PRESS RELEASE | October 27, 2022

LeadingAge And Ziegler Release 19th Annual LeadingAge Ziegler LZ 200 Report

Contact: Christine McCarty

312 596 1617 |

October 27, 2022 (Chicago, IL) — LeadingAge, the association of nonprofit providers of aging services, and Ziegler, the nation’s leading underwriters of financings for not-for-profit senior living providers, today release the 19th Annual LeadingAge Ziegler (LZ 200) report.

The report, developed annually through a partnership between LeadingAge and Ziegler, is a ranking and analysis of the nation’s 200 largest not-for-profit senior living organizations across the country as of December 31, 2021. This year’s report represents more than 306,000 market-rate units and nearly 1,600 market-rate communities across the country. It also outlines relevant business trends in the industry to showcase the variety of older adult services and offerings provided in this sector.

Consistent with the last several years, the 2022 LZ 200 listing shows that not-for-profit senior living providers have grown primarily through community expansions from existing campuses as well as affiliation and acquisition activity. Nearly 30 percent of the total number of units for all senior living systems in the LZ 200 are represented by the 10 largest providers. 

The 10 largest not-for-profit multi-site senior living organizations include:

  1. National Senior Campuses – Wellesley, MA
  2. The Evangelical Lutheran Good Samaritan Society – Sioux Falls, SD
  3. Acts Retirement Services, Inc. – Fort Washington, PA
  4. Presbyterian Homes and Services – Roseville, MN
  5. Ascension Living – St. Louis, MO
  6. HumanGood – Pleasanton, CA
  7. Covenant Living Communities & Services – Skokie, IL
  8. Lifespace Communities, Inc. – West Des Moines, IA
  9. Trinity Health Senior Communities – Livonia, MI
  10. Benedictine – Duluth, MN

The LZ 200 also showed that in the last 10 years, the average annual growth rate in total units since 2000 is 2.3 percent, with independent living and assisted living units growing each year, but decline in the number of nursing care beds.

“Since the publication’s introduction almost two decades ago, we have captured the factors and trends driving innovation and change in how older adults live,” stated Katie Smith Sloan, President and CEO of LeadingAge. “The LZ200’s valuable findings demonstrate the significant role of LeadingAge members both in providing the resources and services older adults seek and also in shaping the sector’s future.”

“This LZ 200 report is a critical annual report that captures the behaviors and characteristics of the country’s largest not-for-profit senior living organizations in the country,” stated Dan Hermann, President & Chief Executive Officer and Head of Investment Banking at Ziegler. “Readers are also able to gain insights into the fastest growing and most progressive organizations nationally, regionally and in their respective states. This information helps to pave a path forward for overall sector growth among not-for-profit providers.”

The LZ 200 report, developed annually through the LeadingAge/Ziegler partnership, includes more than 200 providers of multi-site systems, more than 150 single-site campuses, and government-subsidized multi-site housing providers. Previously known as the LZ 100 and LZ 150, the report was expanded in 2014 from LZ 100 to the LZ 150 and to the LZ 200 in 2018 in response to the growing industry and increasing interest.

To view the full report, click here.

About LeadingAge

We represent more than 5,000 nonprofit aging services providers and other mission-minded organizations that touch millions of lives every day. Alongside our members and 38 state partners, we use applied research, advocacy, education, and community-building to make America a better place to grow old. Our membership, which now includes the providers of the Visiting Nurse Associations of America, encompasses the continuum of services for people as they age, including those with disabilities. We bring together the most inventive minds in the field to lead and innovate solutions that support older adults wherever they call home. For more information visit