Abstract
As states work toward rebalancing their long-term care (LTC) systems to provide services in non-institutional settings, it is important to understand the market for Assisted Living Facility (ALF) services. We obtained records of all licensed Florida ALFs for 2003–2014. We also obtained the socioeconomic and demographic information for each county from the U.S. Census Bureau and the median household income for each county from the Bureau of Labor Statistics. In our study we describe changes in Florida’s ALF market during the observation period. We estimated changes in the prevalence of ALFs at the county-level and over time, by facility size, and compared this with changes in the demographic and socioeconomic makeup of those counties. We also examined the relationship between facility-size and licensure types. Small, 6–12 bed ALFs were the most prevalent and exhibited greatest growth during 2003–2014. Smaller facilities operated in lower income, densely populated areas with a higher proportion of African American and Hispanic individuals. These facilities were more likely to be licensed to provide limited mental health (LMH) services, and had a significantly higher proportion of beds licensed for Optional State Supplementation (OSS) payment. Larger facilities (101+) tended to operate in higher income areas with the highest proportion of individuals over 65 and 85 years of age, and a smaller proportion of racial/ethnic minority populations. Our findings offer insight into the increasing segregation of care found within the ALF market in Florida.