Long-term care services provide essential support to seniors and people with chronic illness or disability who require assistance with activities of daily living. As California’s population of seniors and those living with disabilities continues to grow, the need for long-term care services is also likely to increase. Long-Term Care in California describes the state’s supply, use, and quality of long-term care, including Medi-Cal’s long-term services and supports, nursing facilities, assisted living, and home health care.

Key findings include:

• Medicaid (Medi-Cal in California) is an important payer for long-term care services and supports, accounting for 44% of national spending on these services in 2021.
• Under CalAIM, California has adopted several initiatives impacting the provision of care delivered to Medi-Cal enrollees who are older and/or have disabilities.
• From 2017 to 2022, the number of Medi-Cal enrollees using long-term services and supports grew by 20%. More than six times as many Medi-Cal enrollees used home and community-based services compared to having long-term care stays in 2022.
• Between 2011 and 2021, the number of skilled nursing facility beds, admissions, and patient days in California declined.
• The average number of deficiencies per nursing home in California (16.0) was nearly double the average nationwide (8.9) in 2023. One in four nursing homes in California and nationwide received a deficiency for actual harm or jeopardy of residents.
• Many California counties have limited or no availability of assisted living facilities. In 2022, only 15 counties had “better availability” of these facilities, defined as less than 800 adults age 65 or older per facility.
• From 2012 to 2022, the number of home health agencies licensed in California increased by 79%. Home health visits increased by 46% across this same period.

A companion Quick Reference Guide, California’s Older Adults and Adults with Disabilities, is available.

The full report, and all the charts found in the report, are available for download below. These materials are part of CHCF’s California Health Care Almanac, an online clearinghouse for key data and analyses describing the state’s health care landscape. See our entire collection of current and past editions of Long-Term Care in California.