Executive Summary
Meeting the Demand for Long-Term Care Facilities in New Hampshire
This study reviews the existing New Hampshire Long-Term Health Care Facilities and forecasts their Locational demand for the year 2030 by Facility Type. The Facility Types are Supported Residential Care Facility (SRCF), Assisted Living/Residential Care Facility Residences (AL/RCF) and Nursing Homes (NursH).
The goal of this study is to present the order of magnitude numbers and inform LTC facility owners and operators, governmental, educators and other interested parties of the locational demand outlook for Long-Term Care facilities in New Hampshire. A summary of expected costs and personnel requirements is also provided. Also, processes to support the expansion of New Hampshire’s Long-Term Care (LTC) Facilities are outlined.
New Hampshire is facing a burgeoning demographic and locational challenge for LTC facilities and caring for its seniors. This study reveals that the current NH Government assistance, construction and personnel growth commitments to existing and new LTC beds and locations needs to be expanded to meet this challenge.
Key Findings at a Glance:
Inventory Statistics
There are (late 2022) 217 Long Term Care Facilities with 13948 Beds. There are 89 SRCF, 49 AL/RCF, and 79 NursH Facilities.
IN 2022 New Hampshire had 5279 SRCF beds, 1257 AL/RCF beds and 7412 NursH beds for a total of 13948 beds.
The 2022 availability of Facilities and beds is uneven across the State. Belknap County has 97 beds per 65+ 1000 population while Carroll County has 21 beds per 65+ 1000 population. The NH average is approx. 53 beds per 65+ 1000 population. Carroll County has no AL/RCF facilities.
Demographic Demand
The 2022 to 2030 increase in New Hampshire of 69,000 in the 65+ population is a result of the “Baby Boom”. The NH 65+ Population in 2022 was estimated at 262,000 with a 2030 population estimated at 331,000. The 65+ cohort wave is estimated to peak between 2035 and 2040.
In 2022 the State dependency Ratio was 69, consisting of 35 for ages 1-18, and 34 for ages 65+. Meaning 69 people are being supported by 100 people ages 19 to 64.
State Demographics by County –
The State map here illustrates the 65+ and Total Population by County for the year 2020 and forecast year 2030.
One can see the significance in population between the counties, and where future growth is primarily in the 4 largest counties.
Of note is the increase in 65+ Populations in all counties but a decrease or flat Total Population in the five smallest counties i.e. Coos, Sullivan, Cheshire, Carroll, and Belknap Counties, indicating an out migration, a lower birth rate or both.
In 2030 the 65+ population will constitute 24% of New Hampshire’s total population.
The 65+ % of County Population in 2022 -2030 distribution. Maximum is Carroll Conty at 37% and Strafford at 19%.
The forecast indicates the need for 6300 Total additional beds in existing and 36 new locations by 2030. The forecast utilizes a state top-down and county bottom-up forecasting process of the facility type, and bed counts equating to approx. 780 beds per year, providing a 2030 total in-service of 20,250 beds.
Determining the communities that need new facilities. (Indicated in yellow on maps) utilizing GIS and drive times around existing and new facilities.
New Facility Cost
The capital cost to build the new facilities (Building, machinery and equipment) is estimated between $2.3 Billion and $3.8 Billion from 2023-2030.
The additional beds operating cost is estimated to be $1.3 Billion over the 2023-2030 period.
Additional Staff
An additional 4570 LTC Staff members will be required 2023 -2030, consisting of 2050 Admin Staff, 2520 Nursing Staff.
Select to see full 51-page study as PDF.