When considering a continuing care retirement community (CCRC), it is useful for prospective residents to gain an understanding of the CCRC market in general. At myLifeSite, we get a lot of great questions around this topic: Who are the largest CCRC players? What’s the split between for-profit and non-profit CCRCs? What geographic region has the most CCRCs? Are most CCRCs a single site or owned by a multi-location conglomerate? This post can help shed some light on some of these common questions.
Non-profit CCRCs by the numbers
There are around 2,000 CCRCs in the United States, give or take a few, and approximately 80 percent of these are owned by not-for-profit organizations. According to the 2017 LeadingAge Ziegler 150 report, which only includes non-profit organizations, 632 of these not-for-profit CCRCs are owned by the largest 150 organizations (as measured by number of communities). Note: The report uses the term “life plan community (LPC)” instead of the more traditional term of “continuing care retirement community (CCRC).”
Breaking the report down even further, the top 15 non-profit providers own 281 CCRCs, as shown here:
| Non-profit organization | # of CCRCs (LPCs) | States covered* |
| The Evangelical Lutheran Good Samaritan Society | 67 | SD |
| Benedictine Health Systems | 24 | MN, IL, MS, ND, WI |
| Asbury Communities | 22 | MD, TN, PA, OK |
| ACTS Retirement | 21 | PA, AL, FL, GA, DE, MD, NJ, NC, PA, SC |
| Humangood | 17 | CA, AZ, ID, WA, NV |
| National Senior Campuses | 16 | MD, MI, PA, VA, KS, CO, TX, VA, NJ, PA, MA |
| Presbyterian Manors of Mid-America | 16 | KS, MO |
| Covenant Retirement Communities | 14 | IL, CA, CO, CT, WA, IL, MI, MN, OK, FL |
| Presbyterian Homes and Services | 13 | MN, IA |
| Kendal Corporation | 13 | PA, IL, MA, MD, NH, NY, OH, VA |
| Presbyterian Senior Living | 12 | PA, MD, DE |
| Ohio Living | 12 | OH |
| Lifespace | 12 | IA, FL, MN, PA, IL, KS, MS, NE |
| Lutheran Senior Services | 11 | MO, IL |
| Christian Horizons | 11 | MO, IL, IN, IA |
*Those in italics represent the state in which the main corporate office is located.
>> Related: For-Profit or Not-for-Profit CCRCs- What’s the Difference?
The for-profit CCRC landscape
In terms of for-profit CCRCs, Brookdale is by far the largest provider. Brookdale is a publicly owned company that has hundreds of different types of senior living communities across the country, including approximately 50 CCRCs. There are two other large for-profit companies that own many senior living communities but do not have nearly as many CCRCs as Brookdale, including Sunrise Senior Living and Kisco.
Almost all of the other for-profit CCRCs are single-site locations that are individually owned, owned by a real estate investment trust (REIT), or are part of a small corporate group of CCRCs, such as Continuing Life or Liberty Healthcare.
>> Get more information on for-profit and not-for-profit CCRCs near you!
Regional concentration of CCRCs
Regarding geographical areas with the largest concentrations of CCRCs, the Midwest/Great Lakes region leads the way. Illinois, Indiana, Ohio, and Wisconsin alone have approximately 500 CCRCs, or about 25 percent of the nation’s entire CCRC market.
Next is the Northeast, bolstered in large part by Pennsylvania, the state where CCRCs originated. There are nearly 200 CCRCs in Pennsylvania alone, followed by about 50 CCRCs in New York. Aside from these two states, there are another 100 or so CCRCs in other northeastern states.
After that comes the Southeast, with about 350 CCRCs. The vast majority of CCRCs in the Southeast are found along the coastal states. In fact, about 35 percent of the CCRCs in the Southeast are in Florida.
Despite its recent population boom, the West is still among the regions with the fewest CCRCs. There are around 210 CCRCs in the West Coast states, but all other western states combined (including Colorado, Idaho, Montana, Nevada, Utah, and Wyoming) only have about 50 CCRCs total.
The region with the fewest CCRCs is the Southwest, which includes Arizona, New Mexico, Oklahoma, and Texas, where there are a total of about 150 continuing care retirement communities. The Lone Star State has by far the most in this region, with over 90 CCRCs in Texas.
Here is a list of the top 10 states by number of CCRCs:
| State | Approximate Number of CCRCs |
| Pennsylvania | 195 |
| Ohio | 150 |
| California | 135 |
| Illinois | 110 |
| Florida | 105 |
| Texas | 90 |
| Kansas | 72 |
| Idaho | 70 |
| North Carolina | 62 |
| Virginia | 58 |
Keep in mind that figures shown in this chart are approximate. There are some retirement communities that are similar to CCRCs, but they do not offer a true continuing care residency contract. Additionally, some states do not regulate CCRCs and therefore do not have an official count. Finally, some states only regulate CCRCs that offer a certain type of residency contract. For these reasons, it’s very difficult to assign a specific number to a state, but these are reasonable approximations.
>> Related: Understanding the Regulatory Process for CCRCs
Big picture, better decision
As you explore CCRCs, you will likely home in on a couple of specific communities that are either in a location you desire and/or that offer amenities, pricing, and contracts that you find appealing. While it is great to have narrowed down the many options to just a handful of top contenders, it is still incredibly useful to learn about the broader CCRC landscape.
By using the resources available on myLifeSite, such as our free community search tool, CCRC resource library, and side-by-side CCRC comparison tool, you’ll become a more educated consumer, better informing your decision about which CCRC is right for you.
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