NCHS Data Brief ■ No. 223 ■ November 2015

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Variation in Residential Care Community Resident 

Characteristics, by Size of Community: United States, 2014

Manisha Sengupta, Ph.D.; Lauren D. Harris-Kojetin, Ph.D.; and Christine Caffrey, Ph.D.

Key findings

Data from the 2014 

National Study of LongTerm Care Providers

● Residents in residential care 

communities with more than 

25 beds were older than those 

in smaller communities.

● A higher percentage of 

residents in communities with 

4–25 beds were receiving 

Medicaid compared with 

residents in larger communities. 

● The prevalence of 

Alzheimer’s disease and 

depression was higher among 

residents of communities 

with 4–25 beds than in 

larger communities, but the 

prevalence of cardiovascular 

disease was lower.

● The percentage of residents 

needing assistance in bathing, 

dressing, toileting, transferring, 

walking, and eating was highest 

in communities with 4–25 beds. 

● The percentage of residents 

who had fallen in the previous 

90 days increased with 

increasing community bed size.

Residents of residential care communities are persons who cannot live 

independently but generally do not require the skilled care provided by nursing 

homes. There were 835,200 current residents in residential care communities 

in 2014 (1,2). “Current residents” refers to those who were living in the 

community on the day of data collection (as opposed to the total number of 

residents who lived in the community at some time during the calendar year). 

This report presents national estimates of selected characteristics of current 

residents in 2014 and compares these characteristics by community bed size. 

State-level estimates for these characteristics are available online at: http://

www.cdc.gov/nchs/nsltcp/nsltcp_products.htm. 

Keywords: assisted living • long-term care services and supports • National 

Study of Long-Term Care Providers 

In 2014, residents in larger communities were older than 

those in smaller communities.

● Overall, the majority of residents of residential care communities (53%) 

were aged 85 and over (Figure 1).

Figure 1. Age distribution of residential care residents, by community size: United States, 2014

NOTES: For all age groups, there was a significant difference between communities with 4–25 beds and other community sizes 

(p < 0.05). Percentages are based on unrounded numbers; estimates may not add up to totals because of rounding. 

SOURCE: CDC/NCHS, National Study of Long-Term Care Providers, 2014. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
NCHS Data Brief ■ No. 223 ■ November 2015

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● In 2014, 15% of residents living in residential care communities with 4–25 beds were under 

age 65, compared with 5% in communities with more than 50 beds.

● Residents aged 85 and over made up a higher percentage in communities with more than 25 

beds (54%) than in communities with 4–25 beds (47%). 

A higher percentage of residents in communities with 4–25 beds were 

receiving Medicaid compared with residents in larger communities. 

● Overall, 70% of residents in residential care communities were female. The percentage of 

females was slightly higher in communities with 26–50 beds (72%) than in communities 

with 4–25 beds (69%) or more than 50 beds (70%) (Figure 2).

● Eighty percent of residents in communities with 4–25 beds were non-Hispanic white, 

compared with 87% in communities with 26–50 beds and 85% in communities with more 

than 50 beds.

● The percentage of residents receiving Medicaid decreased with increasing bed size. 

Twenty-three percent of residents in communities with 4–25 beds had at least some services 

paid for by Medicaid, compared with 17% of residents in communities with 26–50 beds and 

13% in communities with more than 50 beds.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Figure 2. Selected characteristics of residential care residents, by community size: United States, 2014

1

Significant difference between communities with 26–50 beds and other community sizes (p < 0.05). 2

Significant difference between communities with 4–25 beds and other community sizes (p < 0.05). 3

Significant differences among communities with 4–25 beds, 26–50 beds, and more than 50 beds (p < 0.05); decrease by bed size is statistically significant 

(p < 0.05) based on a weighted least-squares regression test.

NOTE: For the Medicaid variable, cases with missing data are excluded; see "Data source and methods" for details. 

SOURCE: CDC/NCHS, National Study of Long-Term Care Providers, 2014.

 

 
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The prevalence of Alzheimer’s disease and depression was higher among 

residents in communities with 4–25 beds than in larger communities.

● Overall, nearly one-half of all residents were diagnosed with cardiovascular disease (46%) 

and about 4 in 10 were diagnosed with Alzheimer’s disease or other dementias; fewer were 

diagnosed with depression (23%) or diabetes (17%) (Figure 3). 

● A higher percentage of residents in communities with 26–50 beds (47%) and more than 50 

beds (46%) had cardiovascular disease compared with residents in smaller communities 

(43%).

● The percentage of residents with Alzheimer’s disease and other dementias decreased with 

increasing community size, from 47% of residents in communities with 4–25 beds, to 42% 

in communities with 26–50 beds, to 37% in larger communities. 

● A higher percentage of residents in communities with 4–25 beds had ever been diagnosed 

with depression (27%) compared with residents in communities with 26–50 beds (23%) or 

more than 50 beds (22%). 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Figure 3. Selected diagnosed medical conditions among residential care residents, by community size: 

United States, 2014

1

Significant difference between communities with 4–25 beds and other community sizes (p < 0.05). 2

Significant differences among communities with 4–25 beds, 26–50 beds, and more than 50 beds (p < 0.05); decrease by bed size is statistically significant 

(p < 0.05) based on a weighted least-squares regression test. 3

Significant difference between communities with 4–25 beds and those with more than 50 beds (p < 0.05).

