One in four counties experienced operating capacity declines of 15.1% or more, and hospitals in higher-impact areas reported measurably longer discharge delays and increased patient travel distances to SNF placements.
Changes in US Skilled Nursing Facility Capacity Following the COVID-19 Pandemic
In this cross-sectional study of US skilled nursing facilities, although the number of licensed skilled nursing beds in the US has declined since 2019, estimated operating capacity based on maximum census counts declined 5% by 2024, with many counties experiencing declines of 15% or more. Areas with larger declines in SNF capacity had more frequent reports of facility staffing shortages and larger increases in hospital length of stay.
McGarry, Brian E., et al. “Changes in US Skilled Nursing Facility Capacity Following the COVID-19 Pandemic.” JAMA Internal Medicine, 12 Jan. 2026, jamanetwork.com/journals/jamainternalmedicine/article-abstract/2843861.
Diminished nursing homes capacity may limit access to long-term care, slow hospital release
Likely due to staffing shortages, U.S. nursing home capacity has declined by 15% or more in some cases since the COVID-19 pandemic began, potentially narrowing access to long-term care and complicating hospital releases, according to research published in JAMA Internal Medicine.
The researchers used the 2018-2024 CMS payroll-based journal to measure changes in SNF capacity since 2020, and found reductions of 15% or more at a quarter of facilities.
— HealthLeaders Media, January 16, 2026
Diminished US nursing homes capacity may limit access to long-term care, slow hospital release
The number of licensed SNF beds fell 2.5%, and operating capacity dropped 5.0%, from 2019 to 2024. In total, 25% saw capacity reductions of 15.1% or more, with the largest declines tending to occur in rural counties.
SNF capacity losses were larger in counties with more frequent reports of SNF staffing shortages. A decline of 1 percentage point in county SNF capacity was linked to a 0.20-percentage-point rise in reported staff shortages.
— University of Minnesota – CIDRAP, January 15, 2026
Nurse Staffing Shortages Are Reducing Older Americans’ Access to Care: Study
The areas that had the greatest drops also experienced staffing shortages and patients had longer hospital stays, often greater than 28 days. For every 1% drop in capacity, the facilities experienced more frequent reports of shortages and other consequences.
Researchers also found that hospitals near facilities with larger capacity declines saw longer average hospital stays, a greater share of stays lasting 28 days or more, and patients traveling farther on average to reach a skilled nursing facility.
— AboutLawsuits.com, January 15, 2026
Skilled Nursing Facility Capacity Declined Between 2019 and 2024
The researchers found that 1 in 4 counties experienced operating capacity declines of 15.1% or more, with rural counties having the largest declines.
“We need to invest more in nursing homes and staff. It’s hard to do that when the primary payer for nursing home services — Medicaid — is having its budget slashed,” Dr. McGarry said in a statement.
— Clinical Advisor, January 2026
US nursing home capacity declines twice as steep as estimated: JAMA study
The JAMA study also found that shrinking capacity didn’t affect just nursing homes and their patients. Hospitals in areas where skilled nursing capacity shrunk saw worsening discharge outcomes. A one percentage point decrease in local nursing home capacity correlated to a 1.89 percentage point increase in hospital stays of 28 days or more. Less SNF capacity also was linked to patients having to travel farther for a placement.
“It actually doesn’t take huge reductions to disrupt the healthcare system,” McGarry said. “When that equilibrium gets disrupted, it doesn’t necessarily take really big, 50% reductions in capacity to disrupt patient flows and inhibit patient access to all kinds of healthcare.”
— McKnight’s Long-Term Care News, January 12, 2026
Postpandemic Nursing Home Capacity Declines Tied to Longer Hospital Stays, Increased Patient Travel
The COVID-19 pandemic caused a decline in SNF operating capacity, leading to longer hospital stays and increased patient travel distances for post-acute care.
From 2018 to 2024, SNF bed numbers decreased by 2.5%, with a 14.7% drop in operating capacity by early 2021, affecting hospital discharge outcomes.
Geographic disparities in SNF capacity changes were observed, with rural areas experiencing more significant declines, impacting older adults’ access to care.
— AJMC, January 12, 2026
