Nursing homes are a major part of U.S. long-term care, but the category includes several different populations, facility types and measurement systems. These nursing home statistics bring together 2022 U.S. estimates, 2021–2022 staffing data, 2023 economic measures, recent clinical evidence and the 2024–25 influenza season.
Key Nursing Home Statistics
The figures below summarize the most useful measurements across scale, residents, staffing, economics, outcomes and prevention:
- About 14,700 nursing homes operated in the United States in 2022.
- About 1.6 million licensed beds were available in U.S. nursing homes in 2022.
- About 1.2 million people were nursing home residents in the United States in 2022.
- For-profit organizations owned 72.4% of U.S. nursing homes in 2022.
- More than 1.2 million residents received care each day in Medicare- and Medicaid-certified long-term-care facilities in the 2023 CMS proposal context.
- Freestanding nursing homes averaged 3.71 total staffing hours per resident day from 2021 Q3 through 2022 Q2.
- Hospital-based nursing homes averaged 5.24 total staffing hours per resident day over the same period.
- Freestanding nursing homes averaged 0.63 RN hours per resident day from 2021 Q3 through 2022 Q2.
- CMS proposed 0.55 RN hours per resident day as a national minimum in 2023.
- CMS proposed 2.45 nurse-aide hours per resident day in 2023.
- Average annual pay per employee in skilled nursing care facilities was $47,034 in 2023.
- Health-care occupations represented 64.8% of skilled nursing care facility jobs in 2023.
- BLS projected skilled nursing care employment to decline 1.9% from 2023 to 2033.
- The pooled prevalence of any-stage pressure injury among nursing-home residents was 11.6% in international evidence through 2022.
- The pooled incidence of falls in skilled nursing facilities was 121 per 100 person-years in studies through 2023.
- Influenza vaccination coverage among about 1.2 million U.S. nursing-home residents was 61.3% in the 2024–25 season.
- State-level nursing-home resident influenza coverage ranged from 33.0% to 80.6% in the 2024–25 season.
Contents
- Nursing home facilities, beds and residents
- Resident demographics and long-term-care participation
- Nursing home staffing hours and workforce conditions
- Nursing home costs, wages and employment trends
- Falls, pressure injuries and clinical outcomes
- Vaccination and CMS quality-measure definitions
Nursing Home Facilities, Beds and Residents
The CDC’s 2022 FastStats estimate places the U.S. nursing-home system at about 14,700 facilities, 1.6 million licensed beds and 1.2 million residents. These are national rounded estimates, and licensed capacity should not be read as occupied capacity.
| 2022 U.S. measure | Reported figure | What it represents |
|---|---|---|
| Nursing homes | 14,700 | Facilities |
| Licensed beds | 1.6 million | Licensed capacity |
| Residents | 1.2 million | Rounded resident estimate |
| For-profit ownership | 72.4% | Share of facilities |
Source: CDC FastStats – Nursing Home Care. The simple comparison of licensed beds with residents is approximately 1.33 licensed beds per resident, but it is derived from rounded totals and is not an occupancy rate.
Ownership is measured at facility level rather than resident level. CMS provides a separate administrative view through Form 671, whose facility dataset includes resident census, ownership, special-care units, facility characteristics and staffing information for Medicare- and Medicaid-certified long-term-care facilities.
Source: CMS Long-Term Care Facility Characteristics. Releases are quarterly, while the underlying survey submissions are annual, so coverage and reporting timing vary by release.
CMS’s 2023 staffing proposal described more than 1.2 million residents receiving care each day in Medicare- and Medicaid-certified long-term-care facilities. That broader certified-facility context is not necessarily identical to the CDC nursing-home-only estimate.
Nursing Home Resident Demographics and Long-Term-Care Participation
Residential care communities are a useful comparison population, but they generally do not provide the skilled care of nursing homes. The CDC’s 2022 comparison population included 1,016,400 residents living in residential care communities on a given day.
In that population, 66.9% were female and 33.1% were male. Age was concentrated among older residents: 52.83% were at least 85, 31.21% were 75–84, 10.2% were 65–74, and 5.76% were younger than 65.
Source: CDC Residential Care Community Resident Characteristics: United States, 2022. These are NCHS survey estimates, not nursing-home-only statistics; missing-data exclusions and confidence intervals apply.
| 2022 residential-care comparison | Share of residents |
|---|---|
| Age 85 or older | 52.83% |
| Age 75–84 | 31.21% |
| Age 65–74 | 10.2% |
| Younger than 65 | 5.76% |
| White non-Hispanic | 91.87% |
| Black non-Hispanic | 1.65% |
The same survey found that 16.9% had Medicaid pay some or all long-term-care services during the 30 days before interview. In rounded CDC reporting, 17% were Medicaid beneficiaries, but this payment-window definition should not be treated as a general nursing-home financing rate.
Functional-support measures show why population definitions matter. Among residential-care residents, 61.7% needed help with three to six activities of daily living, 26.4% needed help with one or two, and 11.9% needed no ADL assistance; individual measures included bathing assistance for 74.5% and walking assistance for 70.9%.
