U.S. 75+ Population by State: The Senior Housing Demand Screen, Rebuilt for Underwriting

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  Street of single-story senior living homes in a residential retirement community, illustrating U.S.

Executive Takeaway

The most cited number in senior housing feasibility is the count of people aged 75 and older within reach of a site. Nationally, that population stood at 25,734,956 in 2024, up 17.6% since 2020, an increase of 3,845,913 people in four years (1). It is also the most misused number in senior housing finance. A state population table tells a developer where to look. It does not tell a lender whether a project pencils, and no credit committee will accept it as demand evidence.

This page does both jobs. It ranks all 50 states and the District of Columbia by the size, growth, and concentration of the 75+ population, using the Census Bureau's own estimates and a stated, reproducible method. It then runs the screens a population table cannot: the forward demographic curve through 2040, the supply side (currently at a 14-year construction low), the penetration and income-qualification arithmetic that lenders actually test, the regulatory and labor constraints that reorder any state ranking, and the rent and cost anchors that turn a headcount into an addressable market.

Read the tables for the screen. Read the sections after them for the underwriting.

The Curve Ahead Matters More Than the Curve Behind

Backward-looking growth is a useful sorting variable, but the underwriting question is where the cohort goes from here, and the answer splits sharply by age band.

The Census Bureau's newest vintage of estimates, released June 25, 2026, puts the total U.S. resident population at 341,784,857 as of July 1, 2025, with the 65+ population at 64,617,088, up 16.2% since April 2020 (2). The 80+ population, the core senior housing consumer, stood near 14.7 million in 2025 and is projected to grow by more than a quarter within five years and to nearly 23 million by 2035, growth of over 55% in a decade (3).

The 85+ cohort behaves differently, and the difference is the most consequential fact in this asset class. Today's 85+ population was born in the low-fertility years of the Depression and the Second World War, so its growth through the late 2020s is comparatively muted. That changes at the start of the next decade: the leading 1946 baby boom cohort crosses 85 in 2031, and the Census Bureau's 2023 national projections carry the 85+ population from roughly 6.7 million in 2020 to about 9 million by 2030, 11 to 12 million by 2035, and around 14 million by 2040 (4).

Why the split matters: independent living demand tracks the 75-84 band, while assisted living and memory care demand tracks the 85+ band. Federal survey data show that 53% of residential care community residents are 85 or older and another 31% are 75-84 (5), and industry consumer data compiled from NCAL sources put the average assisted living resident at about 84, with a median stay of just under two years (6). The practical translation for a sponsor: independent living is a this-decade demand story, while assisted living and memory care demand compounds hardest after 2031. A community opening in 2027 or 2028 leases up directly into the steepest part of the curve, which is precisely when today's record-low construction pipeline will still be constraining competitive supply.

For state-level forward cohorts, no federal product exists; the Census Bureau discontinued state age projections after its 2005 interim series. The University of Virginia's Weldon Cooper Center 2026-vintage projections are the only consistent, freely available 50-state set, and they show Vermont, Maine, Hawaii, New Hampshire, and Florida each approaching one quarter of total population aged 65+ by 2030 (7).

The Ten Largest 75+ Markets

Absolute size determines how many units a market can absorb before penetration assumptions strain credibility. These ten states hold 54% of the national 75+ population.

#	State	Age 75+ (2024)	Growth 2020-24	Added since 2020
1	California	2,776,397	+17.0%	403,587
2	Florida	2,347,707	+18.6%	367,622
3	Texas	1,746,936	+20.4%	295,548
4	New York	1,629,965	+16.3%	228,509
5	Pennsylvania	1,129,837	+13.1%	130,667
6	Illinois	953,263	+14.4%	120,186
7	Ohio	934,474	+14.1%	115,142
8	North Carolina	814,586	+20.9%	140,691
9	Michigan	807,211	+15.7%	109,389
10	New Jersey	729,399	+16.2%	101,690

Scale cuts both ways. California added more 75+ residents in four years (403,587) than 20 states hold in total, which supports deep absorption. But large states are also where most existing inventory sits, so size alone says nothing about openings for new supply. The supply screen further down shows why.

