NCHS Data Brief ■ No. 91 ■ April 2012

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Residents Living in Residential Care Facilities: 

United States, 2010

Christine Caffrey, Ph.D.; Manisha Sengupta, Ph.D.; Eunice Park-Lee, Ph.D.; Abigail Moss; 

Emily Rosenoff, M.P.A.; and Lauren Harris-Kojetin, Ph.D.

Persons living in state-regulated residential care facilities (RCFs)—such as 

residents of assisted living communities—receive housing and supportive 

services because they cannot live independently but generally do not require 

the skilled level of care provided by nursing homes. The ability to provide a 

comprehensive picture of the long-term care industry has been hampered by a 

lack of data on RCFs (1–4). Previous estimates of the number of residents in 

RCFs vary depending on how RCFs are defined (5–7). A recent NCHS data 

brief (5) reported that for each day in 2010, 733,300 persons were residents 

of RCFs nationwide. Using data from the first nationally representative 

survey of RCFs with four or more beds, this report presents national 

estimates of these RCF residents by selected resident characteristics.

Keywords: assisted living • long-term care

In 2010, the majority of residents were non-Hispanic white, 

female, and aged 85 and over.

• Nine in ten residents were non-Hispanic white (91%), and seven in ten 

residents were female (70%) (Figure 1).

Key findings

Data from the 2010 

National Survey of 

Residential Care Facilities

• The majority of residents 

living in residential care 

facilities in 2010 were nonHispanic white and female. 

More than one-half of all 

residents were aged 85 and 

over.

• Nearly 2 in 10 residents were 

Medicaid beneficiaries, and 

almost 6 in 10 residents under 

age 65 had Medicaid.

• Almost 4 in 10 residents 

received assistance with 

three or more activities of 

daily living, of which bathing 

and dressing were the most 

common.

• More than three-fourths of 

residents have had at least 2 of 

the 10 most common chronic 

conditions; high blood pressure 

and Alzheimer’s disease and 

other dementias were the most 

prevalent.

NOTE: Estimates may not add to 100% due to rounding.

SOURCE: CDC/NCHS, National Survey of Residential Care Facilities, 2010.

Figure 1. Selected characteristics of residential care residents: United States, 2010 Percent

0

20

40

60

80

100

Non-Hispanic white Female All residents

Under 65

65–74

75–84

85 and over

Age (years):

11

9

27

70 54

91
NCHS Data Brief ■ No. 91 ■ April 2012

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• More than one-half of residents were aged 85 and over (54%), and more than one-quarter of 

residents were aged 75–84 (27%). The remaining one-fifth of residents were about evenly 

split between those aged 65–74 (9%) and those under age 65 (11%).

• The median length of stay among all current residents at the time of interview was 671 days, 

or about 22 months (data not shown).

Nearly 2 in 10 residents were Medicaid beneficiaries.

• Medicaid paid for at least some of the RCF services for 19% of residents (Figure 2).

• Younger residents were more likely to have Medicaid than older residents. Almost 6 in 10 

residents under age 65 had Medicaid (56%) compared with 39% of residents aged 65–74, 

16% of residents aged 75–84, and 10% of residents aged 85 and over.

• In 2010, the mean national total monthly charge per resident for residential care was $3,165 

(data not shown).

NOTES: All age cohorts are significantly different from each other at p < 0.05. Cases with missing data are excluded; see "Data sources and methods" section 

for detail. 

SOURCE: CDC/NCHS, National Survey of Residential Care Facilities, 2010.

Figure 2. Residential care residents with Medicaid, by age: United States, 2010 Percent

Age (years)

0

10

20

30

40

50

60

All residents Under 65 65–74 75–84 85 and over

10

16

39

56

19
NCHS Data Brief ■ No. 91 ■ April 2012

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Almost 4 in 10 residents received assistance with three or more activities 

of daily living.

• About three-quarters of all residents received assistance with bathing (72%), over one-half 

received assistance with dressing (52%), more than one-third received assistance with 

toileting (36%), one-quarter received assistance with transferring (25%), and more than 

one-fifth received assistance with eating (22%) (Figure 3).

• Thirty-eight percent of RCF residents received assistance with three or more of these 

activities of daily living (ADLs), an additional 36% received assistance with one or two of 

the ADLs, and 26% did not receive assistance with any ADL.

1

Activities of daily living.

2

Includes 2% who receive assistance with a toileting device, such as ostomy, indwelling catheter, chairfast, or similar devices.

