A new study from the University of Rochester Medical Center warns that nursing home capacity across the United States has dropped sharply since the COVID-19 pandemic, with rural communities hit the hardest.
The findings, published this week in JAMA Internal Medicine and highlighted by URMC researchers, show that national nursing home operating capacity fell by five percent between 2019 and 2024. That decline equals nearly 4,000 fewer beds available for patients each day.
Researchers analyzed licensed beds, staffing levels, and patient census data from nearly 16,000 skilled nursing facilities nationwide. They found that one quarter of U.S. counties experienced capacity declines of at least 15 percent, with rural counties far more likely to see drops of 25 percent or more.
The study found the impact extends well beyond nursing homes themselves. Reduced capacity was linked to longer hospital stays, particularly for patients hospitalized 28 days or longer while waiting for placement.
“In rare cases, patients can get stuck in the hospital for several months or indefinitely,” said Brian McGarry, an assistant professor of geriatrics and aging at URMC and the study’s author. He said hospitals are not designed for long-term living and extended stays can be difficult for patients and families.
Researchers also found patients often ended up in nursing homes farther from home once discharged. With fewer beds available, families had less choice, making it harder for loved ones to visit and provide support.
The study points to staffing shortages as a key factor behind the decline. While licensed beds may still exist, McGarry said many facilities lack enough staff to safely operate at full capacity. Capacity reached its lowest point in 2021 and has slowly improved since, though researchers warn that funding pressures could reverse that trend.
The findings also highlight ripple effects throughout the health care system. When patients cannot move from hospitals into nursing homes, inpatient beds remain occupied, emergency departments back up, and hospitals struggle to manage patient flow.
URMC cited Strong Memorial Hospital as a local example. The hospital serves the Finger Lakes region, which faces a severe shortage of staffed nursing home beds and has fewer hospital beds per capita than any other region in New York State. As a result, alternate level of care patients regularly occupy a significant share of inpatient beds.
McGarry said the study underscores the need for broader investment in nursing homes and their workforce to prevent bottlenecks that affect care across entire communities.
FingerLakes1.com is the region’s leading all-digital news publication. The company was founded in 1998 and has been keeping residents informed for more than two decades. Have a lead? Send it to [email protected].