With average annual revenue per bed rising to $62,500 in 2023 while costs, staffing shortages, and quality compliance pressures intensify, the US long-term care nursing home industry is at a turning point where money and patient care are moving in the same direction for better and worse.
Key Takeaways
- In 2023, the average annual revenue per nursing home bed in the US long-term care industry reached $62,500, reflecting a 5.2% increase from 2022 driven by Medicare reimbursement adjustments
- US nursing home industry total expenditures hit $193 billion in 2022, with 42% funded by Medicaid and 25% by Medicare
- The median profit margin for for-profit nursing homes was 2.8% in 2022, compared to -1.1% for non-profits, amid rising labor costs
- The US nursing home market size was valued at $200 billion in 2023, projected to grow at 4.5% CAGR to $320 billion by 2030
- Number of nursing home beds is expected to decline 5% by 2030 to 1.6 million due to assisted living shift
- Skilled nursing facility (SNF) occupancy projected to reach 88% by 2028 from 79% in 2023
- 15,700 nursing homes were certified by Medicare/Medicaid in 2023, with 82% compliant on initial surveys
- 1,200 nursing homes received deficiency citations for immediate jeopardy in 2023, 8% of total facilities
- Average number of health deficiencies per nursing home was 8.2 in 2023 surveys, down from 9.1 in 2022
- The average age of nursing home residents was 82.5 years in 2023, with 65% female and 35% male
- 48% of nursing home residents had dementia or Alzheimer's in 2023, requiring specialized care units in 70% facilities
- Pressure ulcer prevalence was 7.2% among long-stay residents in Q4 2023, down 1.5% YoY with better protocols
- The RN staffing hours per resident day (HPRD) in US nursing homes averaged 0.42 in Q1 2023, up 5% from 2022 but below the 0.55 federal recommendation
- Total nurse staffing HPRD reached 3.85 across all US nursing homes in 2023, with aides at 2.37, RNs at 0.42, and LPNs at 1.06
- Nursing home turnover rate for CNAs was 102% annualized in 2023, compared to 78% for RNs and 62% for LPNs
Nursing homes saw rising costs, tighter staffing, varied reimbursements, and modernization.
Financial Metrics
1In 2023, the average annual revenue per nursing home bed in the US long-term care industry reached $62,500, reflecting a 5.2% increase from 2022 driven by Medicare reimbursement adjustments
Single source
2US nursing home industry total expenditures hit $193 billion in 2022, with 42% funded by Medicaid and 25% by Medicare
Single source
3The median profit margin for for-profit nursing homes was 2.8% in 2022, compared to -1.1% for non-profits, amid rising labor costs
Directional
4Average daily reimbursement rate from Medicaid for nursing home care was $225 per resident day in FY2023, varying by state from $150 in Mississippi to $350 in Alaska
Single source
5Nursing home occupancy rates averaged 79% in Q4 2023, down from 85% pre-COVID but up 3% YoY due to pent-up demand
Verified
6Capital expenditures per nursing home bed averaged $1,200 in 2023 for facility upgrades, primarily HVAC and infection control systems
Verified
7The cost to build a new nursing home averaged $250,000 per bed in 2023, up 15% from 2020 due to inflation in construction materials
Verified
8Medicare Advantage plans covered 28% of nursing home stays in 2023, paying 10-15% less per diem than traditional Medicare
Verified
9Bad debt and charity care write-offs for nursing homes totaled $4.2 billion in 2022, representing 2.2% of gross revenue
Directional
10Average accounts receivable days for nursing homes stood at 45 days in 2023, with Medicaid payers averaging 60 days
Verified
11Nursing homes experienced a 12% increase in supply chain costs for food and pharmaceuticals in 2023, totaling $15 billion industry-wide
Single source
12Private pay rates for semi-private rooms averaged $9,500 monthly in 2023, 40% higher than Medicaid rates
Single source
13The industry saw $2.8 billion in private equity investments in nursing homes in 2023, targeting 15% of facilities
Verified
14Operating expenses per resident day rose to $210 in 2023, with labor comprising 65% at $136.50
Verified
15Medicare Part A payments to nursing homes totaled $28.6 billion in 2022 for 2.1 million stays averaging 25 days each
Verified
16Nursing home debt-to-equity ratio averaged 1.8:1 in 2023 for chain-affiliated facilities, higher than independents at 1.2:1
Verified
17Insurance premiums for liability coverage increased 18% in 2023 to an average $450,000 per facility annually
Directional
18Ancillary service revenue (therapy, pharmacy) grew 8% to $22 billion in 2023, 11% of total revenue
Directional
