Residential care in California: Spatial and temporal trends in facility development and care capacity

The development of residential care has not kept pace with the growth of the older population in many places. We merged the California Department of Social Services residential care for the elderly dataset with census place data to document the growth of facilities and beds per older adults in all of California and in its three largest cities. From 1996 to 2015, residential care steadily increased in California by the number of facilities and beds relative to older adults. However, due to a consistently increasing older adult population, the Cities of San Diego and San Jose experienced gradual and intermittent decline in capacity per older adults, respectively, even as they added many beds to their inventories from the sporadic development of large assisted living and continuing care retirement communities. Additionally, San Jose and Los Angeles exhibited the most overlap in densities of facility development and oldest old adults, with San Diego showing less intersection in cartographic analyses. Understanding facility development and care capacity trends can help local agencies and jurisdictions in the United States and other countries discern whether planning policies and other geographical and development factors appropriately encourage the development of residential care and other long-term care facilities.