Census 2025 estimates · CMS September 2026 · CDC 2020
Senior housing development in California
California had 3,031,385 residents aged 75 and older in July 2025, +23.3% since April 2020 (US +23.4%), and 809,992 aged 85 and older (+12.3%). Its 1,165 certified nursing homes hold 114,991 beds, 142.0 for every 1,000 people 85 and older, fewer than the US ratio of 222.6. Certificate of need for nursing home beds: no; for assisted living: no.
- Age 75+ (2025)
- 3,031,385
- Growth since 2020
- +23.3%
- Nursing beds per 1,000 aged 85+
- 142.0
- Assisted living beds per 1,000 aged 75+
- 54.1
Demand: the older population
| Age group | April 2020 | July 2025 | Change | US change |
|---|---|---|---|---|
| 75 and older | 2,458,021 | 3,031,385 | +23.3% | +23.4% |
| 85 and older | 721,498 | 809,992 | +12.3% | +11.3% |
Nationally, the Census Bureau's 2023 projections have the 75+ population growing 21% from 2025 to 2030 and the 85+ population 59% from 2025 to 2035. The bureau publishes those projections for the US only, not by state.
Supply: licensed beds
| Setting | Beds | Per 1,000 aged 75+ | Per 1,000 aged 85+ | Source |
|---|---|---|---|---|
| Nursing homes (Medicare or Medicaid certified) | 114,991 | 37.9 | 142.0 | CMS, September 2026 |
| Residential care / assisted living | 163,900 | 54.1 | 202.3 | CDC survey, 2020 |
US: 222.6 nursing beds and 170.1 assisted living beds per 1,000 aged 85+. Assisted living beds are CDC's 2020 survey estimate, its latest with state detail, set against 2025 population, so the ratio understates any supply added since.
Certificate of need
- Nursing home beds
- No
- Assisted living
- No
- Notes
- None
From NCSL's certificate of need table (updated April 29, 2025, covering January 2025) with later changes checked on state sites on October 24, 2026. "Not listed" means NCSL does not name assisted living, not that it is exempt. Confirm with the state health planning agency before relying on it. HUD requires a state CON for nursing home beds where the state has one (Handbook 4232.1, 2.5.EE).
Counties
The 25 counties with the most residents aged 75+, with certified nursing home beds per 1,000 aged 85+.
| County | Age 75+ | Since 2020 | Share of population | Age 85+ | Nursing homes | Beds per 1,000 aged 85+ |
|---|---|---|---|---|---|---|
| Los Angeles County | 716,759 | +19.3% | 7.4% | 199,962 | 369 | 187.7 |
| Orange County | 262,572 | +22.1% | 8.3% | 73,331 | 72 | 105.5 |
| San Diego County | 253,796 | +25.1% | 7.7% | 67,816 | 83 | 129.6 |
| Riverside County | 188,613 | +23.7% | 7.4% | 46,799 | 54 | 109.5 |
| Santa Clara County | 142,198 | +21.1% | 7.4% | 43,589 | 50 | 117.3 |
| San Bernardino County | 127,364 | +23.6% | 5.7% | 30,202 | 55 | 165.4 |
| Alameda County | 124,694 | +29.0% | 7.6% | 33,973 | 69 | 162.5 |
| Sacramento County | 118,707 | +25.5% | 7.3% | 31,258 | 37 | 125.2 |
| Contra Costa County | 101,669 | +28.2% | 8.7% | 26,724 | 30 | 109.1 |
| San Francisco County | 74,430 | +22.7% | 9% | 22,811 | 18 | 101.8 |
| Ventura County | 74,047 | +24.1% | 8.9% | 19,923 | 19 | 93.5 |
| San Mateo County | 67,392 | +23.9% | 9.1% | 19,781 | 14 | 83.8 |
| Fresno County | 64,547 | +20.1% | 6.2% | 16,614 | 31 | 167.3 |
