The 30 Largest Nursing Home Chains

The largest nursing home chains

The days of small, independent nursing homes are largely gone. In the past, a nurse or physician may expand their practice by purchasing a nursing home–or home for the aged, care homes, or convalescent homes–as they were often called. By operating a nursing home, they were able to care for a greater number of people. Those small, independent nursing homes have been replaced by large corporations funded by private equity firms. 

There are more than 1.3 million residents living in the more than 15,000 nursing homes in the United States. 72% of nursing homes are now for-profit companies, and 66% of all nursing homes are now part of a corporate chain. The 10 largest chains own more than 10% of all nursing homes and operate in more than half the states. The top 30 nursing home chains account for more than 250,000 nursing home beds. 

America’s 30 Largest Nursing Home Chains
Rank Nursing Home Chain Name Headquarters Total Nursing Homes Owned Total Nursing Home Beds States Operated in 
1Genesis HealthCare Corp.Pennsylvania35741,97726
2The Ensign GroupCalifornia21923,17213
3Life Care Centers of AmericaTennessee20927,17928
4ProMedica Senior CareOhio16222,97317
5The Evangelical Lutheran  Good Samaritan SocietySouth Dakota15610,50422
6Consulate Health CarePennsylvania13815,6036
7Saber Healthcare GroupOhio122Unreported 7
8Sava SeniorCareGeorgia12119,34720
9Trilogy Health ServicesKentucky1167,7734
10Signature HealthCAREKentucky10812,48010
13The Ciena Group / Laurel Health Care Co.Michigan809,0795
14American Senior CommunitiesIndiana788,7461
15National Healthcare Corp.Tennessee759,4639
16Infinity Health Care ManagementIllinois699,6418
17CommuniCare HealthOhio66Unavailable 7
18Diversicare Healthcare ServicesTennessee627,3299
19North Shore HealthcareWisconsin594,4894
20EmpRes Healthcare ManagementWashington554,8348
21Foundations Health SolutionsOhio555,6231
22Mission HealthFlorida514,1968
23Nexion HealthMaryland50Unavailable 4
24Athena Health CareConnecticut46Unavailable 3
25Avalon Health Care GroupUtah454,9056
26Care InitiativesIowa442,9671
27Prestige CareOregon443,3975
28Five Star Senior LivingMassachusetts423,39731
29Guardian HealthcarePennsylvania405,3642
30National Health Care AssociatesNew York385,1016

Nursing home corporations often go to great lengths to maintain the image of small, local facilities. They have charming names like The Gardens of …., [insert quant name],  [local name] Manor, The Falls at [you name it], and so on. These are all designed at creating the impression that each nursing home is its own independent entity that is closely connected to the community. In reality, the overwhelming majority of these nursing homes are nothing more than a label applied by the corporation’s marketing team. 

Questions About A Potential Nursing Home or Assisted Living Facility Lawsuit? 

The trial attorneys of Michael Hill Trial Law are nationally recognized and handle exclusively cases against long term care facilities. Michael and his firm, Michael Hill Trial Law, handle cases across the country. If you have any questions about cases involving Communicare or any other nursing homes, assisted living facilities, or group homes, you can contact Michael Hill Trial Law at, by sending an email to, or by calling (800) 659-2712.