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Largest nursing home companies in California

There are 1,134 Medicare-certified nursing homes in California. The ten largest operators control 474 of them — 42% of the state.

This ranking counts what each company actually controls. CMS files list operators as separate legal entities, so a group running 133 buildings can appear as 11 unrelated companies. The rankings you find elsewhere count the paperwork; this one counts the buildings.

RankCompanyCalifornia nursing homesLegal entities CMS listsType
1PACS Group, Inc.13311Operator
2The Ensign Group Inc7510Operator
3Rockport Administrative Services, LLC7513Operator
4Pico Ar LLC4034PE
5Aspen Skilled Healthcare Inc348Operator
6Cambridge Healthcare Services LLC3319Operator
7Life Generations Healthcare, LLC262Operator
8Links Healthcare Group LLC242Operator
9JRB Investments LLC1814Operator
10Global Skilled LLC175Operator

California nursing home chains and corporations, explained

People search for California nursing home companies in a dozen ways — largest nursing homes, top nursing home chains, nursing home corporations, biggest nursing home groups. They are all asking the same thing: who is actually behind the sign on the building. The answer is in CMS ownership filings, which are public, free, and almost unreadable in raw form.

How this is calculated

Every Medicare-certified nursing home files its owners with CMS. We take those filings, group entities whose facility portfolios overlap into a single corporate family, and count distinct facilities. Entities appearing only as lenders or mortgage holders are excluded — a bank holding paper on a building does not operate it. Full method on the methodology page.

Every nursing home operator in California

All California nursing homes with their full ownership chain, every legal entity, ownership percentages, association dates and change-of-ownership history. CSV and PDF.

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Common questions

How many nursing homes are there in California?

1,134 Medicare-certified nursing homes, per CMS enrollment files.

Who is the largest nursing home operator in California?

PACS GROUP, INC., with 133 California nursing homes across 11 separate legal entities on file with CMS.

Why do nursing home companies show up under many different names?

Operators commonly file a separate legal entity per facility, plus separate property, management and therapy companies. CMS records each one individually and nothing in the file links them.

Sources for this page
Skilled Nursing Facility All Owners — CMS file SNF_All_Owners_2026.07.31.csv, published 2026-08-17, retrieved 2026-08-20. Original file
Home Health Agency All Owners — CMS file HHA_All_Owners_2026.07.17.csv, published 2026-08-19, retrieved 2026-08-20. Original file
Hospice All Owners — CMS file Hospice_All_Owners_2026.07.17.csv, published 2026-08-19, retrieved 2026-08-20. Original file
Skilled Nursing Facility Enrollments — CMS file SNF_Enrollments_2026.07.31.csv, published 2026-08-17, retrieved 2026-08-20. Original file
Home Health Agency Enrollments — CMS file HHA_Enrollments_2026.07.17.csv, published 2026-07-27, retrieved 2026-08-20. Original file
Hospice Enrollments — CMS file Hospice_Enrollments_2026.07.17.csv, published 2026-07-27, retrieved 2026-08-20. Original file