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Original research

America’s Residential Treatment Capacity Gap

A state-by-state analysis of residential rehab beds, facilities and utilization. A Treatment Locators analysis of 2024 federal treatment-facility data and U.S. Census population estimates found a more than nine-fold difference between the states with the highest and lowest reported numbers of designated residential treatment beds per capita.

Research & analysis by Treatment Locators · Published September 13, 2026 · Source: SAMHSA 2024 N-SUMHSS detailed tables · Methodology & sources

75.63

Highest reported beds per 100,000 residents (Kentucky)

3,470 designated beds across 97 facilities

8.09

Lowest reported beds per 100,000 residents (South Carolina)

443 designated beds across 14 facilities

85.1%

National reported residential utilization

78,216 clients · 91,875 designated beds

These figures describe reported treatment capacity and utilization. They do not show real-time bed availability, and they are not proof of unmet treatment need.

Download the state datasetJump to the full table
Data analysis by Treatment Locators · Reviewed for clinical accuracy by Cole Timonere

Section 1 · Key findings

A nine-fold spread in reported residential capacity

Nationally, SAMHSA reported 91,875 designated residential beds across 2,852 facilities reporting bed-capacity data, with 78,216 residential clients and 85.1% reported utilization. Underneath that national picture, states differ sharply.

National benchmark · 2024

SAMHSA N-SUMHSS detailed tables

91,875
Designated residential beds reported
2,852
Facilities reporting bed data
78,216
Residential clients on the survey date
27.01
National beds per 100,000 residents
National reported utilization85.1%

Clients on the survey date as a share of designated residential beds. The track ends at 100% of reported designated beds.

Finding 01

Kentucky

75.63

beds per 100k

Kentucky reported the highest residential bed capacity per capita among states with reportable bed data — 3,470 designated beds across 97 facilities.

Finding 02

South Carolina

8.09

beds per 100k

South Carolina reported the lowest — roughly 9.35× below Kentucky, with 443 designated beds across 14 facilities.

  1. Virginia combined relatively low reported capacity, about 10.13 beds per 100,000, with 98.1% reported utilization.

  2. Wisconsin reported about 15.38 beds per 100,000 and 121.4% utilization; Washington reported about 18.02 and 95.1%.

  3. Utilization above 100% is possible under SAMHSA's methodology because some clients may occupy beds that were not reported as designated residential treatment beds.

  4. Bed counts alone do not tell the full story: several states with comparatively high per-capita capacity also reported very high utilization.

Interactive · 51 states and D.C.

Reported residential capacity, state by state

Designated residential treatment beds per 100,000 residents, as reported to SAMHSA in 2024

Map of the United States shaded by designated residential treatment beds per 100,000 residents, as reported to samhsa in 2024. Select a state to open its treatment directory.VTNHMARICTNJDEMDDC

Leanest reported capacity

  1. 1South Carolina8.09 per 100k
  2. 2District of Columbia8.54 per 100k
  3. 3Virginia10.13 per 100k
  4. 4Idaho10.69 per 100k
  5. 5Texas13.89 per 100k

Hover or tab any state to read its reported figures. Small northeastern states are boxed beside the map. Vermont has no reportable bed data in the 2024 table.

Beds per 100k

More reported bedsFewer reported beds

Explainer · Reading the benchmark

What 27.01 beds per 100,000 actually means

The national line, and five states suspended around it

Distance from the line is the difference from the national figure, not a measure of need. Kentucky reported the highest per-capita figure at 75.63; South Carolina reported the lowest at 8.09. A per-capita rate compares states of different sizes — it does not describe how many beds were open on any given day.

Section 2 · Per-capita rankings

States with the most and fewest reported residential beds per capita

A state can have a large absolute number of treatment beds simply because it has a large population. Per-capita comparisons provide a better way to examine how much reported residential capacity exists relative to the number of people living in each state.

Highest reported capacity

Kentucky

75.63

beds per 100,000 residents

national

3,470 designated beds · 97 facilities reporting · 69.5% reported utilization

9.35×

difference in reported beds per capita

Lowest reported capacity

South Carolina

8.09

beds per 100,000 residents

national

443 designated beds · 14 facilities reporting · 90.7% reported utilization

Bars are drawn to the same scale; the hairline marks the national figure of 27.01 beds per 100,000 residents. Among states with reportable 2024 data. Reported capacity is not the same as an available bed.

9.35×

The two poles above are the extremes. The ranked boards below place every other reportable state between them, against the same national reference line.

Ten highest reported capacity

Designated residential beds per 100,000 residents, 2024.

  1. 1Kentucky75.63
  2. 2West Virginia71.58
  3. 3Wyoming71.48
  4. 4Maryland58.52
  5. 5Utah55.60
  6. 6Alaska50.13
  7. 7Minnesota47.80
  8. 8Pennsylvania45.52
  9. 9Massachusetts45.19
  10. 10Louisiana42.67

Hairline = national 27.01 per 100k

Ten lowest reported capacity

States with reportable bed data only. Vermont is excluded — see methodology.

  1. 1South Carolina8.09
  2. 2District of Columbia8.54
  3. 3Virginia10.13
  4. 4Idaho10.69
  5. 5Texas13.89
  6. 6Wisconsin15.38
  7. 7Georgia17.69
  8. 8Delaware17.78
  9. 9Washington18.02
  10. 10Nevada18.61

Hairline = national 27.01 per 100k

What it means

Kentucky’s reported residential bed capacity per capita was approximately 9.35 times South Carolina’s.

This does not establish that South Carolina has a treatment-bed shortage or that Kentucky has excess capacity, and these figures are not measures of treatment quality. Capacity can still be affected by geography, insurance participation, clinical eligibility, program specialization and whether beds are actually available when a person seeks care.

Explainer · Same population, different capacity

Two states of nearly identical size, reporting very different capacity

Maryland and Missouri have populations within roughly 17,754 residents of each other, which removes state size from the comparison.

Maryland

Population
6,263,220
Designated residential beds
3,665
Beds per 100,000
58.52
Reported utilization
84.3%

Beds per 100,000, scaled against the highest reported state

Missouri

Population
6,245,466
Designated residential beds
1,178
Beds per 100,000
18.86
Reported utilization
100.9%

Beds per 100,000, scaled against the highest reported state

Same population, different reported supply — and the state reporting fewer beds per capita reported them being used more heavily on the survey date. Neither figure measures whether a bed was available for admission.

Section 3 · Capacity and utilization together

Where low reported capacity coincides with high utilization

Capacity and utilization become more informative when viewed together. Several states combined relatively limited reported residential bed capacity with high reported utilization.

Four states, one baseline

Capacity bars scale against the highest reported state; gauges scale against the highest reported utilization

South Carolina

14 facilities reporting

8.09

beds per 100k

90.7%

reported utilization

The lowest reported per-capita capacity in the dataset, paired with heavy reported use of the beds facilities did report.

Virginia

27 facilities reporting

10.13

beds per 100k

98.1%

reported utilization

Near the bottom for reported beds per capita, with reported utilization well above the national figure.

Wisconsin

35 facilities reporting

15.38

beds per 100k

121.4%

reported utilization

Mid-range reported capacity, but reported clients nearly match the designated beds facilities reported.

Washington

52 facilities reporting

18.02

beds per 100k

95.1%

reported utilization

Comparatively lean reported capacity for its population, with high reported utilization on the survey date.

What it means

These states are worth watching because their reported residential systems appear comparatively lean relative to population while the reported beds are also being used at high rates.

That pattern is not proof of unmet demand. It is better understood as a signal that capacity and utilization should be considered together rather than treating bed counts as a stand-alone measure of access.

Section 4 · Reported utilization

States with the highest reported residential utilization

SAMHSA's residential utilization measure compares the number of residential clients on the survey date with the number of designated residential beds reported by facilities.

Ten highest reported utilization

Residential clients as a share of designated residential beds, 2024.

  1. 1Mississippi207.0%
  2. 2New Mexico133.7%
  3. 3Oklahoma129.7%
  4. 4Wisconsin121.4%
  5. 5Massachusetts113.3%
  6. 6Minnesota102.0%
  7. 7Missouri100.9%
  8. 8Virginia98.1%
  9. 9Rhode Island96.0%
  10. 10Colorado95.4%

7

states reported utilization above 100%

85.1%

national reported utilization

The hairline on each bar marks 100% of the designated beds a state’s facilities reported.

Reported capacity against reported utilization

Each point is one state with reportable 2024 bed and client data.

Scatter plot of designated residential beds per 100,000 residents against reported residential utilization for each state with reportable 2024 data.0%25%50%75%100%125%150%175%200%225%020406080Designated residential beds per 100,000 residentsKYMAMNMSSCTXVAWI
Hover or tab a point to read a state. The dashed line marks 100% reported utilization; values above it are possible because clients may occupy beds not reported as designated residential treatment beds.

Figures above 100% require explanation. SAMHSA notes that residential clients can occupy non-designated beds, so a utilization rate greater than 100% should not be interpreted as a mathematical error or as literal proof that designated beds were physically overfilled.

What it means

High reported capacity does not necessarily mean low reported utilization.

Minnesota reported approximately 47.8 residential beds per 100,000 residents and 102% utilization. Massachusetts reported approximately 45.19 beds per 100,000 and 113.3%. A state may have comparatively more treatment infrastructure and still show substantial use of that capacity.

Explainer · Four ways states can differ

Capacity and utilization can move independently

Reading the two measures as a pair produces four patterns. Reference points are the national figures: 27.01 beds per 100,000 residents and 85.1% reported utilization.

Higher capacity · higher utilization

More reported beds relative to population, and heavy reported use of those beds on the survey date.

Minnesota

Comparatively deep reported supply, reported clients at or above the designated beds.

47.8

beds / 100k

102%

utilization

Massachusetts

High reported capacity with reported utilization above 100%.

45.19

beds / 100k

113.3%

utilization

Higher capacity · lower utilization

More reported beds relative to population, with reported use below the national figure on the survey date.

Kentucky

The highest reported per-capita capacity, with reported use below the national rate.

75.63

beds / 100k

69.5%

utilization

Louisiana

Well above the national bed rate, with lower reported utilization.

42.67

beds / 100k

70.6%

utilization

Lower capacity · higher utilization

Fewer reported beds relative to population, and the reported beds were used heavily on the survey date.

Virginia

Near the bottom for reported beds per capita, with high reported use.

10.13

beds / 100k

98.1%

utilization

South Carolina

The lowest reported per-capita capacity, with reported use above the national rate.

8.09

beds / 100k

90.7%

utilization

Lower capacity · lower utilization

Fewer reported beds relative to population, and lower reported use of those beds on the survey date.

Texas

A low reported bed rate for its population, with reported use below the national figure.

13.89

beds / 100k

66.1%

utilization

Idaho

Among the leanest reported bed rates, with lower reported utilization.

10.69

beds / 100k

67.8%

utilization

These groupings are descriptive only. A state appearing in any quadrant is not evidence of a shortage, surplus, or of how easily a person could enter care there.

Section 5 · Definitions

What residential treatment capacity measures

Residential treatment provides live-in substance use treatment outside a hospital setting. Depending on the program, residential services may include structured treatment, counseling, recovery support and other services delivered while a person resides at the facility.

  1. Step 1

    Designated residential beds

    The number of beds facilities reported as designated for residential substance use treatment.

    91,875

    beds reported nationally, 2024

  2. Step 2

    Facilities reporting bed data

    The number of treatment facilities included in SAMHSA's residential capacity table.

    2,852

    facilities in the capacity table

  3. Step 3

    Residential utilization

    Residential clients reported on the survey date compared with designated residential beds.

    85.1%

    78,216 clients on the survey date

Read left to right: facilities report designated beds, those reports define the measured supply, and utilization compares clients on the survey date with that reported supply.

None of these measures show whether a specific bed was available for admission on a particular day. Raw facility and bed counts also tend to favor large states, which is why this analysis reports designated beds per 100,000 residents alongside the totals.

What per-capita capacity still leaves out

  • distance to the nearest appropriate program;
  • insurance participation and network status;
  • admission criteria;
  • the availability of specialized care;
  • the mix of short-term and long-term residential programs;
  • co-occurring mental-health treatment capabilities; and
  • real-time bed availability.

Explainer · One layer of many

Capacity is only one layer of access

This report measures the first layer only. More reported beds does not automatically mean treatment is easier to reach, because several other layers sit between a reported bed and a person entering care.

  1. Physical capacity

    Measured here

    Designated residential beds and the facilities that reported them. This is the layer this analysis measures.

  2. Insurance access

    Not measured here

    Whether a program participates in a person's plan, and what the plan pays for. Facility-reported payment data is covered in a separate Treatment Locators analysis.

  3. Clinical fit

    Not measured here

    Whether a program's level of care, admission criteria and specialties — including co-occurring mental-health care — match an individual's clinical needs.

  4. Geographic access

    Not measured here

    Distance and travel to the nearest appropriate program, which per-capita state figures cannot describe.

  5. Real-time availability

    Not measured here

    Whether a designated bed is actually open on the day a person seeks admission. No figure on this page describes real-time openings.

For a separate analysis of payment and payer participation, see the Treatment Locators Addiction Treatment & Insurance Access in America research. For withdrawal-management availability, see the Detox Access Gap analysis. Plain-language guides to these settings are available for residential rehab, inpatient rehab and medical detox. For how commercial plans handle these levels of care, see the insurance coverage guides.

Section 6 · Full dataset

State-by-state residential treatment capacity

Every state and the District of Columbia, sortable by population, facilities reporting bed data, residential clients, designated beds, beds per 100,000 residents and reported utilization.

