ArticleJournal of the American Medical Directors Association2026
Characteristics and Geographic Variability of US-Assisted Living Communities Affiliated With Top-10 Chains.
Article in Journal of the American Medical Directors Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
objectivesTo examine the geographic distribution and organizational characteristics of assisted living (AL) communities affiliated with the 10 largest chains (top-10 chains).
designCross-sectional analysis of secondary data. SETTING AND
participantsA total of 14,735 AL communities operating in 2023 with ≥25 beds across the United States (excluding Alaska, Hawaii, Connecticut, and Washington DC). Data were drawn from a national directory of AL communities, the American Community Survey, the University of Wisconsin and United States Department of Agriculture sources, and Medicare enrollment records.
methodsState-level maps depicted the percentage of AL beds affiliated with top-10 chains. Rates of top-10 chain-affiliated AL beds per 100,000 adults aged ≥65 years were compared with other ≥25-bed AL communities using stacked bar charts. Organizational and market characteristics between top-10 chain-affiliated and other ≥25-bed AL communities were compared using t tests and χ
resultsOf the 14,735 investment-grade AL communities identified nationally, 14.8% were affiliated with top-10 chains, representing 16.8% of AL beds. The share of top-10 chain-affiliated beds ranged from 2% in North Dakota to 33% in Delaware. Compared with ≥25-bed AL communities, top-10 chain-affiliated communities were more often located in socioeconomically advantaged areas (Area Deprivation Index: 45.3 vs 51.4, P < .001) and urban settings (84.7% vs 72.2%, P < .001). They served a lower proportion of dually eligible Medicare-Medicaid beneficiaries (13.7% vs 28.4%, P < .001) and a higher proportion of residents aged ≥85 years (62.2% vs 55.5%, P < .001). CONCLUSIONS AND IMPLICATIONS: Top-10 chains appear likely to be located in densely populated, socioeconomically advantaged areas and to serve older, wealthier resident populations than other ≥25-bed AL communities, although exceptions exist. Future research should examine how regulatory and market factors shape these patterns.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.