23rd Annual LeadingAge Ziegler 200 Report
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Ziegler and LeadingAge are pleased to bring you the 23rd Annual LeadingAge Ziegler 200 (LZ 200) report. The report is a ranking and analysis of the nation’s 200 largest not-for-profit senior living organizations across the country as of December 31, 2025. This year’s report represents more than 300,000 market-rate units and nearly 1,650 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 2026 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.
- National Senior Communities – Washington, DC
- The Evangelical Lutheran Good Samaritan Society – Sioux Falls, SD
- Presbyterian Homes and Services – Roseville, MN
- Acts Retirement Services, Inc. – Fort Washington, PA
- Ascension Living – St. Louis, MO
- HumanGood – Pleasanton, CA
- Covenant Living Communities & Services – Skokie, IL
- Trinity Health Senior Communities – Livonia, MI
- Benedictine – Duluth, MN
- Lifespace Communities – Dallas, TX