Assisted Living Facilities List: Nursing Homes vs the Rest

Building an assisted living facilities list is two different jobs. Certified nursing homes sit in a live federal file with 14,690 currently active rows. Assisted living and other residential care are state-licensed with no national register, so that half has to be assembled state by state.

Senior care looks like one market and is administered as at least two. Which half you sell to determines whether your prospect data is a free federal download or fifty separate collection projects.

How many nursing homes are there in the US?

CMS publishes the answer continuously. The August 2026 Provider Information file contains 14,690 rows for currently active nursing homes, with one row per nursing home. CMS describes the file as general information on currently active nursing homes, which makes it the strongest starting point in the whole sector.

Now the contrast that matters. BLS reported 93,474 private-industry establishments in NAICS 623 in the fourth quarter of 2025, marked preliminary, with employment reaching 3.5007 million in July 2026, also preliminary.

So certified nursing homes are roughly one in six establishments in nursing and residential care. The other five in six, including assisted living, memory care, continuing-care communities and board-and-care homes, are outside the federal certification file entirely.

BLS defines NAICS 623 as residential care combined with nursing, supervisory or other care, divided into subsectors including nursing care facilities, which is why the aggregate is so much larger than the certified count.

What the federal file gives you

More than a list of names. CMS publishes ownership information for currently Medicare-enrolled skilled nursing facilities, which answers the single most useful qualifying question in this market: is this building independent, or does it belong to a group that buys centrally?

For the shape of a usable record, the CMS tribal directory illustrates the fields that matter in a regulated-provider list: facility name, address, administrator and contact details. Those are the fields to aim for when you assemble the state-licensed half yourself.

The half with no register

Assisted living is licensed by states, and states differ in what they call it, what they require and what they publish. Some maintain searchable directories; some publish annual lists; some publish little. There is no equivalent of the CMS file.

Practically, that means:

1. Build the nursing home list from CMS and treat it as near-complete for certified facilities.
2. Attach ownership from the CMS ownership dataset before segmenting, because chain-owned and independent facilities buy differently.
3. Use the NAICS 623 establishment count to size the total market and to understand how much of it the federal file does not cover.
4. Assemble the assisted living half state by state, prioritising the states where your product is viable rather than attempting all fifty at once.
5. Never present a nursing home count as a senior living count. They differ by roughly a factor of six.

Reconciling a live federal file with fifty state licensing regimes into one operator view is the specific problem Causo's aged care prospecting is built for.

Why generic databases miss senior care

They flatten distinct businesses. Nursing homes, assisted living communities, continuing-care retirement communities, home care agencies and staffing providers all land under broad healthcare, real estate or social assistance labels, and the differences between them are the whole basis of qualification.

Certification and licensure are absent. Whether a facility is Medicare certified, what its bed count is, and which state licence it holds are the qualifying facts, and no general database carries them.

Ownership chains are invisible. A single brand can operate dozens of facilities under separate legal entities, so a database shows you buildings where the decision is made at a corporate office.

And the operator versus the property owner are frequently different companies, which means the contact you find may have no authority over operations at all. The general failure of buying rows rather than qualifying them is covered in B2B prospecting for founders.

Selling technology to aged care providers: who decides

At a single facility, the administrator or executive director decides and lives with the result. Directors of nursing hold effective veto over anything touching clinical workflow. At multi-site operators, a regional or corporate operations role owns the decision and the facility becomes an implementation site rather than a buyer.

Two things shape every deal. Staffing pressure is the dominant operational reality, and a tool that saves nursing time will be heard where a tool that produces better reports will not. And regulatory exposure runs through everything: with 58,820 medical and health services managers working in nursing and residential care, the people you are selling to spend much of their week on compliance, so anything that touches documentation must clearly reduce risk rather than add a new place for it to hide. If you are still choosing a vertical, how to find customers for your startup covers the sequencing.