The largest U.S. nursing home chains, ranked by the number of facilities, are:

1. Genesis Healthcare Corp., based in Kennett Square, Pennsylvania, 426 nursing homes

2. HCR Manorcare, based in Toledo, Ohio, 239 nursing homes

3. Life Care Centers Of America Inc., based in Cleveland, Tennessee, 214 nursing homes

4. Sava Senior Care LLC, based in Atlanta, 201 nursing homes

5. The Ensign Group Inc., based in Mission Viejo, California, 169 nursing homes

6. The Evangelical Lutheran Good Samaritan Society, based in Sioux Falls, South Dakota, 156 nursing homes

7. Consulate Health Care, based in Maitland, Florida, 155 nursing homes

8. Signature Healthcare LLC, based in Louisville, Kentucky, 114 nursing homes

9. Golden Living, based in Frisco, Texas, 114 nursing homes

10. Trilogy Health Services LLC, based in Louisville, Kentucky, 103 nursing homes

Source: SK&A , IQVIA report on largest U.S. nursing homes, 2018. The report shows Tennessee has a total of 315 nursing homes with a total of 35,834 beds; Georgia has 363 nursing homes with a total of 39,890 beds, and Alabama has 231 nursing homes with a total of 26,940 beds.