Skilled Nursing Beds at Non-Profit Operators Holding Steady Despite Headwinds

After more than a decade of declines, the proportion of skilled nursing beds at major non-profit senior living operators has held steady in recent years, even as companies in the space have dealt with reimbursement and staffing strains.

Nursing care beds accounted for 32.2% of all units among the top 150 non-profit senior housing providers in the country in 2016, according to the most recent LeadingAge Ziegler 150 (LZ 150). Released last week, the report represents a comprehensive annual analysis of the state of the non-profit senior housing marketplace, conducted by industry trade association LeadingAge and Chicago-based specialty investment bank Ziegler.

Independent living units accounted for 47.9% of the 265,000 units owned by the top 150 providers, with assisted living accounting for the remaining 19.9%. For comparison, back in 2000, skilled nursing beds represented 39.3% of all senior housing units in the LeadingAge Ziegler survey, which at that time included the top 100 providers.


Skilled nursing’s 32.2% share marks a slight uptick from the previous year’s concentration of 31.9%, as well as the continuation of a plateau that formed after steady drops between 2000 and 2014.

Overall, since 2000, the number of skilled nursing beds has grown at an average annual rate of 1.1%, the slowest of the three types: Independent living units grew by 3.7% over that span, while assisted living inventory jumped 4.7%.

Also of note in the data: Despite a nationwide trend toward private skilled nursing rooms, slightly more than half — or 51.9% — of all nursing assets were semi-private among the top 150, with private rooms accounting for 48.1%. In addition, 35% of the total offered some kind of combination skilled nursing/memory care services.


The top 10 largest organizations by skilled nursing beds are:

1. The Evangelical Lutheran Good Samaritan Society — 10,434 units

2. Benedictine Health System — 3,161 units

3. Ascension Senior Living — 2,854 units

4. The Carmelite System, Inc. — 2,564 units

5. Trinity Senior Living Communities — 2,217 units

6. Presence Life Connections — 2,016 units

7. ArchCare — 1,723 units

8. Christian Homes, Inc. — 1,486 units

9. ACTS Retirement Services, Inc.  — 1,432 units

10. Presbyterian Homes & Services — 1,302 units

Written by Alex Spanko

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