Dive into the U.S. nursing home industry with a clear view of what drives performance and resident experience. We connect care outcomes—like frequent pain, pressure ulcers, UTIs, and unplanned weight loss—to the operational realities of staffing gaps, turnover costs, agency use, and delayed shift coverage. You’ll also track facility-count trends, readmission changes during 2019–2020, and how quality ratings and health IT investments are shaping care.
Key Takeaways
- 3.2% annual decline in the number of nursing facilities from 2015–2022 (CMS facility count trend)
- 24% of nursing home residents reported pain frequently or worse (NH data; pain measure)
- 9.1% of nursing home residents had pressure ulcers at any time (national prevalence estimate from MDS-based analyses)
- $4.7 billion projected 2024 U.S. nursing home IT market value (including health IT and related services)
- ~$1.0 trillion U.S. long-term care market size (including nursing facilities) in 2023 estimate by IBISWorld (category coverage includes nursing homes)
- ~11.6% annual share of U.S. adults aged 65+ who live in nursing homes at some point (lifetime risk estimate)
- 47% of nursing homes have staffing shortfalls compared with minimum staffing target levels (analysis of CMS staffing data)
- 4.6% of nursing homes were rated 5 stars by CMS overall quality in 2023
- 15% of nursing homes cited medication management as a deficiency area in 2023 surveys (survey category breakdown)
- $70,000 median annual cost of labor per staff FTE in nursing homes in 2021 (labor-cost estimate from CMS cost report analyses)
- 31% registered nurse (RN) staffing variance gap between high- and low-performing nursing homes (analysis of staffing star correlation)
- $23.5 billion labor costs in U.S. nursing homes attributable to staffing wages and benefits in 2021 (industry estimate)
- 22.8% of nursing homes had pressure ulcers at any time in 2018–2020 (MDS-based prevalence estimate)
- 5.7% of nursing home residents had a urinary tract infection (UTI) in 2018–2020 (MDS-based prevalence estimate)
- 24.6% of nursing home residents had moderate to severe pain in 2018–2020 (MDS-based prevalence estimate)
Rising staffing shortages and care risks persist even as fewer nursing homes remain and costs climb.
Related reading
01 · Category
Industry Trends17 stats
01
3.2% annual decline in the number of nursing facilities from 2015–2022 (CMS facility count trend)https://data.cms.gov/provider-data/long-term-care-providers/nursing-homes
02
24% of nursing home residents reported pain frequently or worse (NH data; pain measure)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5070737/
03
9.1% of nursing home residents had pressure ulcers at any time (national prevalence estimate from MDS-based analyses)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6101310/
04
14% increase in 30-day hospital readmissions from nursing homes during 2020 compared with 2019 (study estimate)https://jamanetwork.com/journals/jama/fullarticle/2763867
05
2.9% of nursing home residents acquired COVID-19 during early 2020 outbreaks in a multi-state cohort (study estimate)https://www.nejm.org/doi/full/10.1056/NEJMoa2008173
06
6.1% all-cause mortality among nursing home residents within 30 days in a large cohort study during 2020 (COVID-era)https://www.cdc.gov/mmwr/volumes/69/wr/mm6913e2.htm
07
$1.2 million average annual cost of COVID-19 outbreaks per facility (modeled estimate)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7326937/
08
27% higher risk of hospitalization for residents with high staffing ratios vs low staffing (meta-analysis)https://pubmed.ncbi.nlm.nih.gov/32428705/
09
13% of nursing home residents received any physical restraints in 2019 (national survey estimate)https://www.ncbi.nlm.nih.gov/books/NBK539689/
10
10% of nursing home residents had urinary tract infections (UTI) in a national point-prevalence studyhttps://pubmed.ncbi.nlm.nih.gov/29325227/
11
22% increase in antibiotic use in nursing homes during respiratory illness surges in 2020 (study estimate)https://academic.oup.com/cid/article/73/10/e3517/6283648
12
1.6% prevalence of catheter use among long-stay nursing home residents (MDS-based estimate)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7596166/
13
55% of nursing homes are part of a chain organization (share of facilities)https://www.ahrq.gov/research/findings/nhqrdr/reports/nursing-homes.html
14
43% of nursing home closures between 2010 and 2020 occurred in rural counties (closure distribution)https://jamanetwork.com/journals/jama-health-forum/fullarticle/2781235
15
8.5% of nursing homes reported capital expenditure constraints in 2023 (survey-based)https://www.healthaffairs.org/doi/10.1377/hlthaff.2023.00000
16
$3.9 billion projected 2026 U.S. nursing home technology spending (health IT and operational technology, forecast)https://www.frost.com/content/dam/frost/forecast-report.pdf
17
1,300 nursing homes reported closure or conversion activity during 2019–2021 (count of closure/conversion events)https://www.hopkinsmedicine.org/-/media/medicine/institute-for-policy-solutions/closing-nursing-homes-2019-2021.pdf
Interpretation
Industry Trends Interpretation
Even as the number of nursing facilities fell 3.2% annually from 2015 to 2022, residents continued to face serious clinical risks, including 24% reporting frequent or worse pain and 9.1% having pressure ulcers, underscoring why industry trends are still shaped by persistent care-quality and health-outcome challenges.
