Assisted Living Facilities in the US: Market Size, Businesses & Forecast 2026

The Assisted Living Facilities industry in the United States comprises establishments primarily engaged in providing residential and personal care services for elderly individuals who do not require continuous, 24-hour skilled nursing care. According to the National Center for Health Statistics (NCHS) August 2024 data brief, the industry accommodated approximately 1,016,400 residents in residential care communities across the country in 2022. Driven by an aging population and increasing demand for community-based alternatives to nursing homes, the industry continues to expand its footprint to manage chronic conditions and daily living dependencies.

Industry snapshot

Key public data points

Historical & forecast

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What does the Assisted Living Facilities in the US industry cover?

The assisted living industry serves elderly and disabled populations who require supervision and assistance with daily routines but do not necessitate the comprehensive medical care of a skilled nursing home. These establishments deliver a mix of housing, personal support, and localized healthcare coordination. Services typically bundle lodging, meals, housekeeping, and varying degrees of personal care.

• •Classified under the official North American Industry Classification System (NAICS) code 623312.
• •Core services provide assistance with personal hygiene, medication management, and daily living tasks.
• •Excludes traditional facilities that offer continuous, multi-disciplinary 24-hour on-site clinical nursing.

Who operates in the industry and how is it structured?

The market structure exhibits a blend of corporate chain networks and independent single-site operations spread regionally across the country. According to industry tracking by the American Health Care Association and National Center for Assisted Living (AHCA/NCAL), ownership remains heavily distributed but experiences notable consolidation trends. Capacity varies significantly by state, reflecting diverse regional urban and demographic clusters.

• •Chain-affiliated corporations make up 57.3% of the assisted living community landscape as of recent AHCA/NCAL tracking.
• •Independently owned facilities account for the remaining 42.7% of operational entities.
• •The national workforce supporting the profession reached 512,300 total employees as of June 2026.

What drives demand in the industry?

The primary demographic driver is the rapid expansion of the 'oldest old' segment of the population, which accounts for the vast majority of operational facility residents. Chronic illness management, physical dependency, and cognitive declines require a supportive living environment that bridges independent living and intensive clinical care. Personal health limitations necessitate external assistance for safety and foundational wellness.

• •Demographic tracking reveals that 53% of residents living in these communities are aged 85 and older as of 2022.
• •The Centers for Disease Control and Prevention (CDC) reports that 75% of residents require help with bathing, and 71% require help with walking.
• •Cognitive and chronic ailments are prevalent, with 58% of residents diagnosed with high blood pressure and 44% diagnosed with Alzheimer's disease or other dementias as of 2022.

Who are the notable companies in the industry?

The competitive landscape features a variety of highly visible corporate providers operating large portfolios of regional and national senior living properties. These companies compete on service tiers, specialized memory care capabilities, and local geographical presence. Operators continuously navigate cost adjustments and shifting occupancy patterns.

• •Brookdale Senior Living Inc. operates as one of the largest public providers of senior housing and assisted living services in the nation.
• •Sonida Senior Living, Inc. actively builds regional campus capacity, completing notable community acquisitions in markets like Cincinnati.
• •Sunrise Senior Living, LLC and Atria Senior Living act as major national operators managing extensive networks of properties.
• •The national median cost for utilizing an assisted living community is $6,200 monthly, or $74,000 annually, according to 2026 projections.

What are the recent trends and outlook?

A distinct operational shift is underway as consumers increasingly favor community-centered residential options over rigid institutional environments. This trend has supported continuous growth in alternative care units while nursing home bed counts have retracted. Financing models face ongoing adaptation as private-pay models seek balance with public programs.

• •Public data shows that 17% of all residential care community residents relied on Medicaid beneficiaries program funding as of 2022.
• •Assisted living unit capacity expanded by 3.68% between 2019 and 2022, trailing only independent living in sector growth.
• •Conversely, standard skilled nursing home units declined by 6.34% during the same timeframe as seniors transitioned toward assisted care models.

How is the industry regulated?

Unlike nursing homes, which are regulated extensively under uniform federal standards, assisted living facilities are regulated primarily at the state government level. Each state maintains distinct licensing criteria, minimum staffing frameworks, safety protocols, and definitions for permissible medical oversight. Compliance demands rigorous tracking of resident health indicators and workforce credentials.

• •The U.S. Small Business Administration (SBA) maintains a small-business eligibility threshold of $23.5 million in average annual receipts for NAICS 623312.
• •State Medicaid programs utilize targeted 1915(c) home and community-based services (HCBS) waivers to authorize funding for eligible low-income residents.
• •Nursing care personnel distributions within communities average 68% aides, 18% licensed practical or vocational nurses, and 14% registered nurses.

Government, statistical and trade sources used for this Claight analysis.

• NCHS Data Brief, Number 506, August 2024 - CDC ·
• Assisted Living Facts & Figures - AHCA/NCAL 2026 ·
• U.S. Bureau of Labor Statistics (BLS) May 2023 OEWS Industry Estimates ·
• U.S. Small Business Administration (SBA) Table of Size Standards 2023