| Sonoma County | 54,098 | +36.8% | 11.1% | 12,402 | 18 | 121.4 |
| San Joaquin County | 52,534 | +24.3% | 6.4% | 13,661 | 24 | 192.4 |
| Kern County | 48,617 | +19.9% | 5.2% | 11,404 | 17 | 153.9 |
| Placer County | 47,233 | +28.6% | 10.7% | 12,662 | 10 | 88.8 |
| Santa Barbara County | 39,570 | +20.8% | 9% | 11,807 | 14 | 108.2 |
| Solano County | 37,064 | +31.2% | 8.1% | 8,842 | 9 | 95.7 |
| Stanislaus County | 36,947 | +17.2% | 6.6% | 9,357 | 17 | 191.8 |
| Marin County | 32,642 | +28.0% | 12.9% | 8,443 | 11 | 112.3 |
| San Luis Obispo County | 31,527 | +31.1% | 11.2% | 7,484 | 7 | 100.9 |
| Monterey County | 31,367 | +25.6% | 7.2% | 8,125 | 14 | 122.3 |
| Tulare County | 27,262 | +19.2% | 5.6% | 6,736 | 16 | 230.4 |
| Santa Cruz County | 24,944 | +43.6% | 9.6% | 5,599 | 7 | 129.5 |
Fastest growth in the 75+ population
- Santa Cruz County: +43.6% (24,944)
- Mendocino County: +41.9% (10,819)
- Humboldt County: +37.0% (12,733)
- Sonoma County: +36.8% (54,098)
- Lassen County: +33.7% (2,213)
- San Benito County: +33.6% (4,477)
- El Dorado County: +33.2% (21,270)
- Solano County: +31.2% (37,064)
- San Luis Obispo County: +31.1% (31,527)
- Alameda County: +29.0% (124,694)
Counties with at least 2,000 residents aged 75+.
Fewest nursing beds per 1,000 aged 85+
- Siskiyou County: 50.9 (59 beds, 1,159 aged 85+)
- El Dorado County: 66.3 (314 beds, 4,739 aged 85+)
- Yuba County: 69.9 (86 beds, 1,231 aged 85+)
- Calaveras County: 70 (99 beds, 1,414 aged 85+)
- Tehama County: 72.1 (113 beds, 1,567 aged 85+)
- San Mateo County: 83.8 (1,657 beds, 19,781 aged 85+)
- Placer County: 88.8 (1,125 beds, 12,662 aged 85+)
- Imperial County: 91.6 (253 beds, 2,763 aged 85+)
- Ventura County: 93.5 (1,862 beds, 19,923 aged 85+)
- Solano County: 95.7 (846 beds, 8,842 aged 85+)
Counties with at least 1,000 residents aged 85+.
HUD Section 232 construction in California
Since fiscal 2001 HUD has insured 47 new construction or substantial rehabilitation loans on care facilities in California (39 assisted living, 7 nursing homes), $528.6 million of original principal, 7 of them since fiscal 2016.
- FY2025: Rancho Cucamonga Memory Care, Rancho Cucamonga, assisted living, $17.3 million
- FY2022: Vine Ridge Cloverdale, Cloverdale, assisted living, $10 million
- FY2021: Mariposa at Ellwood Shores, Goleta, assisted living, $21.9 million
- FY2021: Nikkei Senior Gardens, Arleta, assisted living, $14 million
- FY2020: Oceanside Post Acute, Oceanside, nursing home, $25.2 million
- FY2018: Vine Ridge Cloverdale, Cloverdale, assisted living, $10 million
- FY2016: Mariposa at Ellwood Shores, Goleta, assisted living, $21.9 million
Planning a building in California? Model the budget, lease-up and a HUD 232 construction loan.
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Sources: Census Bureau Vintage 2025 county population estimates; CMS Nursing Home Provider Information (September 2026); CDC/NCHS National Post-acute and Long-term Care Study (2020); HUD Office of Healthcare Programs endorsement database (data run 07/08/2026); NCSL. Absorption is operated by Janover Capital LLC and is not affiliated with any of them. Methodology.