Lists/Largest nursing home groups
Largest nursing home groups in the U.S.
The 50 largest groups include 4,016 of the 10,258 ranked nursing homes. Groups are CMS affiliated entities: homes that share owners or managers, named by CMS after one member.
Updated 2026-10-27 · Source: CMS Nursing Home Care Compare and Medicare enrollment (PECOS) · Methodology
Groups ranked
612
CMS affiliated entities
Homes in ranked groups
10,258
Largest group
344
Ensign Group
| Rank | Group | Homes | Beds | States | Average CMS rating |
|---|
| 1 | Ensign Group | 344 | 37,719 | 17 | 3.2 ★ |
| 2 | Pacs Group | 278 | 31,535 | 16 | 2.9 ★ |
| 3 | Life Care Centers Of America | 194 | 25,340 | 26 | 3.4 ★ |
| 4 | Genesis Healthcare | 190 | 21,423 | 18 | 2.4 ★ |
| 5 | Creative Solutions In HealthcarePublic licensees | 150 | 17,735 | 1 | 2.1 ★ |
| 6 | Trilogy Health Services | 127 | 8,491 | 5 | 4.2 ★ |
| 7 | Saber Healthcare Group | 124 | 13,271 | 5 | 2.9 ★ |
| 8 | Avir Health GroupPublic licensees | 118 | 12,935 | 1 | 2.3 ★ |
| 9 | Communicare Health | 105 | 11,371 | 5 | 3.2 ★ |
| 10 | Pruitthealth | 97 | 10,607 | 4 | 3.0 ★ |
| 11 | Legacy Healthcare | 95 | 11,959 | 4 | 2.9 ★ |
| 12 | Marquis Health Services | 93 | 12,504 | 9 | 3.1 ★ |
| 13 | Good Samaritan Society | 92 | 5,883 | 9 | 3.1 ★ |
| 14 | American Senior Communities | 90 | 8,948 | 1 | 3.9 ★ |
| 15 | Complete Care | 86 | 12,081 | 8 | 3.2 ★ |
| 16 | Simcha Hyman & Naftali Zanziper | 77 | 7,647 | 6 | 2.7 ★ |
| 17 | Infinity Healthcare Consulting | 70 | 8,723 | 3 | 2.1 ★ |
| 18 | Opco Skilled Management | 68 | 8,166 | 4 | 2.3 ★ |
| 19 | National HealthCare Corporation | 67 | 8,332 | 8 | 3.9 ★ |
| 20 | Signature Healthcare Services, LLC | 67 | 7,618 | 5 | 3.1 ★ |
| 21 | Wellsential HealthPublic licensees | 67 | 8,695 | 1 | 2.7 ★ |
| 22 | Ciena Healthcare/Laurel Health Care | 66 | 7,619 | 2 | 2.8 ★ |
| 23 | Fundamental Healthcare | 66 | 7,769 | 6 | 2.5 ★ |
| 24 | Foundations Health Solutions | 64 | 6,198 | 1 | 4.2 ★ |
| 25 | Lifeworks Rehab | 60 | 8,049 | 5 | 2.1 ★ |
| 26 | Autumn Lake Healthcare | 59 | 8,005 | 5 | 2.9 ★ |
| 27 | North Shore Healthcare | 57 | 3,738 | 4 | 2.8 ★ |
| 28 | James & Judy Lincoln | 54 | 5,347 | 2 | 2.5 ★ |
| 29 | Medilodge | 53 | 5,646 | 1 | 3.1 ★ |
| 30 | Nexion Health | 51 | 5,386 | 3 | 2.2 ★ |
| 31 | David Johnson | 50 | 5,433 | 2 | 3.3 ★ |
| 32 | Ethica Health | 50 | 4,822 | 1 | 3.5 ★ |
| 33 | Aviata Health Group | 49 | 5,987 | 1 | 2.4 ★ |
| 34 | Benjamin Landa | 49 | 6,352 | 4 | 3.4 ★ |
| 35 | Monarch Healthcare Management | 48 | 3,423 | 1 | 2.2 ★ |
| 36 | The Beebe Family | 48 | 4,931 | 2 | 2.8 ★ |
| 37 | Accura Healthcare | 47 | 2,380 | 4 | 2.4 ★ |
| 38 | Cascadia Healthcare | 47 | 3,848 | 5 | 3.1 ★ |
| 39 | Diversicare Healthcare | 44 | 4,744 | 5 | 2.5 ★ |
| 40 | Care Initiatives | 43 | 2,764 | 1 | 2.9 ★ |
| 41 | Hill Valley Healthcare | 43 | 5,452 | 6 | 1.7 ★ |
| 42 | Life Care Services | 43 | 2,901 | 18 | 4.0 ★ |
| 43 | Nhs Management | 43 | 5,530 | 3 | 2.9 ★ |
| 44 | Sovereign Healthcare Holdings | 43 | 5,407 | 3 | 3.7 ★ |
| 45 | Evergreen Healthcare Group | 42 | 3,958 | 6 | 2.4 ★ |
| 46 | National Health Care Associates | 42 | 5,506 | 6 | 3.2 ★ |
| 47 | Centers Health Care | 40 | 6,455 | 2 | 2.3 ★ |
| 48 | Corporate Interface Services | 40 | 3,844 | 1 | 2.5 ★ |
| 49 | Anthony & Bryan Adams | 38 | 4,103 | 2 | 3.7 ★ |
| 50 | Aston Health | 38 | 5,023 | 1 | 2.7 ★ |
Public licensees: most homes in this CMS group are licensed to public bodies such as Texas hospital districts or Indiana county hospitals, which contract with a private company to run them. The group is named after that company; the operator shown on each home's page is the public body holding the licence.
Average rating is the mean CMS overall star rating across a group's rated homes. Each home is counted once, in the group CMS lists on its own enrollment. See every nursing home group.
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