Nursing Home Staffing Hours and Workforce Conditions
CMS’s staffing study used Payroll-Based Journal and CASPER data from 2021 Q3 through 2022 Q2. It found materially different averages by facility type, so freestanding and hospital-based nursing homes should not be combined casually.
| Facility type | Total hours per resident day | RN hours per resident day |
|---|---|---|
| Freestanding nursing homes | 3.71 | 0.63 |
| Hospital-based nursing homes | 5.24 | 1.60 |
Source: CMS Nursing Home Staffing Study Comprehensive Report. Staffing hours are not themselves quality outcomes, and an hours-per-resident-day figure does not mean one RN was physically present for the entire period.
CMS’s 2023 proposed rule gave proposed thresholds and a proposed coverage requirement: 0.55 RN hours per resident day, 2.45 nurse-aide hours per resident day, and an RN onsite 24 hours a day, seven days a week. These are proposed standards, not observed national averages or final outcome measures.
The study’s 2021–2022 survey of 168 facilities provides additional workforce context. Usual shifts were reported as days by 73.2% of facilities, evenings by 12.5%, and nights by 6.5%; 38.9% of respondents reported more than 12 overtime hours in the previous three months, while 50.3% reported no missed shifts.
Nursing Home Costs, Wages and Employment Trends
BLS industry figures describe employee pay and employment, not the price paid by a resident or a family. In 2023, average annual pay per employee in skilled nursing care facilities was $47,034, compared with $72,608 across the private sector.
| 2023 industry measure | Average annual pay |
|---|---|
| Skilled nursing care facilities | $47,034 |
| Continuing-care retirement and assisted-living facilities | $38,417 |
| Services for the elderly and people with disabilities | $26,496 |
| U.S. private sector | $72,608 |
Source: BLS Economic trends: home and community-based care versus institution-based care. The comparison industries cover different services and are not nursing-home-only measures.
Skilled nursing care establishments averaged 71.3 employees in 2023, and health-care occupations accounted for 64.8% of jobs. The average workweek in skilled nursing care was 33.2 hours in July 2024, compared with 29.0 hours in home health care services.
BLS projected skilled nursing care employment to decline 1.9% from 2023 to 2033. By comparison, projected employment growth was 14.7% for continuing-care retirement and assisted-living facilities and 26.5% for services for the elderly and people with disabilities; all three figures are forecasts, not guaranteed outcomes.
Nursing Home Falls, Pressure Injuries and Clinical Outcomes
Pooled evidence gives context for two frequently measured nursing-home risks, but international studies and heterogeneous methods limit direct comparison with any one U.S. facility. A systematic review through 2022 found 11.6% pooled prevalence for any-stage pressure injury among older people living in nursing homes, based on 30 studies and 355,784 people; the 95% confidence interval was 9.6%–13.7%, with very high heterogeneity (I² 99.8%).
Source: Prevalence and incidence of pressure injuries among older people living in nursing homes.
The pooled prevalence excluding stage I was 7.2%, based on 15 studies and 5,421,798 people, with a 95% confidence interval of 6.2%–8.3%. Pooled incidence of any-stage pressure injury was 14.3% across four studies and 10,645 people, while the pooled nursing-home-acquired rate was 8.5% across six studies and 79,998 people; both incidence estimates had substantial or high heterogeneity.
Among reported pressure-injury locations, the heel accounted for 34.1%, the sacrum for 27.2%, and the foot for 18.4%. These location percentages describe reported injuries and are not mutually exclusive residents.
A separate systematic review through 2023 included 38 studies after screening 3,103 unique references. Its pooled estimate was 121 falls per 100 person-years among older adults in skilled nursing facilities or similar settings, with a 95% confidence interval of 86–170.
Source: Incidence Morbidity and Mortality From Falls in Skilled Nursing Facilities. The review identified hospital transfer, hospital admission, overall injury, head injury, fracture, 30-day mortality, in-hospital death and disability as measured outcome categories, but the abstract did not provide one pooled percentage for each.
Nursing Home Vaccination and CMS Quality-Measure Definitions
CDC data for the 2024–25 influenza season covered 13,299 U.S. nursing homes and approximately 1.2 million residents. Overall resident influenza vaccination coverage was 61.3%, while the median facility-level coverage was 67.0%, with an interquartile range of 53.0%–78.6%.
Source: Influenza Vaccination Coverage Among Nursing Home Residents and Health Care Personnel.
Coverage varied across states and jurisdictions, ranging from 33.0% to 80.6%. Five jurisdictions reported at least 75% coverage: North Dakota, South Dakota, the District of Columbia, Vermont and New Hampshire.
CMS quality measures also depend on explicit population definitions. CMS defines short-stay residents as those with stays of 100 days or less or those covered under the Medicare Part A SNF benefit; its short-stay rehospitalization measure counts an unplanned hospital readmission within 30 days after nursing-home admission from a hospital.
Source: CMS Quality Measures.
CMS’s successful-return-to-community measure uses a 31-day period without an unplanned hospitalization after skilled nursing facility discharge. These are measurement definitions, not reported national outcome rates, so they should not be presented as percentages without a directly reported numerator and denominator.