HC Family Trust has established itself as one of the dominant players in North Carolina’s skilled nursing sector, according to the latest CMS data. The organization ties with Zanziper Family Trust for the largest skilled nursing portfolio in the state, each operating 38 facilities.
Multi-State Portfolio
Beyond its significant North Carolina presence, HC Family Trust maintains a diversified geographic footprint across five states. The organization operates a total of 82 healthcare facilities, with 81 skilled nursing facilