The number of licensed nursing home beds and facilities has steadily declined in New York, reflecting a broader trend across the country.

There have been 24 nursing home closures in the state since 2020, or a loss of more than 3,000 licensed beds, according to a report in the New York Times. As for operators still in the state like ArchCare, capacity is shrinking in addition to closures, with one facility in the Bronx seeing available beds drop from 120 to 53; nonprofit operator ArchCare has plans to reduce beds even further at this location.

ArchCare’s footprint has 269 fewer usable beds compared to a year and a half ago, NYT reported, a 12% decline for the operator.

On the national stage, the number of nursing homes has fallen by more than 900 between 2015 and 2025, according to data collected by the Centers for Medicare and Medicaid Services (CMS).

The meaningful number to look at when discussing bed capacity is the number of beds that are available depending on a facility’s staffing and other factors, NYT reported. That number is lower than the number of licensed beds and continues to sink, with almost half of nursing homes limiting admissions and 57% creating waitlists for new residents, according to a 2024 report from the American Health Care Association (AHCA).

David Grabowski, health policy researcher at Harvard Medical School, told the NYT that bed capacity is a serious problem that is “heading in the wrong direction.” Grabowski was author in a JAMA Internal Medicine study that found a 5% decrease in national nursing home capacity from 2019 to 2024.

Looking at the demographics, Trump administration policies on immigration and Medicaid financing, as well as workforce challenges, the situation might get “maybe a lot worse,” Grabowski said, referring to the oldest baby boomers turning 80 this year, an age when the need for nursing home care rises drastically.

The administration revoked legal status for certain immigrant groups, and it’s being felt in specific states, including New York, Florida and Massachusetts. Policy ideas are circulating, NYT noted, including special visas for immigrant health workers and targeted grants for nursing homes serving high-cost populations.

It’s possible that tighter nursing home access could be balanced somewhat by diverting patients to alternative care settings like home and community-based services (HCBS), and by patient preference to stay out of a nursing home, according to the report. But more than $900 billion in cuts to Medicaid could mean HCBS takes a greater hit than institutional care, putting the pressure back on nursing homes to increase bed capacity.

“So much of this is speculative,” KFF senior policy manager Priya Chidambaram told NYT regarding Medicaid and how changes might affect access issues. “We don’t know what states will decide. We don’t know how the market will react. We’re in new territory here.”