Residents are older, sicker, and more compromised by impairments than in the past: 55 percent are 85 and older, 77 percent require help with bathing, 69 percent with walking and 49 percent with toileting, according to data from the National Center for Health Statistics.

Also, more than half of residents have high blood pressure, and a third or more have heart disease or arthritis. Thirty-one percent have been diagnosed with depression, at least 11 percent have a serious mental illness, and 42 percent have dementia or moderate-to-severe cognitive impairment.