Full dataset

Every state and D.C., 51 rows

Reported residential substance use treatment capacity by U.S. state and the District of Columbia, 2024
#
1KentuckyKY4,588,372972,4133,47075.6369.5%
2West VirginiaWV1,769,979351,1311,26771.5889.3%
3WyomingWY587,6181435442071.4884.3%
4MarylandMD6,263,2201143,0883,66558.5284.3%
5UtahUT3,503,613611,4821,94855.6076.1%
6AlaskaAK740,1331826537150.1371.4%
7MinnesotaMN5,793,151902,8252,76947.80102.0%
8PennsylvaniaPA13,078,7511234,3665,95345.5273.3%
9MassachusettsMA7,136,171983,6543,22545.19113.3%
10LouisianaLA4,597,740411,3861,96242.6770.6%
11NebraskaNE2,005,4653467776238.0088.8%
12North DakotaND796,5681824230237.9180.1%
13South DakotaSD924,6691327631333.8588.2%
14New JerseyNJ9,500,851542,7163,12032.8487.1%
15ArizonaAZ7,582,384891,7862,24029.5479.7%
16OregonOR4,272,371399951,23128.8180.8%
17IndianaIN6,924,275621,5841,97128.4780.4%
18CaliforniaCA39,431,2635149,48111,19528.3984.7%
19MississippiMS2,943,045231,69581927.83207.0%
20MichiganMI10,140,459622,1722,77327.3578.3%
21HawaiiHI1,446,1461228639427.2472.6%
22KansasKS2,970,6062468780727.1785.1%
23IowaIA3,241,4883160388027.1568.5%
24OhioOH11,883,304972,5743,16626.6481.3%
25New YorkNY19,867,2481493,9445,07325.5377.7%
26New MexicoNM2,130,2561770652824.79133.7%
27Rhode IslandRI1,112,3081126427524.7296.0%
28TennesseeTN7,227,750501,3601,75924.3477.3%
29North CarolinaNC11,046,024642,0622,66824.1577.3%
30FloridaFL23,372,2151474,5635,54323.7282.3%
31ColoradoCO5,957,493431,2511,31222.0295.4%
32ConnecticutCT3,675,0693071080421.8888.3%
33IllinoisIL12,710,158822,1802,70221.2680.7%
34MaineME1,405,0121524729220.7884.6%
35New HampshireNH1,409,0321024028620.3083.9%
36MontanaMT1,137,233916423020.2271.3%
37OklahomaOK4,095,393221,07482820.22129.7%
38AlabamaAL5,157,699258771,03520.0784.7%
39ArkansasAR3,088,3542134559719.3357.8%
40MissouriMO6,245,466391,1891,17818.86100.9%
41NevadaNV3,267,4671935660818.6158.6%
42WashingtonWA7,958,180521,3641,43418.0295.1%
43DelawareDE1,051,917614518717.7877.5%
44GeorgiaGA11,180,878681,5451,97817.6978.1%
45WisconsinWI5,960,975351,11391715.38121.4%
46TexasTX31,290,831882,8734,34713.8966.1%
47IdahoID2,001,6191014521410.6967.8%
48VirginiaVA8,811,1952787689310.1398.1%
49District of ColumbiaDC702,250239608.5465.0%
50South CarolinaSC5,478,831144024438.0990.7%
51VermontVT648,4930————
Showing all 51 rows. Click any column to sort; state names link through to the full directory. Em dashes mark figures SAMHSA does not report.More reported beds per capitaFewer

Vermont

Vermont is not assigned a numerical residential bed-capacity rank in this analysis. SAMHSA’s 2024 residential capacity table does not provide reportable residential bed or client capacity data for Vermont. Treating missing reportable capacity data as proof of zero treatment beds would overstate what the federal dataset establishes.

Appendix · Methodology

How we calculated this

Every figure on this page is reproducible from SAMHSA's 2024 N-SUMHSS published detailed tables and U.S. Census Bureau population estimates.

Publication utility

Republish this analysis

Charts, figures and the dataset on this page are published under a Creative Commons Attribution 4.0 licence. Attribute Treatment Locators and link to this page.

Treatment Locators. “America’s Residential Treatment Capacity Gap.” Analysis of SAMHSA 2024 N-SUMHSS detailed tables and U.S. Census Bureau Vintage 2024 population estimates. https://treatmentlocators.com/research/residential-treatment-capacity

State residential capacity (CSV)

Cole Timonere

Headshot of Cole Timonere

Medically reviewed by Cole Timonere, PhD, JD, LMHC, LPCC

Licensed mental health and clinical counselor with doctoral and legal training, specializing in substance use disorders, withdrawal management, and behavioral health care. Reviews the clinical accuracy of the treatment guides on this site.

Editorial content — always confirm clinical details with a licensed provider.

Questions

Frequently asked questions

Explore the treatment directory

Treatment Locators publishes SAMHSA-listed facilities by state and city, alongside plain guides to levels of care. Listings reflect what facilities report to SAMHSA and do not confirm bed availability, coverage or admission.

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