Long-term care statistics: Costs, who needs care, and key trends

In this article:

• What is long-term care?
• Types of long-term care settings
• Who needs long-term care?
• Long-term care costs
• Long-term care payment statistics
• Worforce statistics and policy reform
• FAQs

In this article

• What is long-term care?
• Types of long-term care settings
• Who needs long-term care?
• Long-term care costs
• Long-term care payment statistics
• Worforce statistics and policy reform
• FAQs

Long-term care statistics at a glance

• 70% of adults 65 and older will need long-term care.
• Most long-term care is provided at home by unpaid caregivers.
• Costs average $75,000–$130,000 per year, depending on care type.

Close to 70% of Americans will need long-term care (LTC) at some point. Long-term care includes a range of services delivered at home, in assisted living communities, and in nursing homes. These long-term care statistics cover who needs care, how it’s delivered, what it costs, and how Americans pay for it.

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. 

“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. Many of these same individuals also require assistance with instrumental activities of daily living (IADLs), which include using the phone, managing finances, transportation, and shopping, and require higher-level planning and cognitive skills than ADLs alone.

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: Small private facilities (also known as residential care facilities or group homes) that frequently provide meals, personal care, laundry, shopping, and supervision, usually without extensive medical services. Board and care homes fall under the broader category of residential care communities, which housed more than 1 million residents across the U.S. in 2022. (NCHS, 2024) Depending on your state or region, the names of these types of programs may vary.
• Assisted living facilities: Residential communities that help with daily activities and medication management while offering limited medical care. There are more than 32,000 assisted living and other residential care communities in the U.S., with nearly 1.2 million licensed beds. (AHCA/NCAL)  
• Nursing homes (skilled nursing facilities): Facilities that provide 24/7 supervision, personal care, and skilled nursing services. As of 2022, there were approximately 14,700 nursing homes in the U.S. caring for about 1.6 million residents. (NCHS, 2026). Some individuals are in nursing homes for permanent skilled or custodial care, while others are there for short-term, subacute rehab needs.
• Continuing care retirement communities (CCRCs): Communities that combine multiple levels of care, from independent living to skilled nursing. Residents can transition between levels of care as their needs change.  
• Aging in place: Receiving long-term care services at home from family caregivers, home health aides, or other care providers who offer support with daily activities. As of 2022, there were approximately 11,500 home health agencies in the U.S., serving about 3.3 million Americans. (Centers for Disease Control and Prevention (CDC), 2026)  

Hospitals, hospice facilities, and palliative care facilities, where the focus is more on medical care, also provide forms of long-term care. 

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 at some point. (Administration for 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 U.S., are more likely to need LTC. (ACL, 2025)
• An estimated 7.2 million Americans aged 65 and older are living with Alzheimer’s in 2026, and about 1 in 9 people (11%) in that age group has the disease. Alzheimer’s and other dementias are among the leading reasons people need long-term care. (Alzheimer’s Association, 2025)
• Forty percent of adults who need LTC only need it for two years, while 22% will use it between two and four years. (ASPE, 2019)

Long-term care statistics worldwide

• It’s estimated that 142 million older adults worldwide are unable to meet their basic care needs without support. (World Health Organization (WHO), 2022)
• Two out of three older adults worldwide will likely need care (assistance with ADLs or IADLs) at some point in their lives. (WHO, 2022)
• In 2025, there were 1.2 billion people around the world aged 60 and older. (WHO, 2025)
• By 2050, it’s estimated that there will be 2.1 billion people around the world age 60 and older. (WHO, 2024)
• The Netherlands (4%), Norway (3%), Sweden (3%), and Denmark (3%) are countries that spend the most on LTC programs. In 2021, the U.S. spent 1% of its GDP on LTC. (KFF, 2023)

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%), the Midwest (23%), and the Northeast (9%). (American Health Care Association (AHCA)/National Center for Assisted Living (NCAL))
• Approximately 63 million Americans, nearly 1 in 4 adults, provided ongoing care for an adult or a child with a complex medical condition or disability in the past year, an increase of 20 million caregivers since 2015. (AARP, 2025)
• Family caregivers make up around 14% of the population in the U.S., 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:

• As of 2022, there were approximately 14,700 nursing homes in the U.S. caring for about 1.6 million residents. (NCHS, 2026)
• As of 2022, there were approximately 11,500 home health agencies in the U.S., serving about 3.3 million Americans. (CDC, 2026)
• There are more than 30,000 assisted living communities in the U.S., with almost 1.2 million licensed beds. (AHCA/NCAL)
• In 2022, there were more than 32,200 residential care communities in the U.S., with over 1 million residents living in them. (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 received 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)
• In 2024, the 59 million adult caregivers provided 49.5 billion hours of care, with an estimated economic value of more than 1 trillion. (AARP, 2026)
• Nearly half of family caregivers experienced at least one major financial impact, such as taking on debt, stopping savings, or being unable to afford food. (AARP, 2025)

Long-term care health outcome statistics

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%)
• Ambulating (71%)
• Getting dressed and undressed (60%)
• Getting in and out of bed or a chair, a skill called “transferring” (57%)
• Safely using 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 medical condition in their lifetime. 
• About half (55%) of residents had two or three chronic medical conditions. 
• Only about 1 in 12 residents (8%) receiving LTC had never been diagnosed with a chronic medical condition. 