The Ten Fastest-Growing 75+ Markets

Growth rate is the better development signal, because it marks a cohort arriving faster than the existing inventory was built to serve. Small bases inflate percentages, so the added-residents column is shown alongside.

#	State	Growth 2020-24	Added since 2020	Age 75+ (2024)
1	Alaska	+28.7%	8,618	38,628
2	South Carolina	+24.6%	87,256	441,869
3	Delaware	+24.4%	18,156	92,516
4	Colorado	+24.3%	76,192	390,223
5	Idaho	+24.1%	27,930	143,914
6	Nevada	+24.0%	46,002	237,978
7	New Hampshire	+23.4%	23,297	122,702
8	Georgia	+22.9%	133,111	713,668
9	Vermont	+22.4%	11,159	60,943
10	Arizona	+22.1%	120,437	665,700

The spread is wide: the fastest state (Alaska, +28.7%) grew two and a half times faster than the slowest (Iowa, +11.6%). Two forces drive the leaders, and they carry different underwriting implications. Most of this growth is the resident 65-74 cohort aging in place, which is stable, forecastable demand. A second layer is retiree in-migration: the most recent IRS migration data show Florida (+261,863 individuals), Texas (+182,704), and North Carolina (+79,317) with the largest net inflows, against outflows led by California (-355,809) and New York (-267,156) (8). Migration-fed demand is real but policy- and price-sensitive; aging-in-place demand is not. No public dataset cleanly decomposes the two by state, which is one reason a trade-area study cannot be skipped.

Where the 75+ Cohort Is Most Concentrated

Share of total population indicates how much of a state's economy, housing stock, and referral infrastructure is already organized around older residents.

#	State	75+ share of population	Age 75+ (2024)	Growth 2020-24
1	Hawaii	10.23%	143,843	+21.3%
2	Florida	10.07%	2,347,707	+18.6%
3	Maine	9.76%	137,036	+20.1%
4	Vermont	9.40%	60,943	+22.4%
5	West Virginia	9.24%	163,499	+14.2%
6	Delaware	8.82%	92,516	+24.4%
7	Arizona	8.80%	665,700	+22.1%
8	New Hampshire	8.71%	122,702	+23.4%
9	Pennsylvania	8.64%	1,129,837	+13.1%
10	New Mexico	8.60%	182,144	+19.7%

A common error is to read high concentration as saturation. It is not the same thing. As the next section shows, Florida, the second most 75+-concentrated state in the country, carries materially fewer residential care beds per 1,000 age-qualified residents than Ohio or California. Concentration measures demand density; only a supply ratio measures how well that demand is already served.

All 50 States and D.C., Ranked by 75+ Population

The table below carries a column most rankings publish and never use: the 85+ count. Read it as a ratio and it becomes a timing signal. In the fast-growing Sun Belt and Mountain states, the 75+ population is young for its age: only 19.5% of Alaska's 75+ residents are 85 or older, 21.0% of Nevada's, and about 22% of Idaho's and Utah's. In the slow-growing interior, the cohort is already old: 30.7% of North Dakota's 75+ residents and 28.3% of Iowa's have crossed 85, with California, Florida, and New York clustered near 26 to 28%. The implication for product selection is direct. In the young-mix states, the independent living wave is arriving now while the assisted living and memory care wave is a decade out; in the old-mix states, acuity-driven demand is already at its local peak against whatever inventory exists. Two states with identical 75+ growth rates can therefore justify entirely different buildings.

