Life in Care: Nursing Home Longevity Trends

In our latest study, Life in Care: Nursing Home Longevity Trends, we analyzed the average lifespans of nursing home residents across the U.S., highlighting key disparities linked to demographics and health factors.Our findings emphasize the critical need for improved end-of-life care, better hospice access, and effective advance directives. Read more to understand the implications for policy, healthcare providers, and families facing elder care decisions.

Key Demographics and Industry Overview

According to our analysis of data by Nursing Home Care Statistics and Facts, 1

.4 million individuals currently reside in U.S. nursing homes. Women comprise 70% of this population, and the average age is about 79 years.

Our findings in a recent study of CDC data confirm that 4.5% of adults aged 65 and older live in nursing homes or similar long-term care facilities.

• Total U.S. nursing homes: 26,514 (2022)
• Industry value: $146.9 billion 
• For–profit facilities: 69.3%
• Average semi–private room cost: $7,756 per month
• Occupancy rates: 75%

This overview reflects both the growing demand and the significant financial burden on residents, families, and public programs.

Length of Stay Patterns

From PMC data, the median nursing home stay before death stands at five months, while the mean extends to about 13

.7 months. Over half (53%) of residents die within six months of admission, and 65% remain in care for less than a year.

• Mean decedent age: 83.3 years
• Men’s median stay: Three months
• Women’s median stay: Eight months

These figures reveal notable disparities based on gender and socioeconomic status, underscoring the role of personal resources in end-of-life care trajectories.

Disease Profiles and Regional Variations

Residents diagnosed with cancer and lung disease tend to have the shortest median stays (three months), while heart disease extends to about five months. Stroke often results in the longest stays at seven months. Our assessment further shows that residents in the West have shorter stays by two to three months compared to those in the Midwest, South, or Northeast.

• 70.4% die in nursing homes, while 22.6% die in hospitals
• By 2020, 40% of Americans were expected to die in these facilities
• Only 44% of residents had advance directives at admission, according to a 2004 study—despite well-documented benefits in care planning.

Social and Financial Determinants

Marital status and wealth play a major role in the length of time individuals stay in nursing homes. Married residents often have shorter stays, while those with fewer financial resources tend to remain longer.With seven in 10 people over age 65 expected to need long-term care, funding models and social support systems must be part of any effort to build more equitable care.

Falls, Hospitalizations, and Care Transitions

Nursing homes report 100–200 falls per year, with each resident averaging 2.6 falls. NIH data indicate 0

.62 admissions per nursing home resident annually, and nearly 30% die within a month of discharge. Such figures reflect the fragility of the nursing home population and the challenges in providing uninterrupted, high-quality care.

• 1,800 older adult deaths per year due to falls
• Nursing home residents account for 20% of fall-related deaths among adults 65+
• 55% of hospitalizations involve respiratory or circulatory diseases or falls

Cost and Payment Structures

A private nursing home room can exceed $100,000 per year. According to the U.S. Department of Health & Human Services, 48% of residents begin by paying out of pocket. Medicaid covers about 61% of long-term care expenses, while Medicare accounts for only 6%, highlighting potential financial vulnerabilities for many families.

• 2020 median private room: $8,821 per month
• Semi–private room: $7,756 per month
• Workforce: 1,721,732 employees
• 1.7 million licensed beds
• RN staffing: 0.86 hours per resident per day
• CNA staffing: 2.21 hours per resident per day

State-by-State Comparisons

State-by-state differences in care quality, staffing, and funding reveal important trends in life expectancy, costs, and workforce capacity.

Highest Nursing Home Life Expectancy

States that prioritize robust staffing, palliative resources, and efficient care coordination often report longer life expectancies among nursing home residents. Our analysis suggests the following states currently stand out:

1. Hawaii
2. Minnesota
3. California
4. Massachusetts
5. Washington
6. Connecticut
7. New Hampshire
8. Vermont
9. Colorado
10. Utah

Lowest Nursing Home Life Expectancy

In contrast, some states face challenges like staff shortages, limited funding, and fewer palliative care programs. These factors can result in shorter nursing home stays before death:

1. Mississippi
2. Alabama
3. Oklahoma
4. Arkansas
5. West Virginia
6. Louisiana
7. Kentucky
8. Tennessee
9. Indiana
10. Missouri

Cost Disparities

Nursing home costs vary widely across the U.S., often reflecting regional differences in labor, regulations, and the overall cost of living.

Highest Nursing Home Costs

The average semi-private room nationwide is $7,756 per month, yet several states far exceed this figure due to higher labor expenses and regulatory requirements:

1. Alaska
2. Connecticut
3. Massachusetts
4. New York
5. Hawaii
6. California
7. New Jersey
8. New Hampshire
9. Maine
10. Rhode Island

Lowest Nursing Home Costs

By contrast, these states often benefit from more affordable living costs and broader Medicaid acceptance, keeping monthly fees below the national average:

1. Texas
   
2. Oklahoma
   
3. Arkansas
   
4. Missouri
   
5. Kansas
   
6. Iowa
   
7. Alabama
   
8. Mississippi
   
9. Louisiana
   
10. Nebraska

Aged-Care Workforce Differences

Staffing levels in nursing homes vary significantly by state, influencing care quality, resident safety, and long-term health outcomes.

Highest Number of Aged-Care Workers

Areas with a robust pool of registered nurses, certified nursing assistants, and other support staff often see improved patient outcomes and fewer preventable hospitalizations. Based on facility employment data, we analyzed:

1. California
2. Texas
3. New York
4. Florida
5. Pennsylvania
6. Illinois
7. Ohio
8. Michigan
9. Georgia
10. North Carolina

Lowest Amount of Aged-Care Workers

Some states struggle to attract and retain adequate staff, impacting service quality and resident safety:

1. Wyoming
2. Alaska
3. Vermont
4. North Dakota
5. South Dakota
6. Montana
7. Delaware
8. New Hampshire
9. Maine
10. Rhode Island

These workforce shortages can compound challenges related to falls, chronic disease management, and end-of-life care.

Palliative and Hospice Care Gaps

Despite clear benefits in pain relief and comfort, hospice care remains underused in many nursing homes. Only 10–30% of residents receive hospice or palliative services, according to our data review.Limited Medicare eligibility and a lack of staff training often prevent broader access, leaving many residents without specialized end-of-life support.

Advance Directives and Family Satisfaction

Our findings in a recent study of statistics by PMC show that only 44% of nursing home residents had an advance directive at admission. Families report higher satisfaction when end-of-life planning is in place, especially with hospice involvement.Without proper palliative care training for staff, symptom and pain management often falls short, highlighting the urgent need for system-wide improvements.

Implications for Policy and Practice

Social factors like wealth, marital status, and location continue to influence nursing home stay duration and care quality.Cost-focused financial policies can overshadow clinical needs, limiting resident autonomy. Stronger staffing standards and expanded hospice access can help close many of the gaps we identified.

Advocating for Dignity and Accountability in Long-Term Care

Nursing homes play a critical role in caring for older adults, but disparities in length of stay, cost, and access to specialized services remain. Chronic health conditions, geography, and social factors shape outcomes.As demand grows, it’s essential that facilities are well-staffed, affordable, and equipped for end-of-life care. Milwaukee nursing home abuse lawyers continue to advocate for transparency and stronger protections to ensure all residents receive the dignified care they deserve.