LeadingAge, Ziegler Expand Largest Nonprofit Senior Housing Providers List

Industry association LeadingAge and specialty investment bank Ziegler’s list of the nation’s largest nonprofit senior housing providers grew a bit this year.

The 15th annual LeadingAge Ziegler 200 (LZ 200), published Monday, ranks the largest not-for-profit systems providing aging services through senior living in the United States, in order of total owned market-rate units, as of the end of 2017. This also marks the first year the list ranks the top 200 providers, up from 150.

The expanded list reflects LeadingAge and Ziegler’s ongoing commitment to try to capture a larger representation of the not-for-profit senior living marketplace, Ziegler Director, Senior Living Research and Development Lisa McCracken told Senior Housing News in an email.

“As the sector has grown over the years, it is meaningful to have robust data on the largest providers,” McCracken said.

The 10 largest organizations by unit count are:

1. National Senior Campuses – 19,645 units
2. The Evangelical Lutheran Good Samaritan Society – 17,343 units
3. Acts Retirement Services, Inc. – 8,370 units
4. Presbyterian Homes and Services – 7,433 units
5. Covenant Retirement Communities – 4,901 units
6. Trinity Senior Living Communities – 4,878 units
7. HumanGood – 4,704 units
8. Ascension Senior Living – 4,624 units
9. Benedictine Health – 4,602 units
10. Retirement Housing Foundation – 4,121 units

Together, these top 10 providers represent about 30% of the total number of units for all organizations in the LZ 200, the report notes. The only changes to the top 10 from last year were Livonia, Michigan-based Trinity Senior Living Communities jumping three spots to sixth place, while Benedictine Health, based in Minnesota, dropped three spots to ninth. The largest provider, National Senior Campuses, increased its portfolio by 594 units last year, while the Evangelical Lutheran Good Samaritan Society, disposed of 496 units over the same time frame.

Consolidation is now driving growth

In the last 10 years, the average annual growth rate in total units is 2.7% among providers on the list, with independent living and assisted living growth each year, but there has been a decline in the number of nursing care beds. Memory care units are becoming an increasingly important component of the annual unit counts, with 60% of the LZ 200 offering specialized memory care units. There has also been a shift in growth patterns, McCracken said.

“A number of years ago, the primary mode of growth was the development of new community locations,” she said. “That has slowed down among not-for-profits for the most part and has been replaced largely with growth through affiliations, mergers and acquisitions as well as ongoing campus expansions.”

Slightly more than one-third of the LZ 200 is engaged in some form of joint venture, either with another provider, a home health or home care agency or a health system. This consolidation trend is expected to continue for the next several years, McCracken said. And it is worth watching as groups integrate their operations, particularly the bigger providers.

“Evangelical Lutheran Good Samaritan Society has actually merged with Sanford Health, so it will be interesting to see how that integration will shape the ELGSS footprint moving forward,” McCracken said.

Written by Chuck Sudo