Hospitalizations, ER visits, and deaths

• Every day, about 1 in 43 nursing home residents contracts an infection associated with their medical care. (CDC, 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)
• For people with dementia, life expectancy after entering a nursing home ranges from two to eight years, depending on age at diagnosis. (BMJ, 2025)
• Falls, trauma, or fractures were the most frequent problems of nursing home residents treated in a hospital emergency department from 2015 to 2016. (Journal of the American Geriatrics Society, 2020)

Long-term care cost statistics

Here are some key facts about the cost of LTC in the U.S.:

• 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. (SingleCare, 2024)
• 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%) pay for LTC for more than two years. (ASPE, 2019)
• In 2025, health and long-term care costs for people living with Alzheimer’s and other dementias are projected to reach $384 billion.  

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 CareScout.

* 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 CareScout, 2025

Long-term care costs today

Long-term care costs have continued to rise. “The single biggest driver is labor,” says Justin Weinberg, a senior leader at Eastern Healthcare Group. “Staffing is the largest line item in any skilled nursing facility’s budget, and compensation now consumes more than half of provider operating budgets.”

Nearly all skilled nursing providers (roughly 96%) reported increased staffing costs over the past year, according to Weinberg. Combined with demand from the Baby Boomer generation, he expects costs to keep rising. “Every day until 2030, 10,000 Baby Boomers are turning 65, and seven out of ten of them will need some form of long-term care in their lifetime,” Weinberg says. “That supply-and-demand imbalance isn’t going away anytime soon.”

Here’s what long-term care costs today based on the most recent national median rates.

* In 2025, CareScout combined homemaker services and home health aide into one “non-medical caregiver” category at a median rate of $35 per hour.
** Calculated based on a 40-hour work week with four weeks in a month, five working days in a week

Long-term care payment statistics

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. 

Who pays for long-term care?

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, long-term care insurance, Medicare, or Medicaid, coverage depends heavily on the type of care, the setting, and the details of an individual’s plan. 

Medicaid

Medicaid is the largest payer for long-term care in the U.S. It covers nursing home care, home and community-based services, and other supports for people who meet certain income and asset requirements. According to the Congressional Research Service (CRS), Medicaid long-term services and support (LTSS) spending reached $257 billion, accounting for nearly 46% of all long-term care spending in 2023. About 6 in 10 nursing home residents are covered by Medicaid, according to KFF.

Medicare

Medicare helps cover some short-term LTC services, including shorter-term skilled nursing facility stays after a qualifying hospital admission (up to 100 days) and limited home health care. But it does not cover custodial care, which is what most long-term nursing home stays require. In 2023, Medicare accounted for about 18% of all LTSS spending, according to CRS. 

“Families walk in assuming Medicare is going to cover a long-term stay, and the reality is much more limited than most people expect,” Weinberg says. “Medicare pays 100% of the cost for the first 20 days in a skilled nursing facility, then covers about 80% for days 21 through 100. After 100 days, Original Medicare coverage for skilled nursing ends entirely.”

Patients

Many families pay for a significant share of LTC costs out of pocket, especially in the early stages of care. In 2023, out-of-pocket spending on long-term services and supports totaled $81 billion, or about 14% of all LTSS spending, according to CRS. Roughly 1 in 5 Americans turning 65 will face more than $200,000 in lifetime LTC costs, according to the Assistant Secretary for Planning and Evaluation (ASPE).  

“Most people who enter nursing homes start by paying for their care out of pocket,” Weinberg says. “The families who fare best are the ones who understood these distinctions before they needed care, not the ones trying to figure it out in a crisis.”

LTC insurance

Long-term care insurance is specifically designed to help cover long-term care expenses. However, despite the rising cost of LTC, only about 1 in 10 of those who responded to our LTC survey said they purchased long-term care insurance. In 2023, premiums for long-term care insurance ranged from $900 to $7,225 per year. 

“The people who benefit most from LTC insurance are those in the middle,” Weinberg says. “If you’re very wealthy, you can likely self-fund your care. If you have very limited assets, Medicaid will eventually cover you. But the vast majority of families fall somewhere in between, where a prolonged stay in a nursing home or assisted living facility would seriously damage their financial security.”

Long-term care workforce statistics and policy reform

The long-term care workforce has been under significant strain. The sector has lost nearly 229,000 caregivers since February 2020. A 2025 AHCA survey found that 58% of nursing homes expect to reduce staff in response to lower Medicaid reimbursement rates, while 44% said they would limit hiring or pause it altogether.  

Federal staffing policy has shifted as well. In May 2024, CMS finalized minimum staffing standards for nursing homes, requiring 3.48 hours of nursing care per resident per day. However, in December 2025, CMS repealed those requirements and returned to the prior standard of eight consecutive hours of registered nurse coverage per day. 

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 U.S., 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. 

How many assisted living facilities are there in 2026?

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

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