ABSTRACT

Long-term care has been defined as "a set of health, personal care, and social services delivered over a sustained period of time to persons who have lost or never acquired some degree of functional capacity" (1). Long-term care includes a broad range of services for chronically disabled individuals over an extended period. Venues for care are predominantly nursing homes (nursing facilities), assisted living facilities, senior housing, and personal dwellings without much, if any, coordination among these sites. The nursing facility remains the most common institutional setting for long-term care. In 1996 there were approximately 16,500 certified facilities with 1.8 million beds (2). This is nearly three times the number of acute care hospitals and twice the number of hospital beds. An aging society will create ever-increasing demands for services and costs associated with longterm care. This chapter will review the relevant demographic and economic factors affecting nursing facilities, with a brief discussion of the assisted living facility market.