A recent study by the Employee Benefit Research Institute, for instance, found that nursing home stays among people aged 65 or older increased from 6 percent in 2000 to 8.5 percent in 2010. The problem is that those who stayed longest in nursing homes were also the poorest.

The reimbursement outlook may still be a bit shaky for nursing home providers, but this year’s Top 50 kept up a steady pace in the ranking of the 2012 Largest Nursing Facility Companies.

The expansion of ancillary services and specialty care among assisted living providers continues at a steady pace this year, with companies citing, as they did last year, an optimistic outlook for the sector.

In 2005, the Centers for Medicare & Medicaid Services (CMS) conducted a study of 1,988 residents from 40 nursing homes in five states. In that study, CMS found that 40 percent of the residents surveyed said they did not get outside as much as they wanted.

Despite, or perhaps because of, the swirl of macro-level concerns and headwinds brought on by recession-driven budget deficits and the Accountable Care Act, interest among major payers in the utility of financial incentives to align quality and value in health care purchasing refuses to recede.

While laundry might not be the first thing that comes to mind when thinking about the quality of care at a long term care facility, it does play an important role.

Occupancy rates and rents are on the upswing for the seniors housing sectors, according to the National Investment Center for the Seniors Housing & Care Industry (NIC).