Use of all long-term care services has increased in California, with the largest growth occurring in home- and community-based services.

Medicare and Medicaid beneficiaries in California used long-term care services at a lower rate than that of the nation, with the exception of Medicaid patients’ use of personal care services, which was nearly four times higher in California than in the US.

California’s per capita supply of residential care beds for the elderly was larger than the nation’s. The state’s supply, however, has not kept pace with population growth since 2004.

California’s performance on care quality in nursing facilities and for home health services was mixed, with top-of-the-nation performance on some measures (for example, nursing facility residents losing too much weight) and bottom-of-the-nation performance on others (for example, home health care patients able to feed themselves).

Gross revenues for California’s freestanding nursing facilities grew over 50% between 2003 and 2010. One-third of these facilities had profit margins of 9% or higher in 2010.