#	State	Age 75+ (2024)	Age 85+ (2024)	Growth 2020-24	Added since 2020	Share of population
1	California	2,776,397	728,742	+17.0%	403,587	7.07%
2	Florida	2,347,707	612,067	+18.6%	367,622	10.07%
3	Texas	1,746,936	411,277	+20.4%	295,548	5.60%
4	New York	1,629,965	450,648	+16.3%	228,509	8.21%
5	Pennsylvania	1,129,837	298,587	+13.1%	130,667	8.64%
6	Illinois	953,263	251,937	+14.4%	120,186	7.51%
7	Ohio	934,474	232,985	+14.1%	115,142	7.87%
8	North Carolina	814,586	185,152	+20.9%	140,691	7.44%
9	Michigan	807,211	193,220	+15.7%	109,389	7.96%
10	New Jersey	729,399	193,246	+16.2%	101,690	7.68%
11	Georgia	713,668	159,859	+22.9%	133,111	6.41%
12	Arizona	665,700	158,340	+22.1%	120,437	8.80%
13	Virginia	652,952	156,638	+20.0%	108,816	7.50%
14	Massachusetts	566,988	145,816	+17.8%	85,748	7.95%
15	Washington	566,530	132,442	+22.1%	102,513	7.16%
16	Tennessee	521,772	117,503	+17.1%	76,232	7.24%
17	Indiana	497,147	125,273	+15.0%	64,721	7.18%
18	Missouri	487,631	124,625	+13.5%	57,919	7.83%
19	Wisconsin	472,100	117,937	+15.4%	62,867	7.92%
20	Maryland	464,895	117,879	+19.6%	76,251	7.46%
21	South Carolina	441,869	93,805	+24.6%	87,256	8.12%
22	Minnesota	439,048	119,959	+16.2%	61,305	7.58%
23	Alabama	395,768	92,714	+15.4%	52,878	7.69%
24	Colorado	390,223	90,022	+24.3%	76,192	6.59%
25	Oregon	358,175	81,027	+21.5%	63,461	8.39%
26	Kentucky	335,429	78,591	+15.1%	44,082	7.34%
27	Louisiana	328,225	77,944	+15.5%	43,951	7.16%
28	Connecticut	308,292	82,125	+16.8%	44,422	8.40%
29	Oklahoma	286,681	70,109	+12.7%	32,287	7.03%
30	Iowa	259,500	73,531	+11.6%	26,930	8.01%
31	Arkansas	238,363	57,997	+12.9%	27,232	7.73%
32	Nevada	237,978	49,927	+24.0%	46,002	7.31%
33	Kansas	219,475	59,082	+13.2%	25,615	7.44%
34	Mississippi	215,508	51,378	+13.0%	24,760	7.35%
35	New Mexico	182,144	42,106	+19.7%	29,926	8.60%
36	Utah	171,523	37,823	+20.0%	28,567	4.90%
37	West Virginia	163,499	38,620	+14.2%	20,321	9.24%
38	Nebraska	144,732	38,155	+13.0%	16,601	7.24%
39	Idaho	143,914	31,927	+24.1%	27,930	7.20%
40	Hawaii	143,843	42,670	+21.3%	25,216	10.23%
41	Maine	137,036	32,607	+20.1%	22,957	9.76%
42	New Hampshire	122,702	29,938	+23.4%	23,297	8.71%
43	Montana	96,573	22,807	+20.5%	16,435	8.52%
44	Delaware	92,516	20,702	+24.4%	18,156	8.82%
45	Rhode Island	92,038	24,832	+14.8%	11,840	8.30%
46	South Dakota	68,060	19,077	+13.1%	7,896	7.39%
47	Vermont	60,943	14,152	+22.4%	11,159	9.40%
48	North Dakota	58,258	17,911	+11.7%	6,079	7.38%
49	Wyoming	45,111	10,784	+20.1%	7,538	7.71%
50	District of Columbia	39,744	11,103	+15.6%	5,358	5.68%
51	Alaska	38,628	7,545	+28.7%	8,618	5.38%

The Screen a Population Table Cannot Run: Supply per 1,000

Demand only becomes an opportunity where supply has not already answered it, and the current supply picture is the tightest in the modern history of the sector. Senior housing occupancy in the 31 NIC MAP primary markets reached 89.9% in the second quarter of 2026, the twentieth consecutive quarter of gains and a level last seen at the end of 2015, with 15 of 31 primary markets at or above 90% (9)(10). Meanwhile, units under construction across primary and secondary markets fell below 24,000, the lowest count since mid-2012, and year-over-year inventory growth slowed to 0.4% (11)(10). In the third quarter of 2025, fewer than 1,500 new units were added to primary markets, the lowest on record since NIC MAP began tracking supply in 2006, and trailing twelve-month construction starts have held below 7,000 units (12). Demand has now outpaced new supply for five consecutive years.

