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 2010 Top 40

A Bright Spot


While economists declared the worst recession in the United States since the Great Depression over in September 2009, there was continuing financial uncertainty for consumers as unemployment remained high. Yet, the assisted living industry seemed to be a bright spot in the seniors housing and traditional real estate sectors. During 2009, seniors had a hard time selling off their homes, and the assisted living overall occupancy rate dropped to 88 percent, a decrease from the highest occupancy rate of 91 percent in 2006, according to the National Investment Center for Seniors Housing and Care. The recession swallowed economic growth for 2008 and most of 2009.

Slots Juggled Slightly

Provider magazine’s 2010 ranking of the Top 40 Assisted Living Companies​ reveals that Emeritus holds the No. 1 position. During 2009, the company grew its assisted living operations by two facilities and a total occupant capacity of 300. For next year’s survey, Emeritus is poised to grow significantly if approved to acquire 149 Sunwest Management communities through a joint venture.

Sunrise Senior Living takes the No. 2 position despite still struggling to meet its debt obligations and just 200 more in occupant capacity. Brentwood, Tenn.-based Brookdale Senior Living earned the No. 3 spot after expanding its operations by 29 more assisted living communities with a capacity for 8,112 residents. During fourth quarter, Brookdale purchased 18 Sunrise Senior Living communities for $190 million, and the company now operates communities in 35 states. Not participating this year is Atria Senior Living Group, which last year held the No. 4 spot and likely would have maintained it this year.

Atria’s absence earns Five Star Quality the No. 4 spot. Continuing its steady growth of the past three years, Five Star reported opening 10 new assisted living communities and one continuing care retirement community that offers assisted living, skilled nursing, and independent living during 2009.

In the No. 5 spot is Assisted Living Concepts, which reported operating 211 communities, down from 216 communities in 2008. No. 6 is Merrill Gardens, which reported operating 56 communities, with a total occupant capacity of 7,462 and an occupancy rate of 93 percent. HCR ManorCare, at No. 7, operated 65 communities with assisted living services with an occupant capacity of 5,084 residents. The No. 8 position is One Eighty-Leisure Care, with 31 communities operating in seven states with a total occupant capacity of 5,000.

Completing the 10 largest assisted living chains is Benchmark Assisted Living and Hearthstone Senior Services, holding the Nos. 9 and 10 spots, respectively.

​Modest Uptick In Servic​​​es

On the services side, 39 of this year’s top 40 companies offer Alzheimer’s care in their facilities, compared with 37 last year.

The provision of independent living units is up this year by one—33 companies compared with 32 last year. This ancillary business has trended upward for several years in a row, and three companies reported plans to add independent living units in the coming year.

​Assisted living providers reported some notable responses to a new question on the survey about culture change initiatives. Six companies will implement resident-centered programs that create more “homelike environments” for residents. One large company plans to make “leadership changes to improve results,” while another company is in the process of installing a proprietary program that “integrates nutrition, mental and physical fitness, spiritual needs, and medication support.”

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