What the New LZ 200 Senior Living Report Says About Nonprofit Assisted Living Availability
A new national report tracks the 200 largest nonprofit senior living organizations. For families, the practical value is not the ranking itself, but what it suggests about where nonprofit senior living is growing, what kinds of units are being added, and where options may still be limited.
LeadingAge and Ziegler have released the 2026 edition of the LZ 200, an annual report ranking the country's largest nonprofit senior living organizations. For families looking at assisted living, memory care, or continuing care options, this matters because large nonprofit providers often shape local availability, campus expansion, and the mix of care levels offered in a region.
What happened
The report covers the nation's 200 largest not-for-profit senior living organizations as of Dec. 31, 2025. According to the release, those organizations account for more than 300,000 market-rate units across nearly 1,650 market-rate communities. The report also includes data on single-site campuses and large nonprofit providers of government-subsidized affordable senior housing.
One of the clearest trend lines in the release: nonprofit providers have continued to grow mainly by expanding existing campuses and through affiliations or acquisitions, rather than by building large numbers of entirely new communities from scratch. The report also says the average annual growth rate in total units since 2015 has been 2.7%, with independent living and assisted living units increasing while nursing care beds have declined.
The top 10 largest nonprofit multi-site senior living organizations listed in the release include National Senior Communities, Good Samaritan Society, Presbyterian Homes and Services, Acts Retirement-Life Communities, Ascension Living, HumanGood, Covenant Living, Trinity Health Senior Communities, Benedictine, and Lifespace Communities.
What this may mean for families
For most families, this report is best read as a supply-and-direction signal, not a quality scorecard. It suggests that nonprofit senior living is still growing, but growth is concentrated among larger organizations and often happens through campus additions, mergers, and affiliations. That can matter if you are looking for a community with multiple care levels in one place, or hoping to avoid another move later if a parent's needs increase.
The report's note that assisted living units have continued to grow, while nursing beds have declined, also fits a longer-running shift in elder care. More older adults are being served in settings that are less medical than a nursing home but provide more help than independent living. Families comparing options may want to review what assisted living actually includes, and how it differs from both memory care and a nursing home.
There is also a practical affordability angle. Nonprofit growth does not automatically mean lower prices. Many nonprofit communities are market-rate, and some are part of larger continuing care or life plan campuses that can still be expensive. Families should not assume that "nonprofit" means cheap or that it guarantees a Medicaid bed later. It is still important to ask how monthly pricing works, what happens if care needs rise, and whether any financial assistance may apply. These guides on how to pay for assisted living and whether Medicaid pays for assisted living can help frame those questions.
What to keep in mind
This is not an inspection report, consumer satisfaction report, or staffing audit. The LZ 200 ranks organizations by size and summarizes sector trends, but it does not tell a family whether a specific community has strong staffing, stable leadership, low complaint volume, or good day-to-day care. Bigger organizations may offer more settings and more geographic reach, but size alone does not prove quality.
The release is also broad. It combines different kinds of senior living and aging services, and it does not give family-level detail about rents, waitlists, resident turnover, or how hard it may be to find an assisted living apartment in a specific city. A family choosing care still needs to compare individual communities carefully and ask detailed tour questions. These practical guides to comparing assisted living communities and what to ask on a tour are more useful for decision-making than a national ranking alone.
Bigger picture
The most useful bigger-picture takeaway is that nonprofit senior living appears to be growing steadily, but not quickly enough to erase local shortages everywhere. A 2.7% average annual unit growth rate over the past decade is meaningful, yet modest when set against population aging, caregiver strain, and rising demand for supportive housing. The decline in nursing care beds also reflects a system that is trying to serve more people in lower-acuity settings for longer. That may be good for many residents, but it can also create pinch points when someone needs a higher level of care on short notice.
Quick questions readers may ask
- Does this report rank the best assisted living communities? No. It ranks large nonprofit organizations mainly by size and system scope, not by day-to-day care quality.
- Does nonprofit mean lower cost? Not necessarily. Some nonprofit communities are still expensive market-rate options, so families should ask for a full pricing breakdown.
- What is the most useful takeaway for families? Assisted living supply is still growing, especially through larger nonprofit systems, but local availability, price, and quality still vary widely by community.