​This year’s line-up of the largest nursing facility companies paints a vibrant portrait of long term and post-acute care providers moving forward with business models that tout person-centered care and services despite ominous threats to Medicare and Medicaid funding.

Notwithstanding a fairly gloomy outlook, the 2011 ranking, which represents more than 396,000 beds, illustrates a sector that is ramping up ancillary services and embracing the adoption of culture change models of care.

At Your Service

This year’s survey revealed that at least 36 providers are planning to renovate buildings or add rehabilitation and specialty services, such as bariatric, dialysis, or ventilator care, while a large number of companies are bolstering their consumer-oriented amenities such as enhanced dining programs and spa-like features.
For example, Golden Living, ranked No. 2 this year, is planning to replace resident beds, room furniture, and generators, as well as add information technology and life safety improvements to its facilities.

No. 6, Sun Healthcare Group, will add rehab suites and specialty care services, in addition to upgrades such as bathing suites or spas and environmental changes to its dining areas, lobby, patient rooms, and staff lounges.

Americare, ranked No. 44 this year, is eliminating nursing stations, med carts, and overhead paging.
At least four providers indicated plans to perk up their dining services to create more restaurant-style environments—one with plans to hold a competition and another rolling out a “may I take your order” service.

Onward With Culture Change

On the culture change front, no less than 30 providers are implementing resident-centered initiatives, up from 24 last year. Plans range from shifting to all-private rooms and implementing consistent assignment staffing, erecting Green House homes or creating household models and neighborhoods. The majority of these respondents also plan to rampu up homelike amenities and environments for residents.
No. 23, Life Care Services, launched its CARES philosophy—Centered Around Resident Empowered Services—that includes homelike renovations and removing nursing stations.
Ranked No. 26, Avalon Health Care is renovating to give its facilities a “hospitality feel,” which it describes as “patient-centered and patient-driven.”
Greystone Healthcare, ranked at No. 36 this year, is building a new facility with all private rooms and baths, country kitchens, spa services, a bistro, wireless Internet access, and mobility gardens, among other things.

Expanding Ancillary Services

The provision of ancillary services continues its upward trend this year. Hospice care is now offered by 36 of the largest 50 companies, compared with 31 last year.
Home care has gained in popularity this year, with 31 companies now offering it—a jump of eight slots.
Among this year’s survey respondents, 19 provide dialysis, 20 ventilator, and 23 offer bariatric services to their residents.
Debuting on the list this year are several mid-sized providers with bed counts of 5,000 or less. Southfield, Mich.-based Ciena Healthcare is a first-timer with 4,142 beds and growing, at No. 25.
Avalon Health Care, based in Salt Lake City, Utah, placed at No. 26 with just over 4,000 beds. Management company iCare, based in Manchester, Conn., with 1,353 beds, lands on the list at No. 48, while No. 41, Roanoke, Va.-based American HealthCare makes the list with a bed count of 1,880.
Making the most notable leap in the ranking this year was Trilogy Health Services, which vaulted from No. 28 last year to No. 17 this year, with a bed count boost of 3,228
Provider’s annual list of the Top 50 largest nursing facility companies, which are ranked by bed count, as of Dec. 31, 2010.