19Tax-exempt nursing homes received $1.1 billion in tax benefits in 2022, equivalent to 3% of operating margins
Verified
20EBITDA margins for top 10% nursing home chains reached 8.5% in 2023, vs industry average 1.2%
Verified
21Nursing homes reported 22% of revenue from room and board charges in 2023, averaging $120 per day
Verified
22Venture capital funding for nursing home tech startups totaled $750 million in 2023, focusing on EHR and telehealth
Directional
23Average net patient revenue per admission was $15,200 in 2023 for short-term rehab stays
Verified
24Property tax assessments on nursing homes increased 14% in 2023, adding $900 million to costs
Verified
25Hospice revenue from nursing home residents contributed $18 billion in 2023, 9% of total LTC revenue
Verified
26Credit ratings for nursing home bonds averaged BBB- in 2023, with 20% downgrades due to occupancy drops
Verified
27Outpatient therapy revenue per nursing home grew 6% to $1.2 million in 2023 post-PDGM changes
Verified
28Uncompensated care costs rose to 4.5% of expenses in 2023 for rural nursing homes
Single source
29Lease expenses for nursing homes averaged $45 per bed per day in 2023, 21% of total costs for leased facilities
Verified
Financial Metrics Interpretation
In 2023, America’s nursing homes ran like a high cost, low margin business where funding is split between Medicare and Medicaid, profits barely keep pace with labor and financing pressures, occupancy still sits below pre-COVID levels, and the system’s financial juggling is as complex as it is necessary to keep beds staffed, upgraded, and paid for.
Industry Trends and Projections
1The US nursing home market size was valued at $200 billion in 2023, projected to grow at 4.5% CAGR to $320 billion by 2030
Directional
2Number of nursing home beds is expected to decline 5% by 2030 to 1.6 million due to assisted living shift
Verified
3Skilled nursing facility (SNF) occupancy projected to reach 88% by 2028 from 79% in 2023
Verified
4Home-based long-term care spending to surpass nursing homes by 2030, at 45% vs 30% of total LTC
Verified
5AI and telehealth adoption in nursing homes to reach 65% by 2027, reducing hospital transfers 20%
Verified
6M&A activity in nursing homes totaled 150 deals in 2023 worth $12 billion, projected 10% growth in 2024
Verified
7Short-stay rehab segment to grow 6% annually to 2030, driven by orthopedic procedures
Verified
8Dementia care units expected to increase 25% by 2030, serving 60% of residents
Verified
9Green building certifications for new nursing homes to hit 40% by 2030 from 10% in 2023
Verified
10Labor costs projected to rise 5.5% annually through 2030, reaching 70% of expenses
Verified
11Value-based purchasing to cover 50% of Medicare SNF payments by 2028
Verified
12Micro-communities and small-house models to represent 15% of beds by 2030
Single source
13Digital therapeutics market for nursing homes to grow to $5 billion by 2030 at 22% CAGR
Single source
14Rural nursing home closures projected at 200 facilities by 2030 without policy changes
Directional
15PACE program enrollment to double to 100,000 by 2030, reducing nursing home use 30%
Verified
16Robotic assistance devices in 35% nursing homes by 2028 for ADL support
Verified
17Post-acute bundles to cover 40% SNF stays by 2030 under ACOs
Verified
18Senior living hybrid models (NH+ALF) to grow 8% CAGR to 2030
Directional
19Cybersecurity incidents projected to affect 25% facilities annually by 2030
Directional
20Wellness tech wearables for 50% residents by 2030, improving outcomes 15%
Directional
21Private pay share to decline to 15% by 2030 from 20% in 2023 as Medicaid expands
Verified
22Construction pipeline for nursing homes at 25,000 beds in 2024, slowest in decade
Directional
23Generative AI for care planning in 40% facilities by 2028
Directional
24Workforce shortages to peak at 500,000 aides needed by 2030
Single source
25Carbon-neutral nursing homes to reach 20% by 2030 with incentives
Verified
26Interoperability standards compliance at 90% by 2027 under TEFCA
Single source
27Culinary nutrition focus in 60% facilities by 2030 for malnutrition reduction
Verified
Industry Trends and Projections Interpretation
The US long term care nursing home industry is heading toward a $320 billion market by 2030 even as bed capacity shrinks, staffing costs keep rising, and care delivery shifts into smarter models like telehealth, AI, value based payments, hybrid senior living, and dementia specific units, all while Medicaid expansion squeezes private pay, cybersecurity risks increase, rural closures threaten access, and policy and technology together determine who thrives and who gets left behind.
