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. Among the top 10 contenders this year are the same companies as last year, with one exception: The Ensign Group, based in Mission Viejo, Calif. A newcomer to the Top 10, Ensign gained a bed count of 1,351, knocking out another California provider, Skilled Healthcare Group, from Foothill Ranch to take over the No. 10 spot.

Among the top nine slots this year were two changes: Atlanta-based SavaSeniorCare switched places with Sun Healthcare Group, Irvine, Calif., which slid down to No. 7 while Sun moved up to No. 6.

Skilled Healthcare landed in the No. 12 spot this year, just behind No. 11, Murfreesboro, Tenn.-based National HealthCare Corp.
Making their debuts in the Top 50 this year are No. 30, AdCare Health Systems, Springfield, Ohio, and Tampa-based Opis Management Resources, at No. 44.

Rehab Still Popular

Just as the addition of business such as assisted living has gained a foothold in the skilled nursing sector, so has rehabilitation therapy. And this year is no exception, as providers continue to report the addition or renovation of facilities for the purpose of adding or expanding rehab suites in order to keep up with baby boomer demand.
At least 18 providers are planning to add rehab suites to their business lines. No. 17, Alisa Viejo, Calif.-based Covenant Care, will add rehab suites, remove nurses’ stations, and add Wi-Fi and private suites as part of its renovation plans.
Miller’s Health Systems, No. 34, Warsaw, Ind., will add rehab suites and home care services to its services.
Culture change initiatives continue to take hold in the sector, with at least a dozen providers reporting that they are incorporating such endeavors. No. 29, Duluth, Minn.-based Benedictine Health System, for example, is adding “more collaborative programs to help residents stay independent and engaged as they age,” while the Evangelical Lutheran Good Samaritan Society, No. 9, Sioux Falls, S.D., is implementing consistent assignment staffing in its facilities.
In addition, many companies have plans to remove nurse stations and revamp dining programs.

Ancillary Services Steady

The list of this year’s Top 50 nursing facility companies represents more than 400,000 beds and some 3,500 facilities, and the Top 10 providers alone represent 235,000 beds.
The expansion of ancillary services, which has become a mainstay of the profession, continues. Bariatric care, which was offered by 23 companies last year, is now on the menu of services for 26 providers.
Twenty-three companies provide ventilator care in their facilities this year, compared with 20 last year. Dialysis, offered by 19 on last year’s list, compares with 18 this year.

Provider’s annual list of the Top 50 Largest Nursing Facility Companies is ranked by bed count as of Dec. 31, 2011.