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 31,415 unique organizations 18,448 unique individuals in the table as of November 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: Providence Group Inc. , Genesis Healthcare 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: November 01, 2024
Providence Group Inc.
Not public
No. of homes: 251
No. of beds: 29,174
Homes with possible abuse: 26 		Avg. Rating: 2.62
Avg. Nursing Hours: 3.74
Worst Overall Rating: 1
Best Overall Rating: 5
Genesis Healthcare Inc.
Public, ticker: GENN
No. of homes: 246
No. of beds: 28,578
Homes with possible abuse: 23 		Avg. Rating: 2.49
Avg. Nursing Hours: 3.47
Worst Overall Rating: 1
Best Overall Rating: 5
Life Care Centers of America, Inc.
Not public
No. of homes: 243
No. of beds: 31,773
Homes with possible abuse: 17 		Avg. Rating: 3.00
Avg. Nursing Hours: 3.61
Worst Overall Rating: 1
Best Overall Rating: 5
Ensign Group
Public, ticker: ENSG
No. of homes: 193
No. of beds: 20,039
Homes with possible abuse: 7 		Avg. Rating: 3.45
Avg. Nursing Hours: 3.92
Worst Overall Rating: 1
Best Overall Rating: 5
American Senior Communities
Not public
No. of homes: 186
No. of beds: 18,112
Homes with possible abuse: 14 		Avg. Rating: 2.80
Avg. Nursing Hours: 3.53
Worst Overall Rating: 1
Best Overall Rating: 5
Saber Healthcare Group
Not public
No. of homes: 125
No. of beds: 13,391
Homes with possible abuse: 9 		Avg. Rating: 2.63
Avg. Nursing Hours: 3.34
Worst Overall Rating: 1
Best Overall Rating: 5
Good Samaritan Society
Not public
No. of homes: 113
No. of beds: 7,730
Homes with possible abuse: 6 		Avg. Rating: 2.89
Avg. Nursing Hours: 3.63
Worst Overall Rating: 1
Best Overall Rating: 5
Pruitt Health
Not public
No. of homes: 89
No. of beds: 9,743
Homes with possible abuse: 7 		Avg. Rating: 2.65
Avg. Nursing Hours: 3.23
Worst Overall Rating: 1
Best Overall Rating: 5
PETERSEN HEALTH CARE
Not public
No. of homes: 60
No. of beds: 5,319
Homes with possible abuse: 22 		Avg. Rating: 1.65
Avg. Nursing Hours: 3.03
Worst Overall Rating: 1
Best Overall Rating: 4
Consulate Health Care
Not public
No. of homes: 50
No. of beds: 5,293
Homes with possible abuse: 6 		Avg. Rating: 1.98
Avg. Nursing Hours: 3.10
Worst Overall Rating: 1
Best Overall Rating: 5

Below are the companies associated with each of the groups:

Providence Group Inc.
Genesis Healthcare Inc.
Life Care Centers of America, Inc.
Ensign Group
American Senior Communities
Saber Healthcare Group
Good Samaritan Society
Pruitt Health
PETERSEN HEALTH CARE
Consulate Health Care

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