NCHS Data Brief ■ No. 171 ■ November 2014

u.s. department of health and human services

centers for disease control and prevention

national center for health statistics

Characteristics of Residents Living in Residential Care 

Communities, by Community Bed Size: United States, 2012

Christine Caffrey, Ph.D.; Lauren Harris-Kojetin, Ph.D.; Vincent Rome, M.P.H.; 

and Manisha Sengupta, Ph.D. 

Key findings 

Data from the National 

Study of Long-Term Care 

Providers, 2012 

• In 2012, 16% of residents 

living in residential care 

communities with 4–25 beds 

were under age 65 compared 

with 5% of residents living in 

communities with more than 

50 beds. 

• A higher percentage of 

residents in communities with 

4–25 beds were male, minority, 

and receiving Medicaid, 

compared with residents in 

communities with 26–50 beds 

and more than 50 beds. 

• The prevalence of 

Alzheimer’s disease and 

other dementias was higher in 

communities with 4–25 beds 

(49%) than in communities 

with 26–50 beds (41%) and 

more than 50 beds (38%). 

• The percentages of residents 

needing assistance with 

bathing, dressing, toileting, 

transferring in or out of a bed, 

and eating were highest in 

communities with 4–25 beds. 

Residents in residential care, including assisted living, are individuals that 

cannot live independently, but generally do not require the skilled level of care 

provided by nursing homes. On any given day in 2012, there were 713,300 

residents in residential care communities (1). With the aging of the population, 

the numbers in residential care communities will likely increase, making them 

an important group within the long-term care population. Using data from the 

first wave of the National Study of Long-Term Care Providers (NSLTCP), this 

report describes characteristics of residents in residential care and compares 

selected characteristics by bed size. State-level estimates for the characteristics 

presented in this data brief are available from: http://www.cdc.gov/nchs/nsltcp/ 

nsltcp_products.htm. 

Keywords: assisted living • long-term care • National Study of Long-Term 

Care Providers 

In 2012, residents in larger communities were older than 

those in smaller communities. 

Figure 1.Age distribution among residential care residents, by community bed size: 

United States, 2012 

100 

80 43 51 50 52 85 and over1 

Percent

60 

75–841 

65–742 

Under 653 

33 

10 

7 

33 

10 

5 

29 

12 

16 

32 

10 

7 

40 

20 

0 

All residents Residents in Residents in Residents in 

communities communities with communities with

with 4–25 beds 26–50 beds more than 50 beds 

1

Differences between communities with 4–25 beds and the other community sizes are significant at p < 0.05; increase by bed size 


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

Differences between communities with 4–25 beds and more than 50 beds are significant at p < 0.05. 
 3

Differences between all community bed sizes are significant at p < 0.05; decrease by size is statistically significant (p < 0.05) 


based on a weighted least-squares regression test.
 

SOURCE: CDC/NCHS, National Study of Long-Term Care Providers, 2012.
 
NCHS Data Brief ■ No. 171 ■ November 2014

•	 In 2012, 16% of residents living in residential care communities with 4–25 beds were under 

65, compared with 5% in communities with more than 50 beds (Figure 1). 

•	 Residents aged 85 and over made up a higher percentage in communities with 26–50 beds 

and more than 50 beds (50% and 52%) than they did in communities with 4–25 beds (43%). 

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

minority, and receiving Medicaid, compared with residents in communities 

with 26–50 beds and more than 50 beds. 

•	 Seventy-two percent of residents in residential care communities were female. The percent 

female was somewhat lower in communities with 4–25 beds (68%) than in communities 

with 26–50 beds and more than 50 beds (73%) (Figure 2). 

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

compared with 90% in communities with 26–50 beds and 88% in communities with more 

than 50 beds. 

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

paid for by Medicaid compared with 20% of residents in communities with 26–50 beds and 

14% of residents in communities with more than 50 beds. 

