At a recent speaking event at an Arizona continuing care retirement community (CCRC or life plan community), an attendee remarked that she assumed Arizona would have a relatively large number of CCRCs compared with its population of older adults. Though that seems logical, it isn’t always the case.
Her comment prompted me to investigate: which states have the most CCRCs per capita among residents aged 65 and older? I gathered available data, ran the calculations, and compiled the results into a PDF showing the top 25 states by CCRCs per senior population. (Ideally this would use data for age 75 and over, since most people don’t move into CCRCs at 65, but that statistic is not available consistently by state.)
Keep in mind that CCRCs are defined and regulated differently from state to state, so precise counts can vary. The figures in my chart are based on a 2008 Senate study, so current totals are likely somewhat higher.
States with the most CCRCs per senior
Arizona’s attendee wasn’t far off: based on my analysis, Arizona ranks 15th for CCRCs per senior, with roughly 668,000 residents age 65 and over (about 16 percent of the state population) and 33 CCRCs.
Additional observations from the findings:
- When people picture states with many CCRCs they often think of Florida or Arizona. Florida does have the highest share of seniors as a percentage of population, but the states with the most CCRCs relative to their senior populations are largely in the Midwest—Kansas, South Dakota, and Iowa top the list. That pattern likely reflects historical migration and the early emergence of non-profit homes for older adults in the region.
- Pennsylvania and Ohio follow closely and also have the highest absolute numbers of CCRCs.
- Although Pennsylvania has more than twice as many CCRCs as Kansas, it has only about half as many CCRCs per senior when adjusted for the retiree population size.
- Florida and California rank high in total CCRCs but are 21st and 22nd respectively when CCRCs are measured per resident age 65 and over.
- A few states on the list have fewer than five CCRCs in absolute terms, yet they rank relatively high because their populations of people age 65 and older are small.
>> Free Resource: Which states regulate CCRCs? (PDF download)
The logic behind CCRCs’ location
Even in the top-ranked states, the number of CCRC residential units typically accommodates a small fraction of the senior population. For example, in Kansas, available CCRC units could house less than 6 percent of residents age 65 and over. Developers do not base location decisions solely on state-level population figures.
CCRCs often target higher-income seniors, so developers weigh local economic conditions and real estate markets when choosing sites. As a result, the total number of retirees in a state may matter less than local wealth concentrations and housing economics.
Comparing CCRC locations with lists of states that have the wealthiest retirees (such as Maryland, California, Virginia, Alaska, and Colorado) doesn’t reveal strong, consistent overlaps. That suggests there isn’t a simple formula determining where CCRCs are built.
>> Related: New study shows CCRC residents are happier and healthier
States with growing senior populations
Some states with large overall populations naturally have many seniors:
- California has about 3.6 million residents age 65 and over—roughly 13 percent of the state’s population—and 129 CCRCs.
- Florida has roughly 2.8 million seniors, nearly one-fifth of its population, with 101 CCRCs. If an average CCRC contains about 300 residential units, Florida’s CCRCs combined would provide housing for only around 1 percent of the state’s seniors.
- Texas counts more than 2 million residents age 65 and over (about 11 percent) and has 86 CCRCs.
A U.S. News & World Report analysis highlights states with the fastest-growing senior populations as a share of total residents. Surprisingly, Alaska topped that list: according to the Administration on Aging, Alaska had about 77,206 people age 65 and older and saw a 65.6 percent increase in that population between 2006 and 2016. My data show Alaska has just one CCRC.
Nevada ranked second in senior population growth, increasing by 57.3 percent over the same period and now with about 441,142 seniors (roughly 15 percent of its population); Nevada did not rank among the top 25 states by CCRCs per senior. Colorado ranked third, growing to approximately 743,524 residents age 65 and over (about 13 percent of the state). Despite significant growth and a sizable retiree population, Colorado’s CCRCs per senior did not make the top 25 in my spreadsheet.
>> Related: Why every retiree should consider a retirement community
CCRC hot spots of the future?
States with rapidly rising senior populations—like Nevada and especially Colorado, which also has a growing share of affluent older adults—could represent opportunities for future CCRC development. However, current distribution patterns and market factors mean increased senior populations do not automatically translate into more CCRCs.
Ideally, developers will consider these demographic trends and invest in communities that meet the needs of expanding senior populations. Until then, the location of CCRCs will continue to reflect a mix of historical patterns, local economics, and developer strategy rather than a simple correlation with the number of seniors in a state.