National Senior Communities Tops Not-for-Profit Rankings

LeadingAge and Ziegler have released the 2026 LZ 200 report, ranking the nation’s 200 largest not-for-profit senior living organizations across the country as of Dec. 31, 2025.

Consistent with the last several years, the 2026 LZ 200 listing shows that not-for-profit senior living providers have grown primarily through community expansions from existing campuses as well as affiliation and acquisition activity, LeadingAge said.

Nearly 30 percent of the total number of units for all senior living systems in the LZ 200 are represented by the 10 largest providers.

The 10 largest not-for-profit multi-site senior living organizations include:

1. National Senior Communities – Washington, DC

2. The Evangelical Lutheran Good Samaritan Society – Sioux Falls, SD

3. Presbyterian Homes and Services – Roseville, MN

4. Acts Retirement-Life Communities, Inc. – Fort Washington, PA

5. Ascension Living – St. Louis, MO

6. HumanGood – Pleasanton, CA

7. Covenant Living Communities & Services – Skokie, IL

8. Trinity Health Senior Communities – Livonia, MI

9. Benedictine – Duluth, MN

10. Lifespace Communities – Dallas, TX

The LZ 200 also showed that in the last 10 years, the average annual growth rate in total units since 2015 is 2.7 percent, with independent living and assisted living units growing each year but declining in the number of nursing care beds.

Comments or questions? Contact Patrick Connole at pconnole@parkplacelive.com.