Newly Expanded 15th Annual LeadingAge Ziegler 200 Report Outlines Senior Living Growth Trends

November 14, 2018

CHICAGO–The 15th annual LeadingAge Ziegler 200 (LZ 200) report was released today detailing the nation’s 200 largest nonprofit senior living providers, as well as relevant business trends for the industry.

The report is developed annually through a partnership between Ziegler, one of the nation’s leading underwriters of financings for not-for profit senior living providers in the United States, and LeadingAge, the nation’s largest association of nonprofit aging service providers in the country. The LZ 200 2018 report was expanded this year to include 200 providers of nonprofit multi-site organizations, single-site campuses and government-subsidized multi-site housing, up from 150 in 2017.

“For 15 years, LeadingAge has partnered with Ziegler to highlight the tremendous work of many of our members,” said Katie Smith Sloan, LeadingAge president & CEO. “By telling their stories, these organizations are engaged in shared learning—offering their experiences, wisdom, and strategies to the field of aging services. At the same time, they are helping to increase awareness about the important role nonprofit providers play in long-term services and supports.”

The LZ 200 is a ranking and analysis of the largest, most complex nonprofit senior living organizations across the country. This year’s report showed that nonprofit senior living providers have grown primarily through expansion within existing campuses as well as affiliations, mergers and acquisitions. Nearly 30%of the total number of units for all senior living systems in the LZ 200 are represented by the 10 largest providers.

The 2018 top 10 largest not-for-profit multi-site senior living organizations include:
1.    National Senior Campuses – Catonsville, MD
2.    The Evangelical Lutheran Good Samaritan Society – Sioux Falls, SD
3.    Acts Retirement Services, Inc. – West Point, PA
4.    Presbyterian Homes and Services – Roseville, MN
5.    Covenant Retirement Communities – Skokie, IL
6.    Trinity Senior Living Communities – Livonia, MI
7.    HumanGood – Pleasanton, CA
8.    Ascension Senior Living – St. Louis, MO
9.    Benedictine Health – Duluth, Cambridge and Shoreview, MN
10.  Retirement Housing Foundation – Long Beach, CA

The LZ 200 also showed that over the last 10 years, the average annual growth rate in total units is 2.7%, with independent living and assisted living units growing each year. Other key areas of growth and innovation within the senior living industry include:

• Memory care units are becoming an increasingly important component of the annual unit counts. LZ 200’s listing shows 60%of its providers offer specialized memory care units.
• Home-based services, such as home health, continuing care at home (CCaH) programs or the Program for All-Inclusive Care for the Elderly (PACE) continue to growth with approximately 45 percent of the LZ 200 offering some type of home and community-based service to non-residents. However, the CCaH model is now offered by slightly more than 12%of the LZ 200, which is two percent less than last year’s report.
• Adoption of new technologies continues to increase as nearly 80%of providers in the LZ 200 use electronic point of care/point of service documentation systems; nearly 76%use electronic health/medical records; and 58.5%use care/case management and coordination software. LZ 200 showed that the use of health and wellness technologies, such as medication monitoring or telehealth remote monitoring is generally lower.
• Formal joint ventures and partnerships, with more than 33%of LZ 200 organizations engaged in a formal joint venture, most commonly with another senior living provider, a health system, or a home health/home care agency.

“Nearly two decades ago, Ziegler began its research to answer many important questions within our field: in what ways are providers growing and evolving and at what pace? How does the past differ from the future growth initiatives being undertaken,” said Dan Hermann, president and CEO at Ziegler. “Now, by analyzing the country’s 200 largest senior living providers, we are able to keep a steady pulse on what is growing, shrinking and changing so the industry is prepared to adapt to the needs of seniors and provide the highest quality of care.”

The full report is available here.