Biennial Overview of Post-acute and Long-term Care in the United States

Data from the National Post-acute and Long-term Care Study

The NCHS National Post-acute and Long-term Care Study (NPALS) collects data on post-acute and long-term care providers every two years. The goal is to monitor post-acute and long-term care providers with reliable, accurate, relevant, and timely statistical information to support and inform policy, research, and practice. These data tables provide an overview of the geographic, organizational, staffing, service provision, and user characteristics of paid, regulated long-term and post-acute care providers in the United States.   The provider types include adult day services centers, home health agencies, hospices, inpatient rehabilitation facilities, long-term care hospitals, nursing homes, and residential care communities.

These tables and a forthcoming National Health Statistics Report (NHSR) replace the previous 2020 report, and those published for 2012, 2014, 2016, and 2018 National Study of Long-Term Care Providers (NSLTCP), now renamed NPALS. The tables will be updated periodically with additional provider types and years of data as available. The associated online methodology documents are available for each year of data. The 2022 data are available as public use files. These data are also available as restricted data files in the NCHS Restricted Data Center.

The tables are interactive, and data users can choose the year of data by selecting the tab at the bottom of the tables. Users can choose to display estimates for all the characteristics by provider type or can choose to display estimates for selected characteristics and selected provider types. For 2020 data, users can also choose to display national estimates or estimates for a selected state.

Table 1: Post-acute and Long-term Care Providers by Geographic and Organizational Characteristics: United States

This table shows the number and percent of providers by various geographic and organizational characteristics. Definitions of each of these characteristics by provider-type is available from the 2020 biennial overview variable crosswalk or 2022 variable crosswalk.

Table 2: Staffing Characteristics of Post-acute and Long-term Care Providers: United States

This table shows estimates of staffing characteristics by provider type. Definitions of each of these characteristics by provider type is available in the 2020 biennial overview variable crosswalk or 2022 variable crosswalk.

Table 3: Types of Services Offered by Post-acute and Long-term Care Providers: United States

This table shows percent of providers that offer various types of services and dementia care, where applicable. Definitions of each of these characteristics by provider type is available in the 2020 biennial overview variable crosswalk or 2022 variable crosswalk.

Table 4: Post-acute and Long-term Care User Demographic and Health-related Characteristics: United States

This table shows the number of users, the percent distribution of demographic characteristics (age, sex, race and ethnicity, Medicaid beneficiary) among providers, and the percent of users with selected diagnoses, needing assistance in physical functioning, and having adverse events. Definitions of each of these characteristics by provider type is available in the 2020 biennial overview variable crosswalk or 2022 variable crosswalk.

Technical Notes

• 2022 NPALS data:
  • In 2022, NCHS collected survey data from adult day services centers and residential care communities and obtained administrative and assessment data from Centers for Medicare and Medicaid Services (CMS) on nursing homes, home health agencies, hospices, inpatient rehabilitation facilities, and long-term care hospitals.
  • The data shown in these tables are based on final survey data collected via mail, web, and CATI survey modes from current providers and users between September 2022 through March 2023 and CMS data on current providers certified during calendar year 2022.
  • The adult day services center (ADSC) estimates in Tables 1-3 are based on provider module responses from 389 eligible ADSCs. The estimates for Table 4 are based on responses in the services user module of 439 participants; 2 participants were randomly sampled from each responding provider. To be eligible to participate in NPALS, an ADSC must be licensed or certified by the state specifically to provide adult day services, or accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF), or authorized or otherwise set up to participate in Medicaid (Medicaid state plan, Medicaid waiver, or Medicaid managed care), or part of a Program of All-Inclusive Care for the Elderly (PACE); have an average daily attendance of one or more participants based on a typical week; and have one or more participants enrolled at the ADSC at the designated location at the time of the survey.
  • The residential care community (RCC) estimates in Tables 1-3 are based on provider module responses from 688 eligible RCCs. The estimates for Table 4 are based on responses in the services user module of 549 residents; 2 residents were randomly sampled from each responding provider. To be eligible to participate in NPALS, a RCC had to be licensed, registered, listed, certified, or otherwise regulated by the state; have four or more licensed, registered, or certified beds; provide room and board with at least two meals a day, around-the-clock on-site supervision, help with personal care, such as bathing and dressing or health related services such as medication management, and serve a predominantly adult population. RCCs licensed to exclusively serve the mentally ill or the intellectually disabled/developmentally disabled populations or both are excluded from NPALS.
  • The 2022 survey is based on representative samples of ADSCs and RCCs and is designed to provide national estimates only. Sample sizes are smaller than the 2020 survey.
  • Data in Tables 1-3 represent providers. Data in Table 4 represent individual users but based on responses from the providers.
  • All estimates shown meet the NCHS data presentation standards for confidentiality and for reliability (/nchs/data/series/sr_02/sr02_175.pdf; (/nchs/data/series/sr_02/sr02-200.pdf).
  • Additional information about methodology for each year of data and public use files is available online.

   

• 2020 NPALS data:
  • In 2020, NCHS collected survey data from adult day services centers and residential care communities and obtained administrative and assessment data from Centers for Medicare and Medicaid Services (CMS) on nursing homes, home health agencies, hospices, inpatient rehabilitation facilities, and long-term care hospitals.
  • The data shown in these tables are based on final survey data collected via mail, web, and CATI survey modes from November 12, 2020 through July 15, 2021 and CMS data on current providers by end of calendar year 2020.
  • The adult day services center (ADSC) estimates are based on survey responses from 1,780 eligible ADSCs, representing over 4,100 ADSCs. To be eligible to participate in NPALS, an ADSC must be licensed or certified by the state specifically to provide adult day services, or accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF), or authorized or otherwise set up to participate in Medicaid (Medicaid state plan, Medicaid waiver, or Medicaid managed care), or part of a Program of All-Inclusive Care for the Elderly (PACE); have an average daily attendance of one or more participants based on a typical week; and have one or more participants enrolled at the ADSC at the designated location at the time of the survey.
  • The residential care community (RCC) estimates are based on survey responses from 4,312 eligible RCCs, representing over 30,600 RCCs. To be eligible to participate in NPALS, a RCC had to be licensed, registered, listed, certified, or otherwise regulated by the state; have four or more licensed, registered, or certified beds; provide room and board with at least two meals a day, around-the-clock on-site supervision, help with personal care, such as bathing and dressing or health related services such as medication management, and serve a predominantly adult population. RCCs licensed to exclusively serve the mentally ill or the intellectually disabled/developmentally disabled populations or both are excluded from NPALS.
  • The 2020 survey is based on a census of ADSCs and census or representative sample of RCCs, depending on the state. The survey was designed to present both national and state-level estimates.
  • Data represent providers, not individual users.
  • All estimates shown meet the NCHS data presentation standards for confidentiality and for reliability of proportions (/nchs/data/series/sr_02/sr02_175.pdf).
  • Additional information about methodology for each year of data is available online.