3

Comprises 12% confined to a bed or chair and 13% receiving assistance with transferring.

NOTE: Cases with missing data are excluded; see "Data sources and methods" section for detail.

SOURCE: CDC/NCHS, National Survey of Residential Care Facilities, 2010.

Figure 3. Residential care residents receiving assistance with activities of daily living: United States, 2010 Percent

0

20

40

60

80

100

Transferring Eating All residents 3 Toileting Bathing Dressing 2

0

1–2

3–5

Number 

of ADLs1

:

26

36

38

22

25

36

52

72
NCHS Data Brief ■ No. 91 ■ April 2012

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Almost three-fourths of residents had ever been diagnosed with at least 

2 of the 10 most common chronic conditions.

• The 10 most common chronic conditions among residents were high blood pressure (57%), 

Alzheimer’s disease or other dementias (42%), heart disease (34%), depression (28%), 

arthritis (27%), osteoporosis (21%), diabetes (17%), chronic obstructive pulmonary disease 

and allied conditions (15%), cancer (11%), and stroke (11%) (Figure 4).

• More than one-quarter of RCF residents had ever been diagnosed with 4–10 of the most 

common chronic conditions (26%); one-half of residents had ever been diagnosed with 2–3 

of the most common chronic conditions; 18% had ever been diagnosed with one of these 

chronic conditions; and the remaining 6% had never been diagnosed with these conditions 

(Figure 4).

1

Chronic obstructive pulmonary disease.

NOTE: Cases with missing data are excluded; see "Data sources and methods" section for detail.

SOURCE: CDC/NCHS, National Survey of Residential Care Facilities, 2010.

Figure 4. Most common chronic conditions of residential care residents: United States, 2010

Percent

Percent

All

Residents

0 10 20 30 40 50 60

High blood pressure

Alzheimer's disease

and other dementias

Heart disease 

Depression 

Arthritis

Osteoporosis

Diabetes

COPD1

 and

allied conditions

Cancer

Stroke

0

20

40

60

80

100

0

1

2–3

4–10

Number 

of chronic 

conditions:

6

18

50

26

57

42

34

28

27

21

17

15

11

11
NCHS Data Brief ■ No. 91 ■ April 2012

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Summary

In 2010, residential care residents were mostly female, non-Hispanic white, and aged 85 and over, 

and had a median length of stay of about 22 months. For about 20% of residents—or 137,700 

persons—Medicaid paid for at least some long-term care services provided by the RCF. This 

estimate is similar to that found in a recent study (3). Almost 40% of all residential care residents 

received assistance with three or more ADL limitations, and over 40% had Alzheimer’s disease or 

other dementias. These findings suggest a vulnerable population with a high burden of functional 

and cognitive impairment.

Residential care is an important component of the U.S. long-term care system. This report 

presents national estimates of people living in RCFs, using data from the first-ever national 

probability sample survey of RCFs with four or more beds. This brief profile of residential care 

residents may provide useful information to policymakers, providers, and consumer advocates as 

they plan for the future long-term care needs of older as well as younger adults. In addition, these 

findings serve as baseline national estimates as researchers continue to track the growth of and 

changes in the residential care industry.

Definitions

Length of stay: Derived from the month and year in which the resident first moved into the RCF 

and the month and year of the interview.

Medicaid beneficiary: A resident who, during the 30 days before the interview, had any of his or 

her long-term care services at the RCF paid by Medicaid.

Charges: The total charge for the month prior to the interview, including the basic monthly charge 

and any charges for additional services.

Assistance with activities of daily living (ADLs): Refers to receiving any assistance in the 

five ADLs (bathing, dressing, transferring, using the toilet, and eating) that reflect a resident’s 

capacity for self-care. A summary variable was created with three categories: no limitations, 

1–2 limitations, and 3–5 limitations. For residents confined to a bed or chair, the question about 

whether the resident received assistance with transferring was not asked in the survey. For the 

current analyses, the 12% of residents chair-ridden or bedridden were defined as receiving 

assistance in the transferring and summary ADL variables. The 2% of residents who receive 

assistance with a device to use the toilet, such as an ostomy, catheter, or chairfast device, were 

defined as receiving assistance in the toileting and summary ADL variables.

