Nearly 800 nursing homes closed between February 2020 and July 2024, displacing nearly 30,000 residents, according to a new report from the sector’s largest provider advocacy group.
The American Health Care Association/National Center for Assisted Living added in its annual Access to Care report that the consequences to rural communities have been devastating.
“It’s not hyperbole to say access to care is a national crisis,” Mark Parkinson, president and CEO of AHCA/NCAL, said in a press release announcing the report on Thursday. “Nursing homes are closing at a rate much faster than they are opening, and yet with each passing day, our nation grows older. Providers are doing everything they can to protect and expand access to care, but without support from policymakers, access to care remains under threat.”
Demand for long-term care facilities continues to increase, but the supply of buildings and staff to provide the necessary services continues to decline, according to the report. Nationwide, only 37 new facilities opened last year, compared to 73 in 2020, 71 in 2021, and 55 in 2022. Eight months into 2024, and just seven new facilities have opened, the association said.
Alongside fewer openings, there have been significant numbers of closures.
Since 2020, at least 774 nursing homes have closed, displacing 28,421 residents. There are also 62,567 fewer nursing home beds than there were in 2020.
Rural communities have been particularly hard hit. Earlier this year, McKnight’s Long-Term Care News produced a four-part series called “Rural Peril” that highlighted this growing problem.
The series examined, among other issues, the impact of the proposed federal staffing rule, the challenges in attracting and retaining staff, and the “astounding” number of facility closures such as in Oklahoma, which lost more than 100 nursing homes between 2000 and 2022.
The report describes the phenomenon of “nursing home deserts” where there are no skilled nursing facilities to serve aging populations.
“Across the United States, there are now dozens of counties that have no nursing homes,” the report said. “The vast majority of these counties are located in rural communities, where 1 in 5 older Americans live. In addition, the federal staffing mandate will require that 92% of rural facilities hire more registered nurses to comply – an impossible challenge for these communities where workers are already scarce.”
The report focuses on three key areas that are growing problems for all nursing homes: limiting admissions, facilities downsizing and closures. The statistics the report presents highlight the stark reality of long-term care in America today (as of July 2024):
- 46% percent of nursing homes are currently having to limit new admissions.
- 57% of nursing homes have a waiting list for new residents.
- 20% percent of nursing homes have closed a unit, wing, or floor due to labor shortages.
“There is not a single factor that determines whether a nursing home can withstand economic pressures, limited federal support, and growing workforce challenges,” the report said. “More than one-third of all closures were facilities with 4- or 5-star rankings, and one in three nursing homes were not-for-profit organizations.”
Among closed facilities, the average bed size was 77, while 69% were located in urban areas. More than 3 in 5 (62%) of affected residents were Medicaid beneficiaries, said the report, which offered a dire warning that 290,642 seniors are at-risk of being displaced as facilities shift operations to comply with the federal staffing mandate.