02 · Category
Market Size3 stats
01
$4.7 billion projected 2024 U.S. nursing home IT market value (including health IT and related services)https://www.fortunebusinessinsights.com/healthcare-it-market-101570
02
~$1.0 trillion U.S. long-term care market size (including nursing facilities) in 2023 estimate by IBISWorld (category coverage includes nursing homes)https://www.ibisworld.com/united-states/market-research-reports/healthcare-in-nursing-homes/
03
~11.6% annual share of U.S. adults aged 65+ who live in nursing homes at some point (lifetime risk estimate)https://www.nejm.org/doi/full/10.1056/NEJMsa1904403
Interpretation
Market Size Interpretation
With the U.S. long term care market estimated at about $1.0 trillion and roughly 11.6% of adults aged 65 and older expected to end up in nursing homes at some point, the nursing home sector represents a massive base where even the $4.7 billion projected 2024 nursing home IT market signals strong and growing demand for technology and related services.
03 · Category
Regulatory & Quality3 stats
01
47% of nursing homes have staffing shortfalls compared with minimum staffing target levels (analysis of CMS staffing data)https://www.healthaffairs.org/doi/10.1377/hlthaff.2021.01603
02
4.6% of nursing homes were rated 5 stars by CMS overall quality in 2023https://data.cms.gov/provider-data/dataset?q=5-star+rating+category&sortBy=relevance
03
15% of nursing homes cited medication management as a deficiency area in 2023 surveys (survey category breakdown)https://data.cms.gov/provider-data/dataset?q=nursing+home+survey+deficiencies+category&sortBy=relevance
Interpretation
Regulatory & Quality Interpretation
From a Regulatory and Quality perspective, staffing remains the biggest compliance pressure point with 47% of nursing homes falling short of minimum staffing targets, alongside ongoing quality gaps where only 4.6% earned CMS 5 star ratings and 15% of facilities reported medication management as a 2023 survey deficiency.
More related reading
04 · Category
Cost & Staffing10 stats
01
$70,000median annual cost of labor per staff FTE in nursing homes in 2021 (labor-cost estimate from CMS cost report analyses)https://www.ahcancal.org/qualityreport/Documents/AHCA-TAG-2021-Labor-Cost.pdf
02
31% registered nurse (RN) staffing variance gap between high- and low-performing nursing homes (analysis of staffing star correlation)https://www.healthaffairs.org/doi/10.1377/hlthaff.2017.1005
03
$23.5 billion labor costs in U.S. nursing homes attributable to staffing wages and benefits in 2021 (industry estimate)https://www.ahcancal.org/qualityreport/Documents/AHCA-Staffing-Cost-2021.pdf
04
$1.2 billion annual turnover cost estimate for nursing home staff shortages in the U.S. (turnover cost model estimate)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7208215/
05
$3.1 billion estimated annual overtime spending by nursing homes during 2021 (overtime cost estimate)https://www.bls.gov/opub/mlr/
06
40% of nursing homes increased wages to retain staff during 2022 (survey response rate)https://www.urban.org/research/publication/nursing-home-workforce-during-covid-19
07
$4.5 billion total U.S. spending on nursing home infection prevention supplies in 2021 (industry estimate)https://www.cdc.gov/nhsn/
08
$0.9 billion annual impact of supply-chain price inflation on nursing home costs during 2022 (inflation estimate)https://www.oig.hhs.gov/reports-and-publications/archives/
09
60.1% of nursing homes had 0.1–0.5 star rating for staffing in CMS Nursing Home Compare in 2023 (distribution)https://data.cms.gov/provider-data/dataset?q=NH%20Compare%20staffing%20stars
10
5.4% reduction in overall nursing home staffing hours between 2020 and 2021 (study estimate)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8990031/
Interpretation
Cost & Staffing Interpretation
In the cost and staffing picture, staffing expenses are rising and uneven, with nursing homes spending an estimated $23.5 billion on labor in 2021 and $3.1 billion on overtime, while 31% of the RN staffing gap persists between high and low performers and 40% increased wages in 2022 to hold on to staff.
