Census 2025 estimates · CMS September 2026 · CDC 2020
Senior housing development in Ohio
Ohio had 1,019,613 residents aged 75 and older in July 2025, +18.2% since April 2020 (US +23.4%), and 259,049 aged 85 and older (+4.0%). Its 922 certified nursing homes hold 81,115 beds, 313.1 for every 1,000 people 85 and older, more than the US ratio of 222.6. Certificate of need for nursing home beds: yes plus moratorium; for assisted living: not listed.
- Age 75+ (2025)
- 1,019,613
- Growth since 2020
- +18.2%
- Nursing beds per 1,000 aged 85+
- 313.1
- Assisted living beds per 1,000 aged 75+
- 59.5
Demand: the older population
| Age group | April 2020 | July 2025 | Change | US change |
|---|---|---|---|---|
| 75 and older | 862,273 | 1,019,613 | +18.2% | +23.4% |
| 85 and older | 249,193 | 259,049 | +4.0% | +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) | 81,115 | 79.6 | 313.1 | CMS, September 2026 |
| Residential care / assisted living | 60,700 | 59.5 | 234.3 | 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
- Yes plus moratorium
- Assisted living
- Not listed
- Notes
- LTC bed moratorium (2019 HB 166) with exceptions
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+ |
|---|---|---|---|---|---|---|
| Cuyahoga County | 112,927 | +13.2% | 9.2% | 30,801 | 92 | 320.6 |
| Franklin County | 81,143 | +26.3% | 6% | 20,360 | 57 | 253.3 |
| Hamilton County | 63,523 | +16.5% | 7.6% | 17,390 | 69 | 382.4 |
| Summit County | 49,462 | +19.3% | 9.2% | 12,535 | 43 | 314.6 |
| Montgomery County | 47,444 | +13.7% | 8.8% | 12,282 | 40 | 352.4 |
| Stark County | 36,325 | +14.4% | 9.7% | 8,999 | 33 | 324.4 |
| Lucas County | 35,246 | +21.5% | 8.3% | 8,644 | 34 | 328.4 |
| Lorain County | 31,211 | +24.9% | 9.7% | 7,994 | 20 | 236.2 |
| Butler County | 29,044 | +22.6% | 7.3% | 7,206 | 25 | 297.5 |
| Lake County | 24,407 | +19.1% | 10.5% | 6,094 | 14 | 255.2 |
| Mahoning County | 23,425 | +10.1% | 10.4% | 6,216 | 29 | 399.8 |
| Trumbull County | 21,123 | +13.0% | 10.6% | 5,238 | 17 | 273.4 |
| Warren County | 19,282 | +28.1% | 7.5% | 4,656 | 16 | 279.4 |
| Clermont County | 18,301 | +30.9% | 8.4% | 4,384 | 15 | 297 |
| Medina County | 17,945 | +30.1% | 9.7% | 4,199 | 13 | 251.5 |
| Delaware County | 17,580 | +49.7% | 7.3% | 4,068 | 8 | 149 |
| Licking County | 15,679 | +23.3% | 8.4% | 3,802 | 10 | 256.2 |
| Greene County | 15,142 | +23.2% | 8.7% | 3,852 | 12 | 243 |
| Portage County | 14,082 | +22.6% | 8.6% | 3,289 | 10 | 273.9 |
| Fairfield County | 13,419 | +24.2% | 7.9% | 3,388 | 10 | 275.4 |
| Clark County | 13,176 | +13.3% | 9.7% | 3,372 | 13 | 352 |
| Richland County | 12,277 | +14.2% | 9.8% | 3,388 | 10 | 225.2 |
| Geauga County | 11,246 | +20.2% | 11.8% | 3,211 | 8 | 231.4 |
| Miami County | 10,765 | +22.1% | 9.6% | 2,741 | 6 | 238.6 |
| Wayne County | 10,673 | +16.6% | 9.1% | 2,700 | 14 | 373 |
Fastest growth in the 75+ population
- Delaware County: +49.7% (17,580)
- Union County: +40.1% (4,226)
- Clermont County: +30.9% (18,301)
- Medina County: +30.1% (17,945)
- Warren County: +28.1% (19,282)
- Franklin County: +26.3% (81,143)
- Lorain County: +24.9% (31,211)
- Fairfield County: +24.2% (13,419)
- Hocking County: +23.7% (2,581)
- Licking County: +23.3% (15,679)
Counties with at least 2,000 residents aged 75+.
Fewest nursing beds per 1,000 aged 85+
- Delaware County: 149 (606 beds, 4,068 aged 85+)
- Richland County: 225.2 (763 beds, 3,388 aged 85+)
- Geauga County: 231.4 (743 beds, 3,211 aged 85+)
- Lorain County: 236.2 (1,888 beds, 7,994 aged 85+)
- Miami County: 238.6 (654 beds, 2,741 aged 85+)
- Greene County: 243 (936 beds, 3,852 aged 85+)
- Ottawa County: 246.5 (283 beds, 1,148 aged 85+)
- Medina County: 251.5 (1,056 beds, 4,199 aged 85+)
- Franklin County: 253.3 (5,157 beds, 20,360 aged 85+)
- Lake County: 255.2 (1,555 beds, 6,094 aged 85+)
Counties with at least 1,000 residents aged 85+.
HUD Section 232 construction in Ohio
Since fiscal 2001 HUD has insured 67 new construction or substantial rehabilitation loans on care facilities in Ohio (18 assisted living, 48 nursing homes), $414.2 million of original principal, 7 of them since fiscal 2016.
- FY2022: Green Hills Community, West Liberty, nursing home, $8.5 million
- FY2022: Wesley Ridge, Reynoldsburg, assisted living, $9.9 million
- FY2021: Altercare Western Reserve, Stow, nursing home, $11.3 million
- FY2021: JUDSON CARE CENTER, CINCINNATI, nursing home, $6.7 million
- FY2017: Banasik - Sanctuary at Tuttle Crossing, DUBLIN, nursing home, $5.8 million
- FY2017: Parkside Village, WESTERVILLE, assisted living, $15.8 million
- FY2016: Windsor Lane Healthcare Center, Gibsonburg, nursing home, $5.3 million
Planning a building in Ohio? Model the budget, lease-up and a HUD 232 construction loan.
Open the development calculatorOther states
Alabama · Alaska · Arizona · Arkansas · California · Colorado · Connecticut · Delaware · District of Columbia · Florida · Georgia · Hawaii · Idaho · Illinois · Indiana · Iowa · Kansas · Kentucky · Louisiana · Maine · Maryland · Massachusetts · Michigan · Minnesota · Mississippi · Missouri · Montana · Nebraska · Nevada · New Hampshire · New Jersey · New Mexico · New York · North Carolina · North Dakota · Oklahoma · Oregon · Pennsylvania · Rhode Island · South Carolina · South Dakota · Tennessee · Texas · Utah · Vermont · Virginia · Washington · West Virginia · Wisconsin · Wyoming
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.