Who Owns California's Nursing Homes, Home Health Agencies and Hospices
Every Medicare-certified facility in California, matched to the corporate family that actually controls it — not just the LLC on the licence. Rebuilt from CMS ownership filings each month.
Largest Operators in California
Ranked by facilities controlled across every legal entity in the corporate family. CMS lists these as separate companies; the family column shows how many.
| Corporate family | Facilities | SNF | Home health | Hospice | Legal entities |
|---|---|---|---|---|---|
| PACS Group, Inc. | 125 | 125 | — | — | 11 |
| Rockport Administrative Services, LLC | 75 | 75 | — | — | 13 |
| The Ensign Group Inc | 62 | 62 | — | — | 10 |
| Cambridge Healthcare Services LLC | 33 | 33 | — | — | 19 |
| Kaiser Foundation Hospitals | 29 | — | 15 | 14 | 1 |
| Life Generations Healthcare, LLC | 26 | 26 | — | — | 2 |
| Sutter Health | 24 | 1 | 15 | 8 | 2 |
| Links Healthcare Group LLC | 24 | 24 | — | — | 2 |
| Commonspirit Health | 19 | 5 | 8 | 6 | 17 |
| Cornerstone Healthcare Inc | 18 | — | 6 | 12 | 6 |
| Adventist Health System/west | 18 | 4 | 8 | 6 | 3 |
| Pico Ar LLC PE REIT | 18 | 17 | 1 | — | 34 |
| Providence Health & Services - Washington | 16 | 5 | 6 | 5 | 8 |
| Renew Health Consulting Services LLC | 16 | 16 | — | — | 13 |
| Covenant Care, LLC PE | 16 | 13 | 3 | — | 14 |
All 2,001 Owner Organisations in California
| facility | ccn | care_setting | owner_org | relationship | ownership_pct | association_date | corporate_family | confidence |
|---|---|---|---|---|---|---|---|---|
| ••••% | ||||||||
| ••••% | ||||||||
| ••••% |
Plus every recorded change of ownership with parties and dates. See a worked example of the file · full field list.
How Concentrated Is California Healthcare Ownership?
Of the 5,307 Medicare-certified nursing homes, home health agencies and hospices WhoOwnsCare tracks in California, 20% are resolved to multi-facility corporate families, and the five largest families alone are associated with 6% of the state’s facilities. The ranked view is on the largest operators in California page; how families are resolved from CMS filings is documented in the methodology.
Recent Nursing Home Ownership Changes
| Buyer | Seller | Effective |
|---|---|---|
| LAZER HOLDINGS LLC | WEST COAST HOSPITALS INC | 2025-11-18 |
| MADERA POST ACUTE LLC | MADERA SNF OPERATIONS LLC | 2025-11-04 |
| CRESCENT CITY POST ACUTE LLC | CRESCENT CITY SKILLED NURSING LLC | 2025-11-04 |
| SARSEN HEALTHCARE LLC | STONEHENGE OF OREM, LLC | 2025-11-01 |
| BRODY BAY HEALTHCARE, INC. | COVENANT CARE LODI, LLC | 2025-08-01 |
152 nursing home ownership changes have been recorded in California since January 2023. CMS's change-of-ownership file lags — recent quarters are incomplete and fill in over time, so treat the most recent months as a floor rather than a count.
California Ownership Intelligence
Largest Nursing Home Operators
Ranked by facilities actually controlled, not by legal entities filed.
Nursing Home Ownership
For-profit, nonprofit, private equity and REIT ownership across California.
Ownership Changes and CHOW
Recorded Medicare ownership transfers, with buyers and sellers attributed.
Nursing Home Acquisitions
Who is buying, who is selling, and which operators are expanding.
Distressed Facilities
Operational, regulatory, financial and corporate stress scoring.
Home Health Operators
Largest home health companies and their ownership in California.
Hospice Operators
Largest hospice companies and their ownership in California.
California Ownership Intelligence Summary
WhoOwnsCare covers 5,307 Medicare-certified providers in California (2924 home health agencies, 1249 hospices, 1134 skilled nursing facilities). 29.9% are resolved to an operating family; the five largest families hold 20.4% of resolved providers and the largest single family, PACS Group, Inc., operates 125 (7.88%).
State pages for the largest families: PACS Group, Inc. in California; Rockport Administrative Services, LLC in California; The Ensign Group Inc in California; Cambridge Healthcare Services LLC in California; Kaiser Foundation Hospitals in California; Life Generations Healthcare, LLC in California; Sutter Health in California; Links Healthcare Group LLC in California; Commonspirit Health in California; Adventist Health System/west in California.
Concentration
691 distinct operating families are present. Herfindahl index (HHI) of resolved providers: 138.0 (below 1,500 is unconcentrated on the customary antitrust scale). Interpretation: California ownership is fragmented at the family level; limitation: shares are computed over resolved providers only.
Ownership Changes
Fastest-Growing and Contracting Operators
Most facilities acquired in the last 36 months: Rockport Administrative Services, LLC (24); Links Healthcare Group LLC (5); Cypress Healthcare Group LLC (5); PACS Group, Inc. (4); The Ensign Group Inc (4).
Most facilities divested in the last 36 months: Covenant Care, LLC (3); Eskaton Properties Incorporated (3).
Basis: recorded CMS SNF changes of ownership only; home health and hospice transfers are not covered by a public CHOW dataset.
Distress and Financial Reporting
Distress 2.0 bands across scored facilities: Low 676 Watch 381 High 48 Severe 9 Insufficient data 4193.
HCRIS financial metrics are available for 76% of eligible California facilities (4,051); among reporting facilities 73% reported a positive net result and the median facility result is positive.
Staffing and quality values are a single CMS snapshot (coverage: staffing 21%, star ratings 21%); trends require archived releases and are not derived.
Related California Research and Reports
- Largest operators in California
- California ownership changes
- California distressed facilities
- California acquisition intelligence
- California home health operators
- California hospice operators
- Get the state ownership intelligence report: California Ownership Dataset ($249)
Largest Corporate Families in California
- PACS Group, Inc. — 125 facilities in California
- Rockport Administrative Services, LLC — 75 facilities
- The Ensign Group Inc — 62 facilities in California
- Cambridge Healthcare Services LLC — 33 facilities
- Kaiser Foundation Hospitals — 29 facilities
- Life Generations Healthcare, LLC — 26 facilities
- Sutter Health — 24 facilities
- Links Healthcare Group LLC — 24 facilities
- Commonspirit Health — 19 facilities in California
- Cornerstone Healthcare Inc — 18 facilities in California
- Adventist Health System/west — 18 facilities
- Pico Ar LLC — 18 facilities