Assisted living remains a robust but ever-changing venture. This year some familiar names recede in the face of three mergers and acquisitions. Emeritis Corp. merged with No. 1 Brookdale Senior Living, hoisting Atria Senior Living and Sunrise Senior Living to No. 3 and No. 2, respectively. Gardant Management Solutions hopped onto the list at No. 16 this year after gobbling up BMA Management Services, which held the No. 16 spot last year.
Lastly, Genesis Healthcare, ranked No. 12 last year and now dipped slightly to No. 13, acquired Skilled Healthcare Group, which held the No. 34 spot in 2014.
With its merger to Emeritus, No. 1 assisted living center Brookdale Senior Living doubled its occupant capacity this year, from 34,513 to 72,577. Yet a wide range remains between the top three facilities, which weigh in at the tens of thousands, to the bottom three facilities, which remain in the hundreds.

What The Numbers Mean

Companies are offering more programs to cater to the variety of residents who enter their facilities. All 40 of this year’s lineup offer dementia care programs, just as they did the previous two years. Most facilities (36) also provide independent living. Nursing home and post-acute care are also being included in more than half of the lineup.

The numbers then dip for services such as outpatient rehabilitation therapy, down to 18 from last year’s 20 offering the service. Hospice is offered by 15 businesses (down from 19). Home care remains for the second year in a row at 14.

Bariatric services are offered by 11 of the Top 40 this year, the same as the previous year. More businesses are also providing dialysis (six) and ventilators (eight).

Payment Plans

Among the companies that reported their revenue sources, most receive private-pay funding. There has been an uptick of funding from Medicaid, comprising from 2 percent up to 67 percent of a company’s total revenue, as 22 organizations accept this form of payment, up from 21 last year. Supplemental security income and other funding sources also saw an increase, from a combined total of five companies in 2014 to eight this year.

Pending Plans

Among its plans, No. 5, Five Star Senior Living, intends to brand a training program, “Putting People First,” and use it for all its employees.

Many companies plan to renovate and refurbish their communities to create more homelike environments, such as the removal of nurse stations and the addition of WiFi access, Internet cafes, laundry and housekeeping, and gourmet dining.

No. 18, Americare, exchanged its med carts for medicine cabinets in each resident’s room; it also allows for “natural awakening” to let residents get up when they want and have their breakfasts made to order.

Provider’s 2015 list of the Top 40 Largest Nursing Facility Companies is ranked by bed count as of Dec. 31, 2014.
Revised June 17, 2015