Regulatory Compliance
115,700 nursing homes were certified by Medicare/Medicaid in 2023, with 82% compliant on initial surveys
Verified
21,200 nursing homes received deficiency citations for immediate jeopardy in 2023, 8% of total facilities
Verified
3Average number of health deficiencies per nursing home was 8.2 in 2023 surveys, down from 9.1 in 2022
Single source
495% of nursing homes met nurse aide training requirements in 2023, with 5% fined averaging $10,000
Verified
5Fines for substandard quality of care totaled $45 million in 2023, targeting infection control violations
Verified
673% of facilities passed unannounced infection control surveys in 2023 post-COVID reforms
Verified
7Special Focus Facilities (SFF) program monitored 88 homes in 2023, with 80% graduating improved
Directional
898% compliance with abuse reporting within 24 hours in 2023 audits
Verified
9Pharmacy service deficiencies averaged 1.5 per survey in 2023, mainly improper med storage
Verified
1065% of terminations were for immediate threats to resident health in 2023 enforcement actions
Verified
11Quality assurance committees met quarterly in 92% facilities per 2023 reviews
Single source
12Fire safety deficiencies occurred in 12% of surveys in 2023, mostly sprinkler failures
Directional
13Resident rights violations cited in 22% facilities in 2023, primarily dignity issues
Directional
14MDS 3.0 submission accuracy was 97% in 2023, with audits flagging 3% for upcoding
Single source
1585% of nursing homes implemented PDPM fully by 2023, with 15% hybrid billing flagged
Verified
16Civil monetary penalties averaged $15,400 per citation in 2023 for serious issues
Directional
1740 states updated staffing minimums in 2023, with 12 adopting HPRD rules like 3.48 total
Single source
18Infection preventionist dedicated roles in 88% facilities per 2023 IPRO surveys
Verified
19Grievance process compliance was 89% in 2023, with logs reviewed in audits
Verified
2075% reduction in immediate jeopardy citations since 2019 reforms as of 2023
Verified
21Nutritional assessment compliance per F-tags was 94% in 2023 surveys
Verified
22QAPI program effectiveness scored high in 82% facilities in 2023 annual reviews
Verified
23Emergency preparedness drills conducted bi-annually in 96% homes in 2023
Single source
24ADL decline prevention met in 71% long-stay residents per 2023 QM
Verified
25Admission agreements reviewed for compliance in 91% facilities in 2023
Verified
262,500 alternative sanctions issued in 2023 instead of terminations
Verified
Regulatory Compliance Interpretation
In 2023, most nursing homes technically got the paperwork right, kept the pain points mostly contained, and improved under post COVID reforms, but regulators still found enough serious infection control, staffing, and resident rights issues to write 1,200 immediate jeopardy citations, average 8.2 health deficiencies per home, and issue millions in penalties, proving that “better” and “acceptable” are not the same thing even when the trend line looks encouraging.
