Data from Economic Analysis re: Long-Term Care Facilities

1. Number of LTCFs

Exhibit 2-1 of the RIA shows the number of healthcare facilities that may be affected by the 

proposed rule. As the exhibit shows, some long-term care facilities are being considered for 

inclusion under the proposed rule, including nursing care facilities (NAICS 6231) and continuing 

care retirement communities with on-site nursing facilities (NAICS 623311). Other long-term 

facilities will not be affected by the proposed rule; these include: residential intellectual and 

developmental disability, mental health, and substance abuse facilities (NAICS 6232), homes for 

the elderly (NAICS 623312) and other residential care facilities (NAICS 6239). These facilities 

would still be excluded under the household hazardous waste exemption.

For the two categories of long-term care facilities that are included under the proposed rule, 

approximately 28 percent are estimated to be hazardous waste pharmaceutical generators. 

Therefore, the remaining 72 percent of these long-term care facilities are estimated to not 

generate hazardous waste pharmaceuticals and will not be impacted by the rule.

Of the 28% of long-term care facilities that generate hazardous waste pharmaceuticals 14% are 

SQGs (834 facilities) and 1% are LQGs (75 facilities), as shown in the Table 1 below. We 

estimate that 85% of long-term care facilities that generate hazardous waste pharmaceuticals are 

CESQGs (5240). Under the proposal, CESQG healthcare facilities are subject only to the sewer 

ban and not to any of the other provisions of the proposed rule. Further, in general CESQGs are 

exempt from the standards that apply to SQGs and LQGs in regards to accumulating, managing, 

transporting, and disposing hazardous waste. 

Table 1: Estimated Number of Long-Term Care Facilities that will be Affected by the Proposed Rule

NAICS FACILITY TYPE

GENERATOR STATUS TOTAL NUMBER OF 

FACILITIES AFFFECTED 

BY THE RULE

(CESQG, SQG, LQG)

TOTAL 

NUMBER OF 

FACILITIES IN 

THE U.S.

NONGENERATOR CESQG SQG LQG

6231 Nursing Care 

Facilities

11,812

(72.4%)

3,701

(22.7%)

740

(4.5%)

67

(0.4%)

4,508

(27.6%)

16,320

(100%)

623311

Continuing Care 

Retirement 

Communities

4,298

(72.4%)

1,539

(25.9%)

94

(1.6%)

8

(0.1%)

1,641

(27.6%)

5,939

(100%)

All Long-term Care Facilities 16,110

(72.4%)

5,240

(23.5%)

834

(3.7%)

75

(0.3%)

6,149

(27.6%)

22,259

(100%)
Summary	of	Interagency	Working	Comments	on	Draft	Language	under	

EO12866/13563 Interagency	Review.		Subject	to	Further	Policy	Review.

2

2. Amount of pharmaceutical waste generated:

As described in Exhibit 2-19 of the RIA, approximately 36,200 tons of hazardous waste 

pharmaceuticals are generated by all healthcare facilities in the United States on an annual basis.

Of this, approximately 873 tons (2.4 percent) is generated by long-term care facilities. As shown 

in Table 2 below, long-term care facilities that are LQGs generate an average of 2 tons of 

hazardous waste pharmaceuticals per facility per year, while long-term care facilities that are 

SQGs generate an average of 0.6 tons of hazardous waste pharmaceuticals per facility per year.

3. Amount of waste that is considered a controlled substance under DEA

Our data does not have sufficient detail to answer this precisely. However, only 5 hazardous 

waste pharmaceuticals are also DEA controlled substances. We are proposing that these 

hazardous waste pharmaceuticals will be exempt from RCRA, provided they are incinerated (at a 

permitted hazardous waste or municipal solid waste incinerator) and managed in accordance with 

DEA regulations.

4. Disposal method(s)/disposal method percentages

Information on disposal method assumptions can be found in Exhibit 3-9 of the RIA. Below, we 

synthesize information from these two tables to show the estimated amount of hazardous waste 

pharmaceuticals generated by long-term care facilities (and disposal management methods). 

Table 2:

Annual Generation and Management of Hazardous Waste Pharmaceuticals by Long-term Care Facilities

GENERATOR 

STATUS

NUMBER 

OF LTCFS

AFFECTED 

BY THE 

RULE

HAZARDOUS 

WASTE 

PHARMACEUTICALS 

PER LTCF

(TONS)

TOTAL 

HAZARDOUS 

WASTE 

PHARMACEUTICALS

(TONS)

DISPOSAL METHOD IN THE BASELINE

(TONS)

SEWERING

MSW 

DISPOSAL INCINERATION

SENT 

TO RD

CESQG 5,240 0.04 212 44 89 63 15

SQG 834 0.60 498 105 0 359 35

LQG 75 2.17 163 28 0 124 11

TOTAL 6,149 N/A 873 177 89 546 61

Table 3

GENERATOR 

STATUS

DISPOSAL METHOD IN THE BASELINE 

(PERCENTAGE)

SEWERING

MSW 

DISPOSAL INCINERATION

SENT 

TO RD

CESQG 21% 42% 30% 7%

SQG 21% 0% 72% 7%

LQG 17% 0% 76% 7%

WTD. AVG. 20% 10% 63% 7%

MSW = MUNICIPAL SOLID WASTE