Most common chronic conditions: Includes the 10 most common chronic conditions that residents 

were ever diagnosed as having by a doctor or other health professional, based on the RCF staff 

respondent’s reference to the resident’s medical record or personal knowledge of the resident. A 

summary variable was created with four categories: no conditions, one condition, 2–3 conditions, 

and 4–10 conditions.
NCHS Data Brief ■ No. 91 ■ April 2012

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Data sources and methods

Resident data from the 2010 National Survey of Residential Care Facilities (NSRCF) were used 

for these analyses. To be eligible for NSRCF, RCFs must be licensed, registered, listed, certified, 

or otherwise regulated by the state; have four or more licensed, certified, or registered beds; and 

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

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

medication management. These RCFs also serve a predominantly adult population. RCFs licensed 

to exclusively serve the mentally ill or developmentally disabled populations were excluded. 

Nursing homes also were excluded unless they had a unit or wing meeting the above definition 

and their residents could be separately enumerated.

The 2010 NSRCF used a stratified two-stage probability sample design. The first stage was the 

selection of RCFs from the sampling frame representing the universe of RCFs. For the 2010 

NSRCF, 3,605 RCFs were sampled with probability proportional to facility size. Interviews 

were completed with 2,302 RCFs, for a first-stage, facility-level weighted response rate of 81%, 

which was weighted for differential probabilities of selection. In the second stage of sampling, 

3–6 current residents were selected depending on RCF bed size. All data collected on sampled 

residents came from interviews with RCF staff who answered questions by referring to the 

residents’ records or their own knowledge of the residents; residents were never interviewed. 

The second-stage, resident-level weighted response rate was 99%. A detailed description of 

NSRCF sampling design, data collection, and procedures is provided both in a previous report (8) 

and on the NSRCF website: http://www.cdc.gov/nchs/nsrcf/nsrcf_questionnaires.htm.

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. 

Significant results from the post hoc procedure are reported here. All significance tests were 

two-sided using p < 0.05 as the level of significance. The difference between any two estimates is 

reported only if it is statistically significant. Lack of comment regarding the difference between 

any two statistics does not necessarily suggest that the difference was tested and found to be not 

statistically significant. Data analyses were performed using the statistical package SAS-callable 

SUDAAN version 10.0 (9). Cases with missing data were excluded from the analyses on a 

variable-by-variable basis. The percentage of weighted cases with missing data varied between 

0.01% and 2.5%. Because estimates were rounded, individual estimates may not sum to totals.

About the authors

Christine Caffrey, Manisha Sengupta, Eunice Park-Lee, Abigail Moss, and Lauren Harris-Kojetin 

are with the Centers for Disease Control and Prevention’s National Center for Health Statistics, 

Division of Health Care Statistics. Emily Rosenoff is with the Department of Health and Human 

Services, Assistant Secretary for Planning and Evaluation’s Office of Disability, Aging, and LongTerm Care Policy.
NCHS Data Brief ■ No. 91 ■ April 2012

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References

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of estimates and methodology. Prepared for U.S. Department of Health and Human Services, 

Assistant Secretary for Planning and Evaluation, Office of Disability, Aging, and Long-Term Care 

Policy. Washington, DC: The Urban Institute. 2005.

2. Spillman BC, Black KJ. The size and characteristics of the residential care population: 

Evidence from three national surveys. Prepared for U.S. Department of Health and Human 

Services, Assistant Secretary for Planning and Evaluation, Office of Disability, Aging, and LongTerm Care Policy. Washington, DC: The Urban Institute. 2006.

3. Polzer K. Assisted living state regulatory review 2011. Washington, DC: National Center for 

Assisted Living. 2011.

4. MetLife Mature Market Institute. Market Survey of Long-Term Care Costs. Westport, CT. 

2010.

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.

6. Mollica R, Sims-Kastelein K, O’Keeffe J. Residential care and assisted living compendium: 

2007. Prepared for U.S. Department of Health and Human Services, Assistant Secretary for 

Planning and Evaluation, Office of Disability, Aging, and Long-Term Care Policy. Washington, 

DC: RTI International. 2007.

7. Stevenson DG, Grabowski DC. Sizing up the market for assisted living. Health Aff 29(1):

35–43. 2010.

8. Moss AJ, Harris-Kojetin LD, Sengupta M, et al. Design and operation of the 2010 National 

Survey of Residential Care Facilities. National Center for Health Statistics. Vital Health Stat 

1(54). 2011.

9. SUDAAN, release 10.0 [computer software]. Research Triangle Park, NC: RTI International. 

2008.
NCHS Data Brief ■ No. 91 ■ April 2012

Suggested citation

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.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Edward J. Sondik, Ph.D., Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health Care Statistics

Clarice Brown, M.S., Director

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