a more effective and sustainable long-term care system.

Long-term care questions and answers

How many people in the U.S. are in assisted living?

There are approximately 30,000 assisted living communities with 1.2 million licensed beds. In 2022, there were more than 1 million residents in residential care communities, including in assisted living facilities. 

What percentage of people receive long-term care?

Someone turning 65 has a 70% chance of needing long-term care in their future. 

How long does the average person receive long-term care services?

The average person receives long-term care services through their family members, typically their spouses, through home-based services. Most people who receive LTC only need it for two years. 

What is the leading cause of death in nursing homes?

There aren’t many updated studies identifying the leading cause of death in nursing homes. One study published in 2008 found the leading cause of death in nursing home residents was Alzheimer’s/dementia (36%). 

Many consider nursing home-acquired pneumonia as the leading cause of death. Nursing home-acquired pneumonia happens in one to two patients for every 1,000 days of living in a nursing home, and it can have a mortality rate (chance of death) between 13% to 41%. 

How many assisted living facilities are there in 2025?

There are more than 30,000 assisted living communities in the United States. Altogether, there are more than 77,500 residential care communities, assisted living communities, and nursing homes in the United States based on available data.

What state has the most assisted living facilities?

In 2024, Texas had the most certified nursing facilities (1,184), followed by California (1,164). In 2023, California had the most assisted living facilities (5,713), followed by Michigan (3,089), and Wisconsin (2,741). 

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