Figure 2. Selected characteristics among residential care residents, by community bed size: United States, 2012 

Residents in 

communities 

with 26–50 beds 

Percent 

1

Differences between communities with 4–25 beds and the other community bed sizes are significant at p < 0.05. 2

Differences between all community bed sizes are significant at p < 0.05; decrease by bed size is statistically significant (p < 0.05) based on a weighted 

least-squares regression test. 

NOTE: Figure excludes cases with missing data; see "Data source and methods" for details. 

SOURCE: National Study of Long-Term Care Providers, 2012. 

Residents in 

communities 

with more than 

50 beds 

Residents in 

communities 

with 4–25 beds 

All residents 

Residents with some or all 

services paid by Medicaid

in the last 30 days 2 

Non-Hispanic white1 Female1 0 

20 

40 

60 

80 

100 

72 

68 

73 73 

87 

83 

90 88 

17 

27 

20 

14 

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NCHS Data Brief ■ No. 171 ■ November 2014

The prevalence of Alzheimer’s disease and other dementias was higher in 

communities with 4–25 beds (49%) than in communities with 26–50 beds 

(41%) and more than 50 beds (38%). 

•	 The highest percentage of residents with a diagnosis of Alzheimer’s disease and other 

dementias was among residents in residential care communities with 4–25 beds (49%) while 

the lowest percentage was among residents in communities with more than 50 beds (38%) 

(Figure 3). 

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

depression (31%) compared with residents in communities with 26–50 beds and more than 

50 beds (24% each). 

 

 

 

 

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

United States, 2012 

All residents 

100 

Residents in Residents in Residents in 

communities communities communities 

with 4–25 beds with 26–50 beds with more than 

50 beds 

Percent

40 

25 

49 

31 

41 

24 

38 

24 

Alzheimer's and other dementias Depression 

0 

20 

40 

60 

80 

NOTES: Differences between communities with 4–25 beds and the other community bed sizes are significant at p < 0.05; decrease by bed size is statistically 


significant (p < 0.05) based on a weighted least-squares regression test. Figure includes imputed cases with missing data; see "Data source and methods" for 


details. 


SOURCE: CDC/NCHS, National Study of Long-Term Care Providers, 2012.
 

The percentages of residents needing assistance with bathing, dressing, 

toileting, transferring in or out of a bed, and eating were highest in 

communities with 4–25 beds. 

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

community bed size, with 78% of those in communities with 4–25 beds needing help with 

bathing compared with 57% of those in communities with more than 50 beds (Figure 4). 

•	 A higher percentage of residents in communities with 4–25 beds than those in larger 

communities needed help with dressing, toileting, transferring in or out of a bed, and eating. 

•	 The need for assistance with walking or locomotion did not vary significantly by community 

bed size. 

■  3  ■
NCHS Data Brief ■ No. 171 ■ November 2014

 

 

 

 

 

 

 

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

bed size: United States, 2012 

80 78

All residents Residents in 

communities 

with 4–25 beds 

Residents in 

communities 

with 26–50 beds 

Residents in 

communities 

with more than 

50 beds 

Percent 

61 

54 

45 

37 

26 

18 

56 56 

47 

35 

32 

67 

54 

43 

32 

21 

17 

57 

53 

43 

36 

25 

15 

0 

20 

40 

60 

Toileting1 Transferring in

or out of bed1 

Eating Bathing1 Walking or Dressing3 3

locomotion2 

1

Differences between all community bed sizes are significant at p < 0.05; decrease by bed size is statistically significant (p < 0.05) based on a weighted
 

least-squares regression test. 
 2

Differences between communities are not significant at p < 0.05; decrease by bed size is not statistically significant (p < 0.05) based on a weighted
 

least-squares regression test. 
 3

Differences between communities with 4–25 beds and the other community bed sizes are significant at p < 0.05. 


NOTE: Figure includes imputed cases with missing data; see "Data source and methods" for details. 


SOURCE: CDC/NCHS, National Study of Long-Term Care Providers, 2012.
 

About 1 in 10 residents in residential care communities had an emergency 

department visit or was discharged from an overnight hospital stay in the 

previous 90 days. 