The state layer of that picture is rarely quantified, because no single free source counts assisted living units uniformly. Two federal datasets get close. The CDC's National Post-acute and Long-term Care Study counted approximately 30,600 residential care communities nationally, serving about 818,800 residents on any given day, and publishes licensed bed estimates by state (13). Separately, industry tabulations from AHCA/NCAL cite roughly 41,465 assisted living communities with nearly 1.4 million licensed beds, a broader universe measured differently (14). Set against the 2024 age-qualified base, the NCAL count implies roughly 54 licensed beds per 1,000 residents aged 75+ nationally, a benchmark against which any state, and any trade area, can be tested.

Skilled nursing is a separate layer and should never be blended into the same ratio. CMS administrative data, an actual census rather than a survey, count roughly 1.6 million certified skilled nursing beds across about 15,270 facilities nationally, with certified bed counts published per facility and summable by state (39). Keeping the two layers apart matters analytically: residential care supply responds to private-pay demand and light regulation, while skilled nursing supply is Medicaid- and CON-shaped, and conflating them flatters or condemns a market for the wrong reasons.

The federal survey data allow the residential care ratio to be computed state by state. A sample of large and contrasting states:

State	Residential care beds (2020 survey)	Age 75+ (2024)	Beds per 1,000 aged 75+
Ohio	60,700	934,474	65.0
California	163,900	2,776,397	59.0
Arizona	37,900	665,700	56.9
Pennsylvania	57,500	1,129,837	50.9
Alaska	1,900	38,628	49.2
Florida	94,800	2,347,707	40.4
Texas	61,200	1,746,936	35.0
Arkansas	8,100	238,363	34.0
Alabama	10,200	395,768	25.8

Three cautions and one conclusion. The bed counts are weighted survey estimates with published confidence intervals, not administrative censuses; the residential care definition bundles assisted living with personal care and board-and-care homes; and the beds are 2020 estimates set against 2024 population, which, given near record-low inventory growth since, makes the ratios directionally conservative in fast-growth states. The conclusion survives all three caveats: the spread runs two and a half to one. Ohio, a bottom-tier growth state, carries 65 beds per 1,000; Alabama carries 26. Florida and Texas, the second and third largest 75+ markets, sit well below the national benchmark despite top-tier growth. Slow-growth, heavily bedded states are repositioning markets; fast-growth, thinly bedded states are development markets. A population ranking alone cannot tell them apart.

From Headcount to Addressable Demand: Penetration and Income Qualification

The chain a lender expects to see runs: age-qualified population in the defined trade area, then the income-qualified share at the intended rents, then a penetration rate tested against competitive supply including units under construction, then an absorption schedule, stabilized occupancy, net operating income, and debt service coverage. Every link is a separate piece of evidence, and the two links most often botched are penetration and income qualification.

Penetration is the share of qualified households in a market that reside in senior housing. NIC estimates the national market penetration rate at 13.6% of the population aged 80 and older as of 2025 (15), but the figure is acutely sensitive to the denominator: computed on 75+ households, national penetration is about 11.4%; computed on 80+ households, about 18% (16). A study that quotes a penetration benchmark without stating its denominator, or that applies a national constant to a local market, is not evidence. Penetration must be computed locally, on a defined age and income base, against actual competitive inventory and the pipeline.

Income qualification is where age-qualified counts shrink to addressable markets. The national median assisted living rate reached $6,200 per month, or $74,400 per year, in 2025, up 5% year over year (17), and continuum-of-care tabulations put independent living near $4,335, assisted living near $6,787, and memory care near $8,612 per month (18). Set those price points against the balance sheet of the cohort: the median net worth of households headed by someone 75+ is about $335,000, against a mean of $1.62 million, a skew that means a modest slice of the cohort holds most of the private-pay capacity (19). The definitive study of the middle of that distribution, the NORC "Forgotten Middle" analysis, projects 15.9 million middle-income Americans aged 75+ by 2033 and finds that 72% of them, 11.5 million people, will be unable to afford assisted living without selling their homes; even counting home equity, 39% still cannot (20). Standard practice therefore screens households against a rent-to-income test and then adds an explicit, stated home-equity or asset-drawdown assumption. The addressable private-pay market at today's rate structure is a minority of the 75+ population in every state; how large a minority varies enormously, which is exactly what the income-qualification step is for.

