Companies in this industry provide long-term skilled nursing care, other types of care, and social services in residential facilities. Major companies include Brickyard Healthcare, Brookdale Senior Living, and Genesis Healthcare (all based in the US); along with Bupa (UK), Extendicare (Canada), and Korian and Orpea (both based in France).
COMPETITIVE LANDSCAPE
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 highly fragmented: the 50 largest companies account for about 20% of revenue.
PRODUCTS, OPERATIONS & TECHNOLOGY
The industry includes assisted daily living (ADL) with rehabilitation (about half of US revenue), ADL without rehabilitation (about 20%), and independent- living services (about 10%).