Board and Care Homes

The number of board and care facilities is difficult to establish, since there is no generally accepted definition of what constitutes such a facility or any systematic way to count them. With the emergence of purpose-built facilities offering assisted living services during the 1990s, the numbers of older adults being served in nonmedical care settings has increased substantially. Prior to the boom in assisted living, a 1987 industry survey identified about 563,000 board and care beds in 41,000 licensed homes nationally. A 1992 GAO study found some 75,000 licensed and unlicensed homes serving a million people, including half a million disabled older adults. A 1999 GAO report on assisted living that includes board and care facilities, estimates the number of beds in the United States at between 800,000 and 1.5 million. The report notes that consumer demand is expected to grow significantly as the projected number of elderly Americans in need of long-term care doubles between 2000 and 2020.