National Senior Communities, The Evangelical Lutheran Good Samaritan Society, and Presbyterian Homes & Services have retained their positions as the three largest nonprofit senior living providers in the United States, according to the latest LeadingAge Ziegler 200 report. This annual ranking evaluates the top 200 nonprofit organizations in the sector while analyzing key developments from the past year.
The combined market share of the top 10 operators now represents about 30% of all units in the industry, though their individual rankings have experienced minor adjustments since 2025. National Senior Communities remains the leader with 24,039 units, while the Good Samaritan Society holds the second spot with 12,330 units. Presbyterian Homes follows closely with 10,746 units. Acts Retirement-Life Communities and Covenant Living Communities complete the top five.
Since 2014, the sector has expanded at an average annual rate of 2.7%, with independent and assisted living facilities driving most of this growth. However, the number of nursing care beds has decreased, while demand for memory care has surged. Currently, 66% of the top 200 providers now offer specialized memory care programs, reflecting a shift in care priorities.
Strategic partnerships have also evolved, with 44% of operators now collaborating with healthcare providers or systems, down from 49% in 2025. Nearly half (46%) of these organizations now deliver home and community-based services, including 14% that provide continuing care at home (CCaH). This segment has grown by 2 percentage points year-over-year, indicating a stronger emphasis on non-institutional care options.
Technology adoption continues to accelerate within the sector. A majority, 78%, of operators now use electronic health records, while 61% have integrated health and wellness tools, such as telehealth monitoring. This trend suggests a broader push toward operational efficiency and improved resident care coordination.
