Who Owns America's Nursing Homes
Nursing homes are run by a long tail of small operators and a smaller number of large multi-state chains. This is what the CMS ownership record shows about how concentrated the sector actually is.
What the ownership record shows
- Ownership groups
- 1,288
- CMS-reported operators
- Single-facility operators
- 16.7%
- of all operators
- Operate in 2+ states
- 383
- multi-state operators
- Facilities in 10+ chains
- 72%
- of grouped facilities
The largest operators by facility count
Operators running the most nursing homes
The largest ownership groups in the CMS record, by number of associated facilities.
Size is not quality. A large chain simply means one operator is associated with many facilities; each still has its own CMS record. Follow any operator to see its full footprint and how its facilities score.
CMS-reported data · site-calculated context, not a CMS rating
Methodology
Concentration: a long tail plus a heavy head
Most operators are small; most facilities are not independently owned.
Two facts sit in tension. On one hand, 16.7% of operators run a single facility — the sector has a very long tail of small owners. On the other, facilities cluster under larger operators: the 303 chains with ten or more facilities hold 72% of grouped facilities, and multi-state operators hold 57.9%. For a family, the practical point is that the name on the door is often part of a larger organization whose other facilities are also on the public record — worth looking at when you research a specific home.
Why ownership is worth checking
What it does — and does not — tell you.
Grouping facilities by owner lets you see patterns a single profile cannot: how an operator’s other facilities are rated, in how many states it works, and whether enforcement history clusters. It is context, not a verdict — a large operator is not inherently better or worse than a small one. Use the ownership lookup to explore any operator, and our guide on finding nursing-home ownership.
Limits of this analysis
Ownership grouping reflects how CMS reports it in a dated snapshot; corporate structures can be complex and change hands. Facilities CMS does not associate with a group are not counted in the grouped percentages. Nothing here evaluates any operator. See Methodology and Data updates.