Census 2025 estimates · CMS September 2026 · CDC 2020
Senior housing development in Massachusetts
Massachusetts had 628,062 residents aged 75 and older in July 2025, +22.5% since April 2020 (US +23.4%), and 165,591 aged 85 and older (+5.4%). Its 341 certified nursing homes hold 40,920 beds, 247.1 for every 1,000 people 85 and older, more than the US ratio of 222.6. Certificate of need for nursing home beds: yes (determination of need); for assisted living: not listed.
- Age 75+ (2025)
- 628,062
- Growth since 2020
- +22.5%
- Nursing beds per 1,000 aged 85+
- 247.1
- Assisted living beds per 1,000 aged 75+
- 30.1
Demand: the older population
| Age group | April 2020 | July 2025 | Change | US change |
|---|---|---|---|---|
| 75 and older | 512,618 | 628,062 | +22.5% | +23.4% |
| 85 and older | 157,112 | 165,591 | +5.4% | +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) | 40,920 | 65.2 | 247.1 | CMS, September 2026 |
| Residential care / assisted living | 18,900 | 30.1 | 114.1 | 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
- Yes (Determination of Need)
- Assisted living
- Not listed
- Notes
- NCSL: a prior LTC bed moratorium was eased the state now accepts some DoN applications
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 14 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+ |
|---|---|---|---|---|---|---|
| Middlesex County | 136,625 | +22.0% | 8.2% | 38,405 | 72 | 226.9 |
| Essex County | 74,808 | +22.5% | 9% | 19,889 | 45 | 265.7 |
| Worcester County | 70,730 | +24.1% | 8% | 18,298 | 50 | 331.6 |
| Norfolk County | 66,457 | +20.8% | 9% | 19,131 | 33 | 196.1 |
| Plymouth County | 52,959 | +28.3% | 9.7% | 12,124 | 27 | 272.2 |
| Bristol County | 51,369 | +19.8% | 8.7% | 12,766 | 28 | 299.7 |
| Suffolk County | 50,209 | +19.1% | 6.3% | 14,100 | 22 | 191.2 |
| Hampden County | 41,097 | +16.8% | 8.9% | 10,854 | 26 | 280.4 |
| Barnstable County | 39,559 | +22.1% | 16.9% | 9,865 | 15 | 168.7 |
| Berkshire County | 16,173 | +20.5% | 12.6% | 4,009 | 13 | 360.9 |
| Hampshire County | 15,863 | +38.2% | 9.7% | 3,638 | 5 | 183.6 |
| Franklin County | 8,047 | +38.1% | 11.4% | 1,584 | 3 | 193.2 |
| Dukes County | 3,033 | +48.3% | 14.3% | 671 | 1 | 158 |
| Nantucket County | 1,133 | +31.3% | 7.7% | 257 | 1 | 175.1 |
Fastest growth in the 75+ population
- Dukes County: +48.3% (3,033)
- Hampshire County: +38.2% (15,863)
- Franklin County: +38.1% (8,047)
- Plymouth County: +28.3% (52,959)
- Worcester County: +24.1% (70,730)
- Essex County: +22.5% (74,808)
- Barnstable County: +22.1% (39,559)
- Middlesex County: +22.0% (136,625)
- Norfolk County: +20.8% (66,457)
- Berkshire County: +20.5% (16,173)
Counties with at least 2,000 residents aged 75+.
Fewest nursing beds per 1,000 aged 85+
- Barnstable County: 168.7 (1,664 beds, 9,865 aged 85+)
- Hampshire County: 183.6 (668 beds, 3,638 aged 85+)
- Suffolk County: 191.2 (2,696 beds, 14,100 aged 85+)
- Franklin County: 193.2 (306 beds, 1,584 aged 85+)
- Norfolk County: 196.1 (3,752 beds, 19,131 aged 85+)
- Middlesex County: 226.9 (8,714 beds, 38,405 aged 85+)
- Essex County: 265.7 (5,285 beds, 19,889 aged 85+)
- Plymouth County: 272.2 (3,300 beds, 12,124 aged 85+)
- Hampden County: 280.4 (3,044 beds, 10,854 aged 85+)
- Bristol County: 299.7 (3,826 beds, 12,766 aged 85+)
Counties with at least 1,000 residents aged 85+.
HUD Section 232 construction in Massachusetts
Since fiscal 2001 HUD has insured 88 new construction or substantial rehabilitation loans on care facilities in Massachusetts (27 assisted living, 59 nursing homes), $735.3 million of original principal, 5 of them since fiscal 2016.
- FY2022: Rogerson House, Boston, assisted living, $8.1 million
- FY2021: Katzman Family Center for Living, Chelsea, nursing home, $17.6 million
- FY2021: Cadbury Commons, Cambridge, assisted living, $7 million
- FY2016: The Arbors at Taunton, Taunton, assisted living, $8 million
- FY2016: The Arbors at Amherst, Amherst, assisted living, $7.4 million
Planning a building in Massachusetts? 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.