National Senior Communities and the Evangelical Lutheran Good Samaritan Society are still the two largest senior living nonprofits in the country, according to the latest LeadingAge-Ziegler 200 report

The annual report, released Thursday, categorizes the largest nonprofit senior living operators by total unit count. Overall, the top-10 largest operators made up just under a third of the ranking’s entire unit count in 2024.

While National Senior Communities decreased its total unit count by 88 units, the Springfield, Virginia-based provider retained its spot as the largest senior living nonprofit in the U.S. in 2024.

Sanford Health-affiliated Good Samaritan Society has a total of 13,280 units.

ACTS Retirement added 744 units in 2024, moving ahead of Presbyterian Homes and Services into the No. 3 spot of the report, with 10,176 units compared to 10,006 units, respectively.

Lifespace Communities fell from the sixth spot in 2023 to no. 8 in 2024 with 5,604 units.

The 10 largest multi-site senior housing and care nonprofits in 2024 were:

– National Senior Communities, 21,871 units

– Evangelical Lutheran Good Samaritan Society, 13,280 units

– ACTS Retirement, 10,176 units

– Presbyterian Homes and Services, 10,006 units

– Ascension Living, 6,692 units

– HumanGood, 5,882 units

– Covenant Living, 5,644 units

– Lifespace Communities, 5,604 units

– Trinity Health, 5,032 units

– Benedictine, 4,859 units

Overall, Pacific Retirement Services reported unit growth of 971 additional units, the highest increase from 2022 to 2023, followed by ACTS Retirement adding 744 units and Ecumen adding 511 units in that time period, the report found.

The largest decreases in unit counts between 2022 and 2023 came from Good Samaritan dropping 2,540 units, followed by Retirement Housing Foundation shedding 1,684 units, and The Kendal Corp. decreasing its unit count by 987, the report states.

The largest jump in the rankings came from FellowshipLife, which ascended to the No. 83 spot. Other nonprofit providers that moved up the rankings included Illuminus Inc. jumping up 57 spots to No. 60 and Saint Therese up 41 spots to No. 63.

Skilled nursing composition for the 200 nonprofit providers listed in the report decreased from 2022 to 2023 by 10%, and home care services remain a key area of emphasis for providers, as 45% reported offering home and community-based services.

In 2023, 21% of providers reported offering adult day care services, compared to 18% in 2022, as PACE services increased three percentage points in 2023 to 14%. A little more than a third of organizations offered affordable senior housing services.

Technology adoption to aid in physical exercise and rehabilitation increased six percentage points to 60%, while adoption of medication monitoring technologies increased four percentage points to 62% of providers offering tech-enabled offerings in 2023.