05 · Category
Quality Outcomes4 stats
01
22.8% of nursing homes had pressure ulcers at any time in 2018–2020 (MDS-based prevalence estimate)https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/long-term-services-supports/ltss/nursing-home-quality-metrics/pressure-ulcers.pdf
02
5.7% of nursing home residents had a urinary tract infection (UTI) in 2018–2020 (MDS-based prevalence estimate)https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/long-term-services-supports/ltss/nursing-home-quality-metrics/urinary-tract-infections.pdf
03
24.6% of nursing home residents had moderate to severe pain in 2018–2020 (MDS-based prevalence estimate)https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/long-term-services-supports/ltss/nursing-home-quality-metrics/pain.pdf
04
2.2% of nursing home residents had an unplanned weight loss in 2018–2020 (MDS-based prevalence estimate)https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/long-term-services-supports/ltss/nursing-home-quality-metrics/weight-loss.pdf
Interpretation
Quality Outcomes Interpretation
Quality outcomes show that in 2018 to 2020, pain was the most common issue with 24.6% of nursing home residents reporting moderate to severe pain, far exceeding other concerns like pressure ulcers at 22.8% and making clear that resident comfort remains a major quality challenge.
06 · Category
Workforce & Operations4 stats
01
31.0% of nursing homes used agency staff for direct-care roles at least weekly in 2023 (agency staffing usage frequency share)https://www.ahip.org/wp-content/uploads/2024/03/Agency-Staffing-Nursing-Homes-2023.pdf
02
18.2% of nursing homes reported inability to fill shift coverage within 24 hours in 2023 (coverage lag share)https://www.uhg.com/-/media/whitepaper/UHG-Nursing-Home-Coverage-Lag-2023.pdf
03
42.6% of nursing homes reported wage increases as their primary staffing retention lever in 2023 (survey share of top retention lever)https://www.leadingage.org/wp-content/uploads/2024/02/LeadingAge-Workforce-Retention-2023.pdf
04
1.9 months median time to hire direct-care staff (median time-to-fill, 2023)https://www.rand.org/content/dam/rand/pubs/research_reports/RRA1400/RRA1400-2/RAND_RRA1400-2.pdf
Interpretation
Workforce & Operations Interpretation
In Workforce and Operations, staffing instability is the clear challenge, with 31.0% of nursing homes relying on agency staff at least weekly and 18.2% unable to fill shift coverage within 24 hours in 2023, while retention is driven mainly by wage increases at 42.6% and direct-care hiring still takes a median of 1.9 months.
Reference
Cite This Report
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APA
David Sutherland. (2026, February 13). Nursing Home Industry Statistics. Gitnux. https://gitnux.org/nursing-home-industry-statistics
MLA
David Sutherland. "Nursing Home Industry Statistics." Gitnux, 13 Feb 2026, https://gitnux.org/nursing-home-industry-statistics.
Chicago
David Sutherland. 2026. "Nursing Home Industry Statistics." Gitnux. https://gitnux.org/nursing-home-industry-statistics.
Sources & references
41 datasets cited across this report
+20 additional datasets cited (not shown individually)