NOTE: Cases with missing data are excluded; see "Data source and methods" for details. 

SOURCE: CDC/NCHS, National Study of Long-Term Care Providers, 2014.

 

 
NCHS Data Brief ■ No. 223 ■ November 2015

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The percentage of residents needing assistance in bathing, dressing, 

toileting, transferring, walking, and eating was highest in communities with 

4–25 beds. 

● About 62% of residents overall needed assistance with bathing, which was the most frequent 

functional limitation among residents (Figure 4).

● The percentage of residents needing assistance with bathing decreased with increasing 

community bed size, with 77% of those in communities with 4–25 beds needing help in 

bathing compared with 58% of those in communities with more than 50 beds. 

 

 

 

 

 

 

 

 

 

 

Figure 4. Need for assistance with selected activities of daily living among residential care residents, by community size: 

United States, 2014

1

Significant differences among communities with 4–25 beds, 26–50 beds, and more than 50 beds (p < 0.05); decrease by bed size is statistically significant 

(p < 0.05) based on weighted least-squares regression test. 2

Significant difference between communities with 4–25 beds and other community sizes (p < 0.05).

NOTE: Cases with missing data are excluded; see "Data source and methods" for details. 

SOURCE: CDC/NCHS, National Study of Long-Term Care Providers, 2014.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
NCHS Data Brief ■ No. 223 ■ November 2015

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The percentage of residents who had fallen in the previous 90 days 

increased with increasing community bed size.

● Overall, about 2 in 10 residents in residential care communities had a fall in the previous 

90 days (21%). The percentage increased with increasing community bed size, from 11% 

of residents in communities with 4–25 beds to 24% in communities with more than 50 beds 

(Figure 5).

● About 1 in 10 residents in residential care communities visited a hospital emergency 

department in the previous 90 days (12%). A slightly higher percentage of residents in 

communities with more than 50 beds (13%) had an emergency department visit compared 

with residents in communities with 26–50 beds (11%). 

● A slightly higher percentage of residents in communities with more than 50 beds were 

discharged from overnight hospital stays in the previous 90 days (9%), compared with 

residents in communities with 50 or fewer beds (7%). 

Figure 5. Falls, emergency department visits, and discharges from overnight hospital stays, among residential care 

residents, by community size: United States, 2014

1

Significant differences among communities with 4–25 beds, 26–50 beds, and more than 50 beds (p < 0.05); increase by bed size is statistically significant 

(p < 0.05) based on a weighted least-squares regression test. 2

Significant difference between communities with 26–50 beds and those with more than 50 beds (p < 0.05). 3

Significant difference between communities with more than 50 beds and other community sizes (p < 0.05).

NOTE: Cases with missing data are excluded; see "Data source and methods" for details. 

SOURCE: CDC/NCHS, National Study of Long-Term Care Providers, 2014. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
NCHS Data Brief ■ No. 223 ■ November 2015

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Summary

In 2014 in the United States, the resident population living in residential care communities with 

4–25 beds differed from the resident population living in larger residential care communities in a 

variety of sociodemographic, functional and health status, and service utilization characteristics. 

Compared with residents in communities with more than 25 beds, a higher percentage of residents 

in 4- to 25-bed communities were older, receiving Medicaid, living with Alzheimer’s disease 

or other dementias or depression, and needing assistance with each of the six activities of daily 

living (ADLs) examined. Conversely, compared with residents in communities with more than 25 

beds, a lower percentage of residents in communities with 4–25 beds were non-Hispanic white, 

lived with cardiovascular disease, or had fallen in the previous 90 days. 

This report presents the most current national estimates of selected characteristics of residents in 

residential care communities and compares these characteristics by bed size. This brief profile of 

residential care residents provides useful information to policymakers, providers, researchers, and 

consumer advocates as they plan how best to meet the needs of an aging population. The findings 

also highlight the diversity of residents across the different sizes of residential care communities. 

Corresponding state estimates, and their standard errors, for the national figures in this data brief 

can be found at http://www.cdc.gov/nchs/nsltcp/nsltcp_products.htm. 

Definitions

Assistance with selected activities of daily living (ADLs): Refers to needing any help or 

supervision from another person, or use of special equipment for assistance, with six limitations 

in ADLs (bathing, walking or locomotion, dressing, transferring in and out of a bed, toileting, and 

eating) that reflect a resident’s capacity for self-care.

Cardiovascular disease: Includes conditions such as heart disease, stroke, and high blood pressure.

Community bed size: Residents were grouped based on the number of licensed, registered, or 

certified residential care beds (both occupied and unoccupied) in their residential care community: 

4–25 beds, 26–50 beds, and more than 50 beds. 

Emergency department visits: Includes residents who were treated at least once in a hospital 

emergency department in the 90 days prior to the survey.

