Who is the largest nursing home operator in America?

Based on CMS ownership filings, the largest U.S. skilled nursing operator is Burnam, Soon, which controls 327 facilities across 17 states. The full top 25 ranking — plus the biggest home health and hospice chains — is below.

How are the largest operators ranked?

Each operator is matched to the Medicare-certified facilities it owns in CMS PECOS ownership filings. Operators are ranked by the number of distinct facilities (CCNs) they control within each facility type. We count distinct CCNs so an operator is not double counted where a facility has multiple owners.

Why does the largest-operator landscape matter for M&A?

The biggest chains are the strategic and private-equity-backed platforms that drive post-acute consolidation. Knowing who already owns what — and how many states each platform spans — maps the acquisition landscape: who the incumbent buyers are, where the roll-ups are concentrated, and which operators are positioned for the next deal.

STETHO · DATA STUDY · 2025 EDITION

The largest post-acute operators in America

Burnam, Soon is the largest U.S. skilled nursing operator — 327 facilities across 17 states. Who owns post-acute care? This ranking maps the acquisition landscape: the biggest skilled nursing, home health, and hospice chains by facility count — the roll-up platforms and strategic buyers driving consolidation. Drawn from the latest CMS ownership filings; updated annually.

327 facilities

LARGEST SNF OPERATOR

STATES IT SPANS

13,050

MULTI-SITE SNF OPERATORS

95,240

CHAIN-OWNED SNFs

BIGGEST OPERATORS

Largest skilled nursing operators — top 12 by facility count

BY FACILITY TYPE

The biggest platform in each post-acute market

Skilled Nursing Facilities

327

Facilities · largest operator

Burnam, Soon · 17 states · 13,050 multi-site operators

Home Health Agencies

Facilities · largest operator

Lhc Group, INC · 1 states · 2,258 multi-site operators

Hospices

Facilities · largest operator

Mitchell, Kelly · 0 states · 2,216 multi-site operators

SKILLED NURSING · LARGEST OPERATORS

The 25 largest skilled nursing operators

Operators ranked by facility count — the number of distinct Medicare-certified skilled nursing facilities each controls in CMS ownership filings. These are the incumbent roll-up platforms that shape the acquisition landscape. Explore the full set in the operator roll-up tracker.

#	Operator	Facilities	States
1	Burnam, Soon	327	17
2	Mitchell, John	257	16
3	Hancock, Mark	256	15
4	Apt, Frederick	254	15
5	Murray, Jason	253	15
6	Jergensen, Joshua	241	16
7	Pacs Group, INC.	241	16
8	Pacs Holdings, LLC	240	16
9	Hccf Management Group Xi LLC	226	19
10	The Ensign Group INC	208	17
11	Keetch, Chad	205	14
12	Life Care Centers of America, INC.	194	26
13	Thurmond, Joan	191	26
14	Preston, Forrest	187	26
15	Gen Operations II LLC	183	18
16	Gen Operations I LLC	182	18
17	Cross, Cindy	181	26
18	Genesis Healthcare LLC	181	18
19	Genesis Healthcare INC	180	18
20	Sun Healthcare Group INC	174	16
21	Zac Properties Xi LLC	174	17
22	Fc-gen Operations Investment LLC	171	17
23	Providence Group Nh, LLC	171	15
24	Whitman, Arnold	170	18
25	Berg, Michael	169	17

Methodology

Every Medicare-certified facility is matched to its owners in CMS PECOS facility-ownership filings (the ownership dataset). For each operator we count the number of distinct facilities (CCNs) it controls within a facility type, and the number of distinct states those facilities span. Operators are ranked by facility count. We count distinct CCNs so an operator is not double counted where a facility has multiple organizational owners (holding structures).

Only operators controlling two or more facilities are treated as chains and included in the leaderboard. Counts reflect facilities present in CMS ownership filings, which is a subset of all certified facilities, and operators recorded under multiple legal-entity names may appear separately. Figures are refreshed annually.

Want the deals behind the names? See the state-by-state consolidation study, the operator roll-up tracker, and the deal-signal feed.

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CITATION

Stetho. (2025). The Largest Post-Acute Operators in America. Retrieved from https://stetho.io/largest-operators

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<a href="https://stetho.io/largest-operators" style="display:inline-block;border-left:4px solid #84cc16;padding:10px 14px;font:14px/1.4 system-ui,sans-serif;color:#0f172a;text-decoration:none;background:#f8fafc;border-radius:4px;max-width:520px"><strong>Burnam, Soon is the largest U.S. skilled nursing operator with 327 facilities</strong><br>Source: Stetho — The Largest Post-Acute Operators in America (2025)</a>

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Burnam, Soon is the largest U.S. skilled nursing operator with 327 facilities
Source: Stetho — The Largest Post-Acute Operators in America (2025)