Hospitals and health systems proactively prescreen providers for quality outcomes. What’s more, if you haven’t heard from the hospital and health systems in your area, you should be concerned.

Gov. Mark Parkinson, president and chief executive officer of the American Health Care Association (AHCA), says he’s not sure how much longer interest rates will be so favorable and that providers could save a lot of money if they refinance properly.

This year’s lineup represents a resident capacity of more than 240,000 and more than 2,900 buildings.

This year’s Top 10 looks quite different from the preceding seven years or so, as Genesis HealthCare lands the No. 1 spot, having purchased Sun Healthcare Group (No. 7 in 2012) last year.

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.