•	 Overall, 12% of residents in residential care communities visited the emergency department 

in the last 90 days, and there was little variation by community bed size (Figure 5). 

•	 Of the 10% of residents who had a discharge from an overnight hospital stay in a 90-day 

period, 18% were subsequently readmitted to the hospital within 30 days of discharge. 

•	 Discharges from overnight hospital stays and subsequent readmissions did not vary by 

community bed size.
 

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NCHS Data Brief ■ No. 171 ■ November 2014

 

 

 

 

 

 

Figure 5. Emergency department visits, discharges from overnight hospital stays, and hospital readmissions among 

residential care residents, by community bed size: United States, 2012 

All residents Residents in Residents in Residents in 

communities communities communities 

with 4–25 beds with 26–50 beds with more than 

50 beds 

Percent 

60 

40 

20 

Emergency department visit Discharge from an overnight 

in last 90 days1 hospital stay in last 90 days2 

Readmission within 30 days of 

discharge from an overnight 

hospital stay2 

0 

12 10 

18 

11 

8 

18 

12 

9 

18 

12 10 

18 

1

Differences between residents in communities with 4–25 beds and residents in communities with more than 50 beds are significant at p < 0.05. 
 2

Differences between communities are not significant at p < 0.05; increase by bed size is not statistically significant (p < 0.05) based on a weighted
 

least-squares regression test. 


NOTES: Percentages based on unrounded numbers. Estimates may not add to totals because of rounding. Figure excludes cases with missing data; see 


"Data source and methods" for details. 


SOURCE: CDC/NCHS, National Study of Long-Term Care Providers, 2012.
 

Summary 

In 2012, there was a higher percentage of older, female residents in communities with more than 

25 beds compared with communities with 4–25 beds. Residents in communities with 4–25 beds 

were more racially diverse than residents in larger communities. The percentage of Medicaid 

beneficiaries was higher in communities with 4–25 beds than it was in communities with 26–50 

and more than 50 beds. A higher percentage of residents living in communities with 4–25 beds 

had a diagnosis of Alzheimer’s disease or other dementias compared with residents in larger 

communities. Need for assistance with each of the activities of daily living (ADLs) examined 

(except walking or locomotion) was substantially higher among residents in communities with 

4–25 beds, compared with residents in larger communities. Emergency department visits and 

discharges from an overnight hospital stay in a 90-day period did not vary across residents by 

community bed size. 

This report presents national estimates of residents living in residential care, using data from the 

first wave of NSLTCP. This brief profile of residential care residents provides useful information 

to policymakers, providers, researchers, and consumer advocates as they plan 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 on the NSLTCP website, available from: 

http://www.cdc.gov/nchs/nsltcp/nsltcp_products.htm. These national and state estimates establish 

a baseline for monitoring trends among residents living in residential care. 

■  5  ■
NCHS Data Brief ■ No. 171 ■ November 2014

Definitions 

Assistance with selected activities of daily living (ADLs): Refers to need for assistance with six 

limitations in activities of daily living (bathing, walking or locomotion, dressing, transferring in 

or out of a bed, toileting, and eating) that reflect a resident’s capacity for self-care. The walking 

or locomotion ADL includes using a cane, walker, wheelchair, or receiving help from another 

person. 

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, 26–50, and more than 50 beds. 

Emergency department visits: Includes residents who were treated in a hospital emergency 

department in the 90 days prior to the survey. 

Overnight hospital stays: Includes discharges 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. 

Readmissions after an overnight hospital stay: Refers to readmissions to the hospital for an 

overnight stay within 30 days of a hospital discharge. Asked about when a respondent reported 

at least one resident with a discharge from an overnight hospital stay in the 90 days prior to the 

survey. 

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

(e.g., personal care homes, adult care homes, board care homes, and adult foster care) that meet 

the study eligibility criteria; see “Data source and methods.” 

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 last 30 days. 