Rent, Cost to Build, and the Operating Economics In Between

The demand side only matters if the project economics close, and the cost side has moved faster than rents. The average all-in cost of senior housing development reached $388,830 per revenue unit, or $364 per square foot, in 2026, up 23.6% since 2023, with hard costs at 72.5% of the total, soft costs 16.2%, and site acquisition 8.1% (21). Construction-cost briefs prepared for ASHA put mid-level assisted living construction at $280 to $356 per square foot and high-level at $363 to $452, with 2026 escalation expected at 3 to 4%, down from the 8 to 12% of the pandemic recovery years (22).

On the operating side, the most recent industry benchmarking reports median operating margins of 32.5% for freestanding independent living, 29.2% for communities with an assisted living component, and roughly 26.6 to 26.7% for freestanding assisted living and combined campuses (23). Capital markets have noticed the demand-supply imbalance: the most recent investor survey recorded the first broad capitalization-rate compression across every senior housing segment since 2021, with 84% of investors expecting further compression (24). In our underwriting work, new construction is typically modeled to stabilization over roughly 18 to 30 months, with the monthly absorption assumption defended from local comparable lease-ups rather than a national rule of thumb.

The bridge from this page to that pro forma is short but unforgiving: a state with strong 75+ growth, thin bed supply, and a deep income-qualified band can still fail at the project level if the rent the market clears cannot carry $388,830 per unit of cost at a 1.15x or better coverage. That test is run in the feasibility study, not the demographic table.

The Constraint Layer That Reorders the Ranking

Population growth misranks states because supply is not free to respond and operations are not free to staff. Three constraints matter most.

Entry regulation. Thirty-five states plus the District of Columbia maintain certificate of need laws (25), but the detail matters more than the count: most CON states regulate skilled nursing beds while exempting assisted living. The clear exceptions are New Jersey, where new assisted living residences pass CON review and must reserve 10% of beds for Medicaid-eligible residents (26), and New York, where assisted living program slots are capped and allocated through CON. States with no CON program at all include Texas, California, Colorado, Idaho, New Hampshire, Pennsylvania, and Utah; South Carolina repealed CON for everything except nursing homes in 2023, and Wyoming repealed its last CON requirement in 2025 (25). Where CON gates entry, an approved site carries scarcity value and incumbents enjoy protected occupancy; where it does not, demand attracts competition quickly, and the pipeline check in a feasibility study carries more weight.

Medicaid depth. Forty-one states fund some assisted living services through Medicaid, almost always via home and community-based services waivers that pay for care but never for room and board (27). Waiver capacity is capped in many states, and more than 600,000 people sat on HCBS waiting or interest lists in 2025, up 14% in a year (28). The structure determines private-pay depth: thin Medicaid coverage concentrates a market on private payers, while capped waivers put a hard ceiling on the Medicaid-supported segment a project can underwrite.

Labor. Home health and personal care aides are now the largest single occupation in the United States, roughly 4 million workers, with a national median wage of $34,900 per year, or $16.78 per hour, and projected growth of 17% over the coming decade (29). The state spread is the widest cost differentiator in the asset class: median direct-care wages run from about $20.35 per hour in Washington down to about $10.00 in Louisiana, a two-to-one gap for the same job (30). Immigrants make up 28 to 30% of the direct care workforce, which makes staffing costs sensitive to federal immigration policy (31)(32), and assisted living turnover, while improving, still ran 34.5% overall in 2025, with care-staff roles above 40% (33). A 100-unit assisted living community is, economically, a payroll with a building attached; the state wage floor belongs in the screen alongside the population count.

Reading the Layers Together

Run the layers jointly and the single-variable rankings rearrange. Texas pairs top-five growth (+20.4%) with the thinnest measured bed base among the large states (35 per 1,000) and no CON review: the classic development quadrant, with competition arriving as fast as demand. Ohio pairs bottom-tier growth (+14.1%) with the heaviest bed base in the sample (65 per 1,000): a repositioning and acquisition market, not a greenfield one. Washington's +22.1% growth meets the nation's highest direct-care wage floor, so the demand case must clear a structurally higher expense line. Louisiana offers the cheapest labor in the country against modest growth (+15.5%). New Jersey and New York combine deep, affluent 75+ bases with CON gates that meter entry, which suppresses new development and raises the value of anything already approved. And the small fast growers, Alaska, Vermont, Delaware, New Hampshire, post the steepest percentages on bases so shallow that a single 120-unit project can move a whole submarket's penetration rate.

