Across the country, the supply of nursing homes is dwindling.
Nationally, the Centers for Medicare & Medicaid Services reports 900 fewer certified nursing homes in 2025 than in 2015.
Why the decline?
The most commonly cited reason is inadequate payments from Medicaid, the leading payer for nursing home care, which generally pays less than the daily cost of care. Another is staffing: nursing home jobs pay poorly and are considered stressful, making it difficult to attract and retain staff.
Even the erosion in the number of beds may not completely capture the decline in access to skilled nursing care. More than half of all nursing homes are limiting their admissions, even when they have available beds.
To compensate for the nursing home bed shortage, growing numbers of potential nursing home residents are choosing to live in assisted living facilities. At the same time, more are remaining in their homes, with Medicaid long-term-care spending devoted to home- and community-based services – services designed to enable people to continue living in their homes – rising from 10 percent of Medicaid expenditures for long-term-care services in 1988 to more than 60 percent in 2020.
Learn more about the nursing home bed shortage, its causes, and why the situation is unlikely to change, at least in the short term, from the KFF Health article “Nursing Home Beds Are Becoming More Scarce.”