While stormy economic conditions buffeted the business last year, indicators now point to smoother sailing ahead. As businesses in nearly every U.S. sector struggled to stay afloat last year, assisted living was the buoy in the choppy waters. Steady demand for quality services helped keep companies stable-even if accompanied by a hiatus from major mergers and acquisitions.

As businesses in nearly every U.S. sector struggled to stay afloat last year, assisted living was the buoy in the choppy waters. Steady demand for quality services helped keep companies stable-even if accompanied by a hiatus from major mergers and acquisitions.

Now, as economic forecasters allude to the end of the "Great Recession," companies like this year's Largest Providers are poised for growth, some of which is already underway. Forty-two of those companies (60%) that made the 2010 list report increases in licensed assisted living resident capacity-though much of that growth was in single-digit percentages. Another 16 of the top 70 companies maintained their size, while just 12 reported losses.

Here's a look at Assisted Living Executive's 2010 Largest Providers, and the business environment, transactions, and trends that landed each company a spot.

Top Players Hold Steady

In 2009, no assisted living providers merged nor acquired any other complete company. However, while most deals were small, the year did produce a few large portfolio acquisitions and considerable reshuffling. The biggest gains and losses were among the biggest players and occurred through simple sales and acquisitions.

For the first time since Assisted Living Executive began compiling this annual Largest Providers list, Sunrise Senior Living, based in McLean, Virginia, no longer sits at No. 1. The company, now No. 2, had no new building starts and sold off about 9 percent of its assisted living capacity (about 2,896 units) last year. Its biggest transaction was a portfolio of 21 communities in 11 states to Milwaukee, Wisconsin-based Brookdale Senior Living for $204 million, but Sunrise also sold smaller portfolios to regional providers, such as Baltimore-based Brightview Senior Living (The Shelter Group), which purchased two of Sunrise's New Jersey communities.

The Sunrise downsize has made Seattle-based Emeritus Senior Living the nation's largest assisted living provider. Emeritus acquired 2,221 new licensed assisted living units and grew by 7 percent in the past year, and it's very likely that Emeritus will not only maintain the top spot next year, but expand significantly in 2011. The company's partner, Blackstone Real Estate Advisors, is pursuing the purchase of 134 communities operated by Sunwest Management, which is in Chapter 11 bankruptcy. Under a preliminary agreement, Emeritus would manage the properties with the option to invest up to 10 percent of the equity in a joint venture with Blackstone and Columbia Pacific Management, an entity controlled by Dan Baty, Emeritus chairman and co-CEO.

Brookdale Senior Living maintained its No. 3 ranking, but also grew by 3,808 residents, or 15 percent, in 2009. Sunwest Management, last year's No. 4 company, comes in at No. 7 this year with 9,186 assisted living residents, a 43 percent drop. The company will disappear completely from the 2011 list if Blackstone or another entity receives court approval to buy the remainder of Sunwest's portfolio.

In terms of percentage growth, the clear winner is Solana Beach, California-based Senior Resource Group, another beneficiary of Sunwest's financial woes. The company picked up management contracts for 41 properties in 11 states, under the name LaVida Communities, when institutional investor Lone Star Funds of Dallas acquired the properties in the first big deal of 2009. Senior Resource Group catapults from No. 55 to No. 11, having grown its assisted living resident capacity more than 500 percent, to 4,897.

Big Movers

For the next Largest Providers percentage spike, look to CRL Senior Living Communities, which enters the list at No. 57, thanks to more than doubling its assisted living capacity from 502 to 1,019. Also on the growth path, Frontier Management expanded by 64 percent, from 828 to 1,358 licensed assisted living units, thanks to seven new management contracts and two new buildings. Frontier Management jumps 15 spots from No. 57 to No. 42. Watch this Western regional provider to grow further next year as several more new buildings open.

The fourth-largest list jumper is Carmichael, California-based Eskaton Senior Residences and Services, rising 12 spots to No. 56. The company reports 1,036 licensed assisted living units (up from 732 last year) due to either expansions or applications for additional assisted living licensing.

Only seven other providers report gains of 20 percent or more in the past year, and among them is Bradley, Illinois- based BMA Management. Because of its focus on the affordable market, the company continues to benefit from accessible financing sources not available to traditional providers. BMA Management's assisted living resident capacity jumped 27 percent in the past year as the company opened six new communities. In 2010, the company moves up the list by three spots, coming in at No. 21.