None of these observations underwrites a site. All of them change which sites are worth underwriting.

What Lenders Will Actually Ask For

Every major financing program converges on the same evidentiary chain, and none of them accepts a state population table as demand evidence.

Under HUD Section 232, every application requires an appraisal, and every appraisal must include a market study covering supply, demand, and estimated absorption; where a state requires a certificate of need, the borrower submits it, and where it does not, the lender documents that none is required (34). Fannie Mae's seniors housing program requires an experienced sponsor, generally at least five years and five properties, and a full third-party report package including appraisal, property condition assessment, environmental review, and a market study where required (35). Freddie Mac governs seniors housing through dedicated seller/servicer requirements in Chapter 3.14 of its Multifamily Guide, with appraisal standards under Chapter 60 (36). For SBA borrowers, SOP 50 10 8, effective June 1, 2025, classifies assisted living and nursing facilities as special purpose properties requiring going-concern appraisals, and a feasibility study is indicated wherever repayment rests on projections rather than history, which captures startups, ground-up construction, and substantial expansions, against minimum coverage of 1.15x on an operating basis and 1.00x globally (37). USDA's guaranteed programs codify the requirement most explicitly: 7 CFR Part 5001 requires an independent feasibility study addressing economic, market, technical, financial, and management feasibility, each evidenced separately, prepared by a party with no financial interest in the project (38).

The pattern is uniform. The demographic table is the first link in the chain, and the only one this page can supply. The remaining links, income qualification, penetration against competitive supply and pipeline, absorption, coverage, are built in a trade-area study, where the age-qualified population within a five- to ten-mile urban ring or a fifteen- to thirty-mile rural ring can differ from the state average by a factor of three.

Method and Maintenance

Population figures are the U.S. Census Bureau's Vintage 2024 state characteristics estimates of the resident civilian population by single year of age and sex (file sc-est2024-agesex-civ). We summed both sexes across ages 75 through the top-coded 85+ bucket for each state for the July 1, 2020 and July 1, 2024 estimate dates and computed growth between them; share of population uses each state's total civilian population for 2024 from the same file. No adjustment, projection, or interpolation has been applied. The Bureau released Vintage 2025 (sc-est2025-agesex-civ) on June 25, 2026, which revises the full series and incorporates 2020 Census demographic detail into the estimates base for the first time; the tables on this page are scheduled for rebuild on that file in the next maintenance cycle (2). Supply ratios use CDC/NCHS survey estimates and AHCA/NCAL tabulations as labeled, and market series are NIC MAP data as published. Nothing on this page is an opinion on any specific site, and no figure here should be relied on as a demand conclusion for a project.

Frequently Asked Questions

Which state has the largest 75+ population? California, with 2,776,397 residents aged 75+ in 2024, followed by Florida (2,347,707) and Texas (1,746,936). The ten largest states hold 54% of the national total (1).

Which state's 75+ population is growing fastest? Alaska, at +28.7% from 2020 to 2024, though on a small base of 38,628. Among large states, South Carolina (+24.6%), Colorado (+24.3%), Georgia (+22.9%), and Arizona (+22.1%) lead; California added the most people outright, 403,587 (1).

When does the 85+ wave actually arrive? At the start of the 2030s. The first 1946 baby boomers cross 85 in 2031, and federal projections carry the 85+ population from roughly 9 million in 2030 to around 14 million by 2040, the demand core for assisted living and memory care (4).

Is state-level population enough to support a senior housing loan application? No. HUD, Fannie Mae, Freddie Mac, SBA, and USDA each require site-specific market or feasibility evidence: a defined trade area, income qualification, penetration against competitive supply and pipeline, and an absorption schedule (34)(35)(36)(37)(38). State data screens markets; it does not underwrite them.

What penetration rate should a feasibility study use? None off the shelf. The national market penetration rate is about 13.6% of the 80+ population, but the figure swings from roughly 11.4% to 18% depending solely on the denominator used (15)(16). Penetration must be computed for the subject trade area, on a stated age and income base, against actual inventory and units under construction.