Falls: Includes residents with at least one onsite or offsite fall in the 90 days prior to the survey. 

Overnight hospital stays: Includes residents with at least one discharge from an overnight hospital 

stay in the 90 days prior to the survey. Trips to the emergency department that did not result in a 

discharge from an overnight hospital stay were excluded.

Residential care communities: Includes assisted living communities and other residential care 

communities (e.g., personal care homes, adult care homes, board care homes, or adult foster care) 

that meet the study eligibility criteria described in the “Data source and methods” section.

Residents with some or all long-term care services paid for by Medicaid: Refers to residents who 

had some or all of their long-term care services paid for by Medicaid during the 30 days prior to 

the survey. 
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Data source and methods

Data for this report are from the residential care community survey component of the 2014 wave 

of the biennial National Study of Long-Term Care Providers (NSLTCP), conducted by the Centers 

for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS). 

To be eligible for the study, a residential care community must (a) be regulated by the state to 

provide room and board with at least two meals a day, around-the-clock onsite supervision, 

and help with personal care such as bathing and dressing or health-related services such as 

medication management; (b) have four or more licensed, certified, or registered beds; (c) have 

at least one resident currently living in the community at the time of the survey; and (d) serve 

a predominantly adult population. The survey used a combination of probability sampling and 

taking a census. More details about the NSLTCP design and outcomes are available elsewhere 

(2,3). The percentage of cases with missing data for variables in this report ranged from 1.7% for 

type of ownership to 7.4% for computerized support for electronic health information exchange 

with hospitals. These cases were excluded from the analyses on a variable-by-variable basis. 

Data analyses were performed using the following statistical packages: SAS, version 9.3 (SAS 

Institute, Cary, N.C.); SAS-callable SUDAAN, version 11.0.0 (RTI International, Research 

Triangle Park, N.C., 2012); and STATA/SE, version 12.1 (StataCorp, College Station, Texas, 

2013). Statements of differences among subgroups are based on two-tailed chi-squared and t tests 

with significance at the p < 0.05 level. If a chi-squared test was statistically significant, a post hoc 

t test procedure was used to make pairwise comparisons among different community bed sizes. A 

weighted least-squares regression method was used to test the significance of linear trends in bed 

size. The estimate of the number of residential care communities and residents varied among the 

2010 National Survey of Residential Care Facilities and the 2012 and 2014 waves of NSLTCP 

(1–6). 

About the authors

Manisha Sengupta, Lauren D. Harris-Kojetin, and Christine Caffrey are with CDC’s National 

Center for Health Statistics, Division of Health Care Statistics. 

References

1. Caffrey C, Harris-Kojetin L, Sengupta M. Variation in operating characteristics of residential 

care communities, by size of community: United States, 2014. NCHS data brief, no 222. 

Hyattsville, MD: National Center for Health Statistics. 2015. Available from: http://www.cdc.gov/

nchs/data/databriefs/db222.pdf.

2. National Center for Health Statistics. 2014 National Study of Long-Term Care Providers 

survey methodology and documentation. Hyattsville, MD. Available from: http://www.cdc.gov/

nchs/data/nsltcp/NSLTCP_2014_survey_methodology_and_documentation.pdf.

3. National Center for Health Statistics. 2014 National Study of Long-Term Care Providers 

(NSLTCP) residential care communities survey restricted data file: Data description and 

usage (readme). Hyattsville, MD. 2015. Available from: http://www.cdc.gov/nchs/data/nsltcp/

NSLTCP_2014_RCC_Readme_RDC_Release.pdf.
NCHS Data Brief ■ No. 223 ■ November 2015

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4. Caffrey C, Harris-Kojetin L, Rome V, Sengupta M. Characteristics of 

residents living in residential care communities, by community bed size: 

United States, 2012. NCHS data brief, no 171. Hyattsville, MD: National 

Center for Health Statistics. 2014. Available from: http://www.cdc.gov/nchs/

data/databriefs/db171.pdf.

5. Park-Lee E, Caffrey C, Sengupta M, et al. Residential care facilities: 

A key sector in the spectrum of long-term care providers in the United 

States. NCHS data brief, no 78. Hyattsville, MD: National Center for Health 

Statistics. 2011. Available from: http://www.cdc.gov/nchs/data/databriefs/

db78.pdf.

6. Caffrey C, Sengupta M, Park-Lee E, et al. Residents living in residential 

care facilities: United States, 2010. NCHS data brief, no 91. Hyattsville, MD: 

National Center for Health Statistics. 2012. Available from: http://www.cdc.

gov/nchs/data/databriefs/db91.pdf.

Suggested citation

Sengupta M, Harris-Kojetin LD, Caffrey 

C. Variation in residential care community 

resident characteristics, by size of 

community: United States, 2014. NCHS 

data brief, no 223. Hyattsville, MD: National 

Center for Health Statistics. 2015.

Copyright information

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the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Charles J. Rothwell, M.S., M.B.A., Director

Nathaniel Schenker, Ph.D., Deputy Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health Care Statistics

Clarice Brown, M.S., Director

Alexander Strashny, Ph.D., Associate 

Director for Science

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