<p>Aging in place (AIP), supported by home and community-based services (HCBS), has become a dominant global strategy for addressing the challenges of geriatric care. However, empirical evidence supporting the long-term adaptability of HCBS allocation to actual service demand remains scarce. To address this gap, this study analyzed 9586 observations of urban adults aged ≥60 years across the 2016, 2018, and 2020 waves of the China Longitudinal Aging Social Survey (CLASS). Descriptive statistics and Markov transition matrices were employed to examine utilization intentions and their evolution over time, while age-stratified differences (60–74 vs. ≥75 years) were assessed using statistical tests. Within a social-ecological systems framework, generalized linear mixed models and logistic regression analyses were applied to quantify predictors of both intentions and their dynamics. Results indicate that: (1) Intentions to utilize HCBS increased over the five-year period, although the majority of older adults maintained without such intentions; older adults aged ≥75 years exhibited stronger perceived intentions for healthcare services and a higher likelihood of maintaining such intentions compared with those aged 60–74 years. (2) HCBS utilization intentions demonstrated significant temporal continuity; older adults aged 75–84 years, living in intergenerational households, with fewer living sons, or residing in eastern China, were more likely to maintain their perceived intentions for healthcare services, while those with multiple chronic conditions, higher educational attainment, or residence in eastern China were more likely to maintain their effective intentions for eldercare services. These findings provide data-driven insights for optimizing HCBS planning, enabling a more responsive service supply, and establishing a foundation for societies that promote greater well-being.</p>