Data source and methods 

These analyses used data from the residential care community component of the 2012 NSLTCP, 

which is conducted by the Centers for Disease Control and Prevention’s National Center for 

Health Statistics (NCHS). NCHS intends to conduct NSLTCP every 2 years. 

To be eligible for the study, a residential care community must have: 

•	 Been licensed, registered, listed, certified, or otherwise regulated by the state to:

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

supervision

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

medication management

•	 Had four or more licensed, certified, or registered beds

•	 Had at least one resident currently living in the community

•	 Served a predominantly adult population

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NCHS Data Brief ■ No. 171 ■ November 2014

Residential care communities licensed to exclusively serve individuals with severe mental illness 

or intellectual or developmental disabilities were excluded. Nursing homes were also excluded. 

The 2012 NSLTCP used a combination of probability sampling and census-taking. Probability 

samples were selected in the states that had sufficient numbers of residential care communities to 

enable state-level, sample-based estimation. A census was taken of residential care communities 

in the states that did not have sufficient numbers of communities or where the number of 

communities needed for a sample was very close to the total number of communities. From 

39,779 communities in the sampling frame, 11,690 residential care communities were sampled 

and stratified by state and facility bed size. Data were collected through three modes: selfadministered, hard-copy questionnaires; self-administered Web questionnaires; and computerassisted telephone interviews conducted by interviewers. The questionnaire was completed for 

4,694 communities, for a weighted response rate (for differential probabilities of selection) of 

55.4%. State-level response rates ranged from 40.4% in Michigan to 84.0% in Wyoming. 

Aggregate data on resident demographics were collected from each participating residential 

care community. These data included race and ethnicity, age, sex, living arrangements, select 

medical conditions, need for assistance with ADLs, hospital stays, and emergency department 

visits. For example, respondents were asked: “Of the residents currently living in this residential 

care community, how many are in each of the following categories? a. Male b. Female.” The 

total number of residents they provided here should have been the same as the overall number of 

residents they had provided earlier in the survey. 

Differences among subgroups were evaluated using chi-square and t tests. If chi-square tests 

were statistically significant, a post hoc t test procedure was used to make pairwise comparisons 

of different facility sizes. A weighted least-squares regression method was used to test the 

significance of trends. All significance tests were two-sided using p < 0.05 as the level of 

significance. Data analyses were performed using SAS version 9.3; SAS-callable SUDAAN 

version 11.0.0 statistical package (RTI International, 2012); and STATA/SE 12.1 (STATACorp 

LLP, 2013). Cases with missing data were excluded from the analyses on a variable-by-variable 

basis, ranging from 1.0% for Medicaid to 9.3% for emergency department visits. Imputed 

variables were used for the following resident topics: age, sex, race and ethnicity, select ADLs 

(bathing and eating), and select conditions (Alzheimer’s disease and other dementias and 

depression). Because estimates were rounded, individual estimates may not sum to totals. The 

estimate of the number of residential care communities and residents varied between the 2010 

National Survey of Residential Care Facilities and the 2012 NSLTCP (2,3). For more details, see 

Chapter 5 of “Long-Term Care Services in the United States: 2013 Overview” at http://www.cdc. 

gov/nchs/data/nsltcp/long_term_care_services_2013.pdf. 

■  7  ■
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NCHS Data Brief ■ No. 171 ■ November 2014

About the authors

Christine Caffrey, Lauren Harris-Kojetin, Vincent Rome, and Manisha 

Sengupta are with CDC’s National Center for Health Statistics, Division of 

Health Care Statistics.

References

1. Harris-Kojetin L, Sengupta M, Park-Lee E, Valverde R. Long-term care

services in the United States: 2013 overview. National health care statistics 

reports; no 1. Hyattsville, MD: National Center for Health Statistics. 2013.

2. Park-Lee E, Caffrey C, Sengupta M, Moss AJ, Rosenoff E, Harris-Kojetin

LD. 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.

3. 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.

Suggested citation

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.

National Center for Health 

Statistics

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

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health Care Statistics

Clarice Brown, M.S., Director

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