Companies in this industry provide long-term skilled nursing care, other types of care, and social services in residential facilities. Major US companies include Brookdale Senior Living, Genesis Healthcare, Golden Living (owned by GGNSC Holdings), and HCR Manor Care (all based in the US), along with Bupa (UK), ExtendiCare (Canada), Korian (France), and Orpea (France).
Demand for long-term care services is strong due to rapidly aging populations in the US and other developed nations. However, the profitability of individual nursing facilities depends heavily on efficient operations, as revenue per patient is largely controlled by government insurance programs such as Medicare and Medicaid. Many companies are struggling with low reimbursements and the shift toward outpatient care. Large companies have some economies of scale in administration and purchasing, but small operators can compete effectively by offering better service. The US industry is fragmented: the 50 largest companies account for about 20% of revenue.
Products, Operations & Technology
The industry includes skilled nursing facilities for recovery from acute or chronic medical conditions (about 55% of US revenue), retirement and assisted living centers (about 25%), mental health and substance abuse facilities (about 15%), and various types of group home and community care arrangements.