Census 2025 estimates · CMS September 2026 · CDC 2020
Senior housing development in Montana
Montana had 106,575 residents aged 75 and older in July 2025, +27.8% since April 2020 (US +23.4%), and 24,810 aged 85 and older (+13.2%). Its 61 certified nursing homes hold 4,997 beds, 201.4 for every 1,000 people 85 and older, fewer than the US ratio of 222.6. Certificate of need for nursing home beds: yes (ltc only); for assisted living: not listed.
- Age 75+ (2025)
- 106,575
- Growth since 2020
- +27.8%
- Nursing beds per 1,000 aged 85+
- 201.4
- Assisted living beds per 1,000 aged 75+
- 55.4
Demand: the older population
| Age group | April 2020 | July 2025 | Change | US change |
|---|---|---|---|---|
| 75 and older | 83,385 | 106,575 | +27.8% | +23.4% |
| 85 and older | 21,920 | 24,810 | +13.2% | +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) | 4,997 | 46.9 | 201.4 | CMS, September 2026 |
| Residential care / assisted living | 5,900 | 55.4 | 237.8 | 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 (LTC only)
- Assisted living
- Not listed
- Notes
- 2021 HB 231 limited CON "to only include oversight of long-term care facilities and swing beds"
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+ |
|---|---|---|---|---|---|---|
| Yellowstone County | 14,941 | +24.2% | 8.7% | 3,893 | 7 | 229.6 |
| Flathead County | 11,169 | +33.4% | 9.7% | 2,606 | 6 | 234.1 |
| Missoula County | 10,347 | +37.8% | 8.4% | 2,214 | 3 | 143.6 |
| Gallatin County | 7,838 | +39.5% | 6.1% | 1,749 | 1 | 39.5 |
| Cascade County | 7,771 | +12.1% | 9.1% | 2,029 | 4 | 165.1 |
| Lewis and Clark County | 6,793 | +36.7% | 9% | 1,378 | 2 | 143.7 |
| Ravalli County | 6,358 | +30.0% | 13.1% | 1,421 | 2 | 76 |
| Lake County | 3,870 | +29.4% | 11.6% | 832 | 2 | 174.3 |
| Silver Bow County | 3,439 | +16.7% | 9.5% | 804 | 4 | 558.5 |
| Lincoln County | 2,931 | +31.4% | 13.1% | 632 | 2 | 237.3 |
| Sanders County | 2,135 | +38.4% | 15.2% | 423 | 2 | 160.8 |
| Park County | 1,869 | +31.8% | 10.3% | 415 | 1 | 277.1 |
| Fergus County | 1,469 | +16.2% | 12.4% | 359 | 2 | 607.2 |
| Carbon County | 1,440 | +50.5% | 12.6% | 331 | 0 | 0 |
| Jefferson County | 1,358 | +48.9% | 10.2% | 235 | 1 | 297.9 |
| Madison County | 1,297 | +39.6% | 12.9% | 262 | 2 | 271 |
| Hill County | 1,212 | +23.3% | 7.5% | 277 | 1 | 487.4 |
| Custer County | 1,196 | +19.4% | 9.9% | 327 | 1 | 256.9 |
| Deer Lodge County | 1,191 | +30.9% | 12.3% | 279 | 1 | 222.2 |
| Stillwater County | 1,093 | +39.4% | 11.6% | 218 | 1 | 0 |
| Beaverhead County | 1,083 | +16.1% | 10.8% | 231 | 1 | 376.6 |
| Richland County | 854 | +21.0% | 7.5% | 260 | 1 | 357.7 |
| Broadwater County | 830 | +48.5% | 9.8% | 130 | 0 | 0 |
| Valley County | 821 | +7.7% | 11.1% | 235 | 1 | 408.5 |
| Dawson County | 808 | +5.3% | 9.3% | 221 | 2 | 524.9 |
Fastest growth in the 75+ population
- Gallatin County: +39.5% (7,838)
- Sanders County: +38.4% (2,135)
- Missoula County: +37.8% (10,347)
- Lewis and Clark County: +36.7% (6,793)
- Flathead County: +33.4% (11,169)
- Lincoln County: +31.4% (2,931)
- Ravalli County: +30.0% (6,358)
- Lake County: +29.4% (3,870)
- Yellowstone County: +24.2% (14,941)
- Silver Bow County: +16.7% (3,439)
Counties with at least 2,000 residents aged 75+.
Fewest nursing beds per 1,000 aged 85+
- Gallatin County: 39.5 (69 beds, 1,749 aged 85+)
- Ravalli County: 76 (108 beds, 1,421 aged 85+)
- Missoula County: 143.6 (318 beds, 2,214 aged 85+)
- Lewis and Clark County: 143.7 (198 beds, 1,378 aged 85+)
- Cascade County: 165.1 (335 beds, 2,029 aged 85+)
- Yellowstone County: 229.6 (894 beds, 3,893 aged 85+)
- Flathead County: 234.1 (610 beds, 2,606 aged 85+)
Counties with at least 1,000 residents aged 85+.
HUD Section 232 construction in Montana
Since fiscal 2001 HUD has insured 2 new construction or substantial rehabilitation loans on care facilities in Montana (0 assisted living, 2 nursing homes), $13 million of original principal.
Planning a building in Montana? 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.