The Largest Nursing Home Owners and Operators: An Analysis of Their Size, Network, and Overall Performance

We have gone through a close analysis of the owner and management data for nursing homes in the United States that is compiled by The Centers for Medicare & Medicaid ("CMS"). The table is supposed to provide the names of all owners and operators of US skilled nursing facilities. The data includes both the direct owners and holding companies (indirect owners). Ideally this data can allow us to trace the entire corporate hierarchy.

There are a total of 31,368 unique organizations 18,538 unique individuals in the table as of October 1, 2024. The organizations represent a mix of for-profit and non-profit organizations.

The typical organizational structure for a nursing home is to have a company (or occasionally an individual) that holds the license for the facility and either owns or leases the real estate and improvements (buildings, equipment, etc.) This initial owner is more than likely a single purpose entity, meaning it does not hold any other assets than those related to the nursing home. Multi-unit nursing home owners will then have another company (or trust) that holds the equity in the direct owner. For larger groups of nursing homes there will often be several layers of holding companies.

What is difficult is to figure out how the entities fit together. For example, Agawam West Rehab and Nursing shows 16 owners but the table does not show how the owners are related to one another nor what other owners there are in the corporate hierarchy. What we have been able to do is to pull together the network of affiliated companies through additional searching online and in regulatory filings to identify the top level holding company (which may not be shown as an owner at all). It's like we have been handed a bunch of Russian dolls with no idea which doll belongs with each other.

These are what we believe are the largest companies are the either owners or operators of nursing homes in the United States as disclosed by CMS: Genesis Healthcare Inc. , Providence Group Inc. , Life Care Centers of America, Inc. , Ensign Group , American Senior Communities , Saber Healthcare Group , Good Samaritan Society , Pruitt Health , PETERSEN HEALTH CARE and Consulate Health Care.

The table below shows each of these companies with links to their websites and aggregate data about the companies. We have tried as well to show how well the company is performing overall by showing an average of the CMS 5-Star Overall Rating, the number of homes where abuse is indicated, and the trend over the past few years.

The names of the affiliated companies for each of these groups is shown below the table along with a link to a detail page showing the home ownership. You can also see a list of the nursing home associated with each of the organizations by clicking on the company name.

Data as of: October 01, 2024