Healthcare Insights

How many assisted living facilities are in the U.S.?

An assisted living facility (ALF) is a type of long-term care facility that provides personal care for full-time residents, many of whom are over the age of 65. These facilities generally offer housing, meals, and support with daily activities for residents who may feel they are unable to live safely and independently on their own.

In total, there are more than 33,000 active ALFs across the U.S., according to data from our LongTermCareView product. The heatmap below illustrates which states across the country have the most assisted living facilities.

Number of ALFs across the U.S.


Fig. 1. Data is from Definitive Healthcare’s LongTermCareView product. Data accessed in April 2023.

Which states have the most assisted living facilities?

The five states with the most ALFs are:

  1. California – 5808
  2. Michigan - 3213
  3. Wisconsin - 2859
  4. Florida – 2524
  5. Texas – 1612

The results aren’t surprising, as these five states also have the highest population of adults over the age of 65, according to 2020 data from the Census Bureau.

The five states with the least number of assisted living facilities are:

  1. Hawaii – 18
  2. Wyoming – 32
  3. Delaware – 34
  4. Rhode Island – 62
  5. North Dakota – 84

While not a state itself, Washington D.C. has 15 ALFs, according to data from LongTermCareView.

What’s the difference between assisted living and skilled nursing?

The primary difference between an assisted living facility and a skilled nursing facility (SNF) is the degree of medical care provided to residents.

An SNF provides short or long-term rehabilitation services to patients in need of transitional care following a stay at a hospital for illness, injury, or surgery. Care is often available 24 hours a day, to help patients recover quickly and minimize post-discharge complications. On the other hand, residents at ALFs don’t require round-the-clock medical supervision, and generally live at these facilities for long periods of time.

In addition, the overwhelming majority of residents at an ALF are adults aged 65 and up. Skilled nursing facilities are equipped to care for patients of all ages.

Interested in learning more about skilled nursing facilities? See which states have the most SNFs, or check out the 50 most common diagnoses made at a skilled nursing facility.

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Healthcare Insights are developed with healthcare commercial intelligence from the Definitive Healthcare platform. Want even more insights? Start a free trial now and get access to the latest healthcare commercial intelligence on hospitals, physicians, and other healthcare providers.