Understanding how LeadingAge members use technology and supporting them in doing so is core to the Center for Aging Services Technologies (CAST).

A review of the technology adoption data drawn from the most recent LeadingAge LZ 200 report, a ranking of the U.S.’ largest 200 not-for-profit senior living providers—a group that includes many CAST patrons—demonstrates their wide embrace of many technology tools.

Released September 15, 2026, this year’s LZ 200 shows that, on average, 78% of the LZ 200 multi-site communities have adopted electronic point of care/point of service documentation systems and electronic health/medical records. Adoption of health and wellness technologies like medication monitoring or telehealth remote monitoring among this group is generally lower (41%) and care/case management and coordination uptake is higher, at 61%. Also at 61% is the use of social connectedness/resident engagement software—holding steady over the past four years.

Not surprisingly, as the sector has evolved, the LeadingAge Ziegler rankings have changed significantly since the publication’s initial 2004 release (based on data as of December 31, 2003). The largest multi-site list, begun at 100, has increased twice, as has the largest 100 single-site campus listing since it was added to the publication in 2005 (using data as of December 31, 2004).

Questions offering a point-in-time insight into the use of specific types of technologies, from electronic medical/health records systems to social connectedness-and-engagement platforms, automatic fall detectors, and more, by multi-site providers began in 2014; for single-sites, the tech exploration started in 2019 with the single-site LZ 150.

Looking at the LZ 200 multi-site tech adoption compared to that of LZ 200 single-sites from 2022 to 2025 (the period for which we have comparable data):

• Adoption of both electronic medical/health records systems and point of care/point of services documentation systems is steady: around 96% adoption for single-sites, and 75% for multi-sites.
• Access control/wander management systems are embraced by about 94% of single- sites; among multi-sites, it is nearly 70%.
• Physical exercise and rehab technologies hit a roughly 76% uptake among single-sites, according to respondents. Multi-sites in the category, in contrast, were fairly constant over the same four year period: around 58%.
• Adoption of electronic medical/health records systems, electronic point of care/point of services documentation systems, and access control/wander management systems among single-sites was more than 20% higher in each category by single-sites than multi-sites.
• Multi-sites’ uptake of telehealth/remote patient monitoring outpaced single-sites’ adoption over the same period by, on average, 7%, and, for automatic fall detectors, 4%.
• While single-sites’ adoption of physical exercise and rehab technologies, resident social connectedness and engagement platforms, medication management technologies and care/case management and coordination software tools generally outpaced multi-sites, the difference was smaller, ranging from 19% in social connectedness and engagement platforms to 7%, in care/case management and coordination software tools.

“Single-site providers report higher technology adoption rates in most of the categories surveyed, reminding us that organizations of all sizes can be leaders in adopting technology,” notes Scott Code, vice president, CAST. “These findings offer an opportunity to learn from one another about what supports successful adoption and how these tools benefit residents and staff.”

In contrast to the technologies covered in the LZ 200 survey questions, the CAST-and-Ziegler Link•age Funds CTO Hotline survey, now in its second year, tracks how leaders are approaching technology strategy, adoption, governance, and innovation based on responses from more than 100 professionals at a diverse group of small, medium, and large not-for-profit senior living organizations.

Several emerging themes from the most recent CAST-and-Ziegler Link•age Funds survey, released in August, may impact future findings for both surveys. Specifically, “technology governance to support more intentional decision-making is becoming the norm.” To avoid what one survey respondent called “random acts of technology,” providers are “increasingly creating formal innovation or technology committees that help align technology decisions with their strategic information technology (IT) plans.”