Resources: Expanding Affordable Assisted Living

​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​The National Center for Assisted Living (NCAL) has developed materials providers can use to explore the feasibility of expanding affordable assisted living options across the country. ​​The suite of resources, below, includes the executive summary, state-specific data, the Assisted Living Operating Proforma and Financial Feasibility Analysis Model, and a user guide for the financial model. 

These resources are part of a larger effort by NCAL to help members meet the changing needs of a growing senior population. Nationally, the 80 and over population is forecasted to grow over 9 percent between now and 2027. The number of unpaid caregivers will on average decrease over the next five years, resulting in the increased need for paid caregiving in an appropriate long term care setting such as assisted living. Lower incomes for those 75-plus and home ownership status also play a role in affording assisted living care. 

​​​​​NCAL also offers a white paper entitled, “The Importance of Expanding Affordable Assisted Living Options and Proposed Solutions.” It outlines challenges to offering more affordable assisted living for low- and middle-income seniors and offers solutions.

Please contact ncal@ncal.org​​ with any questions.  


Affordable Assisted Living Resources

2023 State Planning Guides (Member Only)


​Executive Summary

Demographics
​On a national basis the over 80+ population is forecasted to grow over 9% between 2022 and 2027.

 

Caregiver Support Ratio
​The caregiver support ratio represents the 45‐64 population divided by the 80+ population. This is designed to illustrate the adult child who may be providing natural
supports to a senior and the related decline that this ratio is experiencing. One could infer that services may be needed to replace this natural care giving model. The information below illustrates this decline on a macro level as well as state related trends.

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Home Ownership
​The national average of the percentage of head of household age 75+ home ownership approximates 75% with variability across regions of the country. Home ownership can
be an important development characteristic in relation to resources available for a senior in transition to assisted living. *Note: Throughout this document, the acronym HH represents Head of Household (or Householder)


Penetration Rates
​A penetration rate helps measure the degree to which a market is either under‐served or saturated. A penetration rate is calculated by comparing the number of households
related to an income screen in comparison the number of assisted living units available. A lower percentage indicates a smaller number of assisted living units compared to the population profile or an under‐served market. In the cases in which there are no affordable assisted living units identified, the calculation indicates a zero percentage. A
higher percentage indicates potential market saturation of that product type. Other factors including location, quality, design, size of units, age of units, and overall occupancy of the existing supply are other factors to be considered in conjunction with penetrations rates.

Affordable Assisted Living Penetration Rates
​An affordable assisted living penetration rate is calculated by analyzing head of households that are age 75+ along with those that have an income below $30,000. The number of individuals in this demographic is compared to the state’s total number of assisted living units with Medicaid waivers. Note that in some states the number of units
was unavailable and the number of waiver slots was used in the calculation.

 



*Note: States with 0% penetration rates have a Medicaid Waiver program that does not cover assisted living fees or no Medicaid Waiver program is currently in place.

Market Rate Assisted Living Penetration Rates
​A market rate assisted living penetration rate is calculated by analyzing head of households that are age 75+ along with those that have an income above $30,000. The number of individuals in this demographic is compared to the state’s total number of assisted living units.

 


Income Level by Age of Head of Household
​The following figure examines the average income level based on the age of the homeowner (head of household). On a national level 26% of homeowners aged 45‐64 earned $150,000+, 24% of homeowners aged 65+ earned less than $25,000, and 31% of homeowners aged 75+ earned less than $25,000. Figured based on 2022 data.


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