Trends in Assisted Living and Memory Care Supply From 2019 to 2023

Area of Science:

• Gerontology and Long-Term Care
• Healthcare Access and Equity
• Rural Health Disparities

Background:

• Assisted living (AL) and memory care facilities provide essential long-term care services.
• Geographic and socioeconomic disparities in access to these facilities are not well understood.
• Understanding supply variations is critical for addressing the needs of the aging population.

Purpose of the Study:

• To analyze geographic variations in assisted living (AL) and memory care supply from 2019 to 2023.
• To examine the correlation between AL and memory care supply and county-level socioeconomic characteristics.
• To identify trends in AL and memory care availability across different types of US counties.

Main Methods:

• A descriptive study analyzing licensed AL communities in the United States for 2019 and 2023.
• Data sourced from a national registry of AL facilities and the US Census Bureau's American Community Survey.
• Primary outcomes included AL and memory care supply (beds per 1000 adults aged 65+) at the county level, analyzed descriptively by county characteristics and changes over time.

Main Results:

• In 2023, counties with higher AL and memory care supply were urban, wealthier, and had higher educational attainment.
• Between 2019 and 2023, AL supply decreased in 43% of counties, with decreases concentrated in rural areas with lower incomes.
• Memory care supply decreased in 29% of counties, particularly in rural areas with lower educational attainment, higher poverty, and lower home values.

Conclusions:

• Significant decreases in AL and memory care supply were observed in rural and socioeconomically disadvantaged US counties.
• Overall availability of these long-term care services remains low, exacerbating access issues in underserved areas.
• Incentivizing the development and operation of AL and memory care facilities in underserved regions is essential for ensuring equitable access to care.