Skilled nursing facility companies continue to be big business and are poised to grow exponentially given that in 2011, the first baby boomers turned 65.

An array of services and specialty care remains a strong trend for this year’s Top 50 survey. Similar to last year, dementia care is at the top of the list (48 facilities), followed closely by assisted living (42, from 39 last year) and outpatient therapy (41 from 38).

Hospice care remains a steady option, with 32 companies offering it (33 offered last year). Home care is also a main option, with 26 of the companies offering this service (27 offered last year).

Sectors To Watch

Key sectors to watch include bariatric beds and services, which are offered by 29 of this year’s Top 50, down from 30 last year, but still up a bit from the 23 companies that offered such care in 2012. The same can be said for dialysis services, which 17 companies offer this year, down from 20 last year and 19 the prior year. Ventilator services are on an incline—at 26 this year, up from 24 last year and 19 from the year before.

Old As Well As New Faces

Genesis HealthCare Corp. dominates the field, fostered by the recent acquisition of Skilled Healthcare Group, which was at No. 14 last year. HCR ManorCare and Golden Living remain in 2014’s previous spots of No. 2 and No.3.

Most facilities experienced positive growth, advancing up this year’s chart. Ensign moved from its 10th position last year to No. 8, while Saber moved from No. 22 to No. 20. Benedictine Health System rose from No. 35 in 2014 to No. 32 this year. Care Initiatives (37 to 36), Revera Health Systems (39 to 34), and Miller’s Health Systems (40 to 35) followed suit.

What Lies Ahead

Renovations and improvements are on the mind of these Top 50 SNF companies.

No. 1 Genesis seeks to add more specialty care such as dialysis, ventilator, and bariatric services as well as rehabilitation suites and units. HCR ManorCare hopes to include amenities such as Internet cafes.

Signature HealthCARE reports that it will overhaul its dining experience and move toward a more homelike/neighborhood concept. More of its facilities will join the Eden Alternative registry and incorporate initiatives such as its Music and Memory programming.

PruittHealth is trying pod module staffing in several of its facilities to “provide a team approach that results in better care delivered to the patients.”

Provider’s 2015 list of the Top 50 Largest Nursing Facility Companies is ranked by bed count as of Dec. 31, 2014.

Revised Aug. 12, 2015.