Industry snapshot
Key public data points
Historical & forecast
Base year 2025. Each series is official through its own latest government-data year (shown in the legend on each chart), and years beyond that are Claight estimates. As of July 2026 the current year is still in progress (2026 annual data is not yet published), so the forecast runs to 2030.
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What does the Adult Care Services in the US industry cover?
The adult care services industry includes residential care facilities, home health agencies, and community-based services that provide assistance with daily living activities, medical care, and social support for elderly and disabled adults. These services range from independent living communities to skilled nursing facilities and home care services. The industry serves approximately 12 million Americans aged 65 and older who require some form of long-term care assistance.
Market Structure and Operators
Who operates in the industry and how is it structured?
The industry comprises both non-profit and for-profit operators, with approximately 70% of nursing homes being for-profit facilities. Major providers include Brookdale Senior Living, Emeritus Senior Living (now part of Brookdale), and Five Star Senior Living. The home care segment is more fragmented, dominated by local agencies and franchises. The market includes skilled nursing facilities, assisted living communities, home health agencies, and adult day care centers, each serving different levels of care needs.
Demand Drivers
What drives demand in the industry?
The primary driver is the aging US population, with 10,000 people turning 65 daily. Increasing life expectancy has led to a larger elderly population requiring extended care services. Additionally, chronic conditions such as diabetes and heart disease require ongoing care management. The COVID-19 pandemic accelerated demand for home-based care options, and family caregivers' declining capacity to provide unpaid care has increased reliance on professional services.
Competitive Landscape and Notable Public Companies
Who are the notable companies in the industry?
The industry features a mix of national chains and local operators, with varying market positions in different regions. Notable publicly traded companies include Brookdale Senior Living, Kindred Healthcare, and LHC Group. Home care operators like Comfort Keepers and Home Instead are often franchised or part of larger networks. The competitive landscape varies by segment, with nursing homes being more consolidated than home care services, which remain largely local and community-based.
Recent Trends and Outlook
What are the recent trends and outlook?
Industry trends include a preference for aging in place, driving growth in home care and community-based services. Telehealth integration has expanded access to care during the pandemic. Staffing shortages remain a significant challenge, affecting service quality and capacity. The industry faces increased pressure to improve quality metrics while managing rising costs. Medicare and Medicaid payment policies significantly impact industry revenue and operating models.
Regulation
How is the industry regulated?
The industry is heavily regulated, with federal oversight through Medicare/Medicaid conditions of participation. State agencies license and regulate facilities, with varying standards across jurisdictions. The Centers for Medicare & Medicaid Services (CMS) sets quality metrics and reporting requirements. Recent regulatory emphasis has focused on infection control, staffing ratios, and quality of care improvements. The Older Americans Act provides federal funding and guidelines for community-based services.
Sources
Government, statistical and trade sources used for this Claight analysis.
- US Census Bureau (https://www.census.gov) ·
- Administration for Community Living (https://acl.gov) ·
- Centers for Medicare & Medicaid Services (https://cms.gov) ·
- National Center for Health Statistics (https://www.cdc.gov/nchs) ·
- Kaiser Family Foundation (https://kff.org) ·
- American Health Care Association (https://www.ahcancal.org)
Claight analysis of public industry data.