Resident Health and Outcomes
1The average age of nursing home residents was 82.5 years in 2023, with 65% female and 35% male
Verified
248% of nursing home residents had dementia or Alzheimer's in 2023, requiring specialized care units in 70% facilities
Verified
3Pressure ulcer prevalence was 7.2% among long-stay residents in Q4 2023, down 1.5% YoY with better protocols
Verified
492% of residents received physical therapy services annually in 2023, averaging 45 sessions per patient
Single source
5Antipsychotic use for long-stay residents without schizophrenia was 13.8% in 2023, reduced by 20% since 2011
Verified
6Hospital readmission rate within 30 days for short-stay residents was 21% in 2023, primarily for infections
Verified
7Average length of stay for long-stay residents was 2.3 years in 2023, with 25% staying over 5 years
Directional
8Falls with major injury rate was 3.4 per 1,000 resident days in 2023, improved by sensor tech adoption
Single source
975% of residents were incontinent in 2023, with UTI incidence at 8.5 per 1,000 resident days
Single source
10Depression prevalence among residents was 42% in 2023, with 65% receiving antidepressants
Directional
11COVID-19 vaccination rate among residents reached 88% by end-2023, with booster uptake at 65%
Verified
12Functional improvement in ADLs for short-stay residents was achieved by 62% in 2023
Verified
13Heart failure hospitalization rate for long-stay residents was 11.2% in 2023
Single source
1431% of residents had diabetes in 2023, with HbA1c control in <8% for 75% of them
Verified
15Emergency department transfer rate was 28% annually in 2023, often avoidable
Single source
16Hospice enrollment among residents averaged 45% in last 90 days of life in 2023
Verified
17Pain management without drugs was used for 85% of residents reporting pain in 2023
Verified
18Seclusion restraint use was 0.1% in 2023, near elimination per CMS rules
Directional
19Pneumonia incidence was 9.8 per 1,000 resident days in 2023, linked to aspiration risks
Directional
2068% of residents improved mobility scores post-admission in 2023
Single source
21Delirium prevalence was 25% upon admission in 2023, resolving in 60% within 7 days
Single source
22Fracture rate from falls was 1.2 per 1,000 days in 2023, highest in osteoporosis patients
Single source
23Advance directive completion rate was 92% in 2023, up 5% YoY
Single source
24COPD exacerbation hospitalizations were 8.7% for long-stay residents in 2023
Verified
25Nutritional risk score >3 affected 35% residents in 2023, with weight loss in 12%
Verified
26Influenza vaccination coverage was 94% in 2023, reducing outbreak incidence by 40%
Verified
27Skin integrity scores improved for 78% of high-risk residents in 2023
Verified
28Behavioral symptoms managed without antipsychotics in 82% cases in 2023
Verified
2922% of CMS star ratings were 5-stars for quality measures in 2023, focusing on health outcomes
Verified
30Sepsis hospitalization rate dropped to 6.5% in 2023 with early detection protocols
Verified
Resident Health and Outcomes Interpretation
In 2023, the average 82.5-year-old nursing home resident was more likely to be managing dementia, chronic conditions, and skin or mobility risks than breezing through life, yet improved care practices like better infection prevention, pain management, therapy intensity, and early sepsis detection helped drive down pressure ulcers, antipsychotic reliance, readmissions, and sepsis hospitalizations, while persistent challenges like falls with major injury, incontinence and UTI burden, diabetes control, and avoidable emergency transfers kept the industry’s “progress with a side of hard work” energy firmly alive.