How many senior housing beds exist per 1,000 people aged 75+? Roughly 54 licensed assisted living beds per 1,000 nationally, using industry counts of about 1.4 million beds against the 2024 age-qualified base (1)(14). The state spread runs from about 26 per 1,000 (Alabama) to 65 (Ohio) in the federal survey data (13), which is why supply, not population, decides whether a market is open.

What does assisted living cost, and can the cohort afford it? The national median is $6,200 per month in 2025, with memory care near $8,612 (17)(18). Affordability is the binding constraint: 72% of middle-income seniors are projected to be unable to afford assisted living by 2033 without tapping home equity (20), which is why income qualification, not the raw 75+ count, defines the addressable market.

Sources:

• U.S. Census Bureau, Annual Estimates of the Civilian Population by Single Year of Age and Sex, Vintage 2024 (sc-est2024-agesex-civ), released 2025.

• U.S. Census Bureau, Vintage 2025 Population Estimates, press release, June 25, 2026.

• NIC MAP, "The Impending Age Wave," 2025.

• U.S. Census Bureau, 2023 National Population Projections, Table NP2023-T2, November 2023.

• CDC/NCHS, Data Brief No. 506, "Residents Living in Residential Care Communities: United States, 2022," August 2024.

• NCAL resident profile data as compiled by

• Weldon Cooper Center for Public Service, University of Virginia, National and 50-State Population Projections, 2026 vintage.

• IRS Statistics of Income, U.S. Population Migration Data 2022-2023, released September 30, 2025.

• NIC, "Senior Housing Occupancy Climbs in Second Quarter 2026," July 2026.

• NIC MAP, "Occupancy in Senior Housing Climbs as Half of Primary Markets Top 90%," July 2026.

• NIC MAP, "Senior Housing Construction Trends Fall to a 2012 Low, 2Q 2026," 2026.

• Multi-Housing News, "2026 Senior Housing Market Update," reporting NIC MAP data, 2026. CDC/NCHS, National Post-acute and Long-term Care Study, 2020 wave, state tables and dataset.

• AHCA/NCAL, Assisted Living Facts and Figures.

• NIC Academy, "Senior Housing Market Analysis: A Framework for Investors," 2025.

• NIC, "Looking into the Future: How Much Seniors Housing Will Be Needed?" white paper. CareScout, 2025 Cost of Care Survey, released 2025.

• NIC MAP continuum cost data as reported by Senior Housing News, July 30, 2026.

• Federal Reserve Board, Survey of Consumer Finances 2022, "Changes in U.S. Family Finances from 2019 to 2022," October 2023.

• NORC at the University of Chicago, "The Forgotten Middle: Housing and Care Options for Middle-Income Seniors in 2033," August 2022.

• CBRE, "2026 Senior Housing Development Costs," 2026.

• The Weitz Company Senior Living Construction Costs Brief, as reported by Senior Housing News, February 3, 2026.

• ASHA, "The State of Seniors Housing," operating margin data as reported by Senior Housing News.

• CBRE, U.S. Senior Housing and Care Investor Survey, H2 2025.

• National Conference of State Legislatures, Certificate of Need State Laws.

• New Jersey Department of Health, Certificate of Need program (N.J.A.C. 8:33H).

• KFF, "Medicaid Home Care (HCBS) in 2025."

• KFF, "A Look at Waiting Lists for Medicaid Home and Community-Based Services from 2016 to 2025."

• U.S. Bureau of Labor Statistics, Occupational Outlook Handbook, Home Health and Personal Care Aides, May 2024 data.

• U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, SOC 31-1120, state estimates.

• PHI, "Direct Care Workers in the United States: Key Facts 2025," September 2025.

• KFF, "Who Are Direct Care Workers and How Might Federal Policy Changes Impact the Workforce?"

• HCS Assisted Living Salary and Benefits Report data as reported by Senior Housing News, January 30, 2026.

• HUD, Section 232 Handbook, Section II, Production, Chapter 2.

• Fannie Mae, Multifamily Selling and Servicing Guide, Seniors Housing and third-party report requirements.

• CMS, Care Compare nursing home provider data (certified beds by facility).