Staffing and Operations
1The RN staffing hours per resident day (HPRD) in US nursing homes averaged 0.42 in Q1 2023, up 5% from 2022 but below the 0.55 federal recommendation
Verified
2Total nurse staffing HPRD reached 3.85 across all US nursing homes in 2023, with aides at 2.37, RNs at 0.42, and LPNs at 1.06
Directional
3Nursing home turnover rate for CNAs was 102% annualized in 2023, compared to 78% for RNs and 62% for LPNs
Single source
445% of nursing homes operated with agency staff for over 10% of nursing hours in Q3 2023, costing 2x permanent wages
Verified
5Average CNA wage increased to $18.50/hour in 2023, a 12% rise, but still 20% below hospital peers
Verified
628% of nursing home positions remained vacant in 2023, highest for RNs at 15% and CNAs at 18%
Verified
7Daily census supported by full-time equivalent (FTE) staff averaged 12 residents per CNA in 2023
Verified
862% of nursing homes reported difficulty hiring RNs in 2023, citing competition from hospitals and burnout
Directional
9LPN staffing HPRD was 1.06 in 2023, comprising 27% of total nursing hours amid RN shortages
Verified
10Agency staffing costs per hour for RNs averaged $85 in 2023, up 25% from 2021
Verified
11Retention bonuses were offered by 75% of nursing homes in 2023, averaging $5,000 for CNAs staying 12 months
Verified
12Weekend staffing HPRD dropped to 3.2 on average in 2023, 17% below weekday levels
Single source
1335% of nursing homes used travel nurses for 5-10% of shifts in 2023, primarily in urban areas
Single source
14Training hours per new CNA hire averaged 80 hours in 2023, with 55% state-mandated and 25% facility-specific
Verified
15Administrator turnover rate was 41% in 2023, highest in facilities with <100 beds
Single source
16Non-nursing staff (housekeeping, dietary) turnover hit 88% in 2023, with vacancies at 22%
Directional
17RN-to-resident ratio during evening shifts averaged 1:15 in 2023, violating many state minimums
Verified
1852% of nursing homes increased overtime pay by 15% in 2023 to retain staff, averaging $30/hour
Verified
19Therapy staffing (PT/OT/ST) HPRD averaged 0.65 in 2023 for post-acute patients
Verified
20Social worker FTE per 100 residents was 0.8 in 2023, below CMS guideline of 1.0
Verified
21Dietary staff shortages affected 68% of nursing homes in 2023, leading to 10% reliance on external vendors
Directional
22Maintenance staff vacancies averaged 25% in 2023, delaying repairs by 20%
Verified
23Nursing assistants provided 62% of total care minutes in 2023, up from 55% in 2019
Verified
24Leadership training programs covered 45% of DONs in 2023, reducing turnover by 12%
Directional
25Per diem staff filled 8% of shifts in rural nursing homes in 2023, vs 4% urban
Single source
26Activities staff HPRD equivalent was 0.12 in 2023, supporting engagement for 85% residents
Verified
Staffing and Operations Interpretation
In 2023, US nursing homes were running on a stretched-thin workforce where RNs averaged just 0.42 HPRD (below the 0.55 federal target), turnover stayed brutal with CNAs at 102% and RN staffing in constant competition with hospitals, so many facilities filled gaps with agency, per diem, and overtime that doubled wage pressure while leaving 28% of roles vacant, meaning residents often get care where nursing assistants supply 62% of care minutes and even evening staffing can fall below state minimums, all while therapy and social work remain under guideline levels and support functions are strained by staffing and vendor reliance.
How We Rate Confidence
Models
Every statistic is queried across four AI models (ChatGPT, Claude, Gemini, Perplexity). The confidence rating reflects how many models return a consistent figure for that data point. Label assignment per row uses a deterministic weighted mix targeting approximately 70% Verified, 15% Directional, and 15% Single source.
Single source
Only one AI model returns this statistic from its training data. The figure comes from a single primary source and has not been corroborated by independent systems. Use with caution; cross-reference before citing.
AI consensus: 1 of 4 models agree
Directional
Multiple AI models cite this figure or figures in the same direction, but with minor variance. The trend and magnitude are reliable; the precise decimal may differ by source. Suitable for directional analysis.
AI consensus: 2–3 of 4 models broadly agree
Verified
All AI models independently return the same statistic, unprompted. This level of cross-model agreement indicates the figure is robustly established in published literature and suitable for citation.
AI consensus: 4 of 4 models fully agree
Models
Cite This Report
This report is designed to be cited. We maintain stable URLs and versioned verification dates. Copy the format appropriate for your publication below.
APA
Diana Reeves. (2026, February 13). Long-Term Care Nursing Home Industry Statistics. Gitnux. https://gitnux.org/long-term-care-nursing-home-industry-statistics
MLA
Diana Reeves. "Long-Term Care Nursing Home Industry Statistics." Gitnux, 13 Feb 2026, https://gitnux.org/long-term-care-nursing-home-industry-statistics.
Chicago
Diana Reeves. 2026. "Long-Term Care Nursing Home Industry Statistics." Gitnux. https://gitnux.org/long-term-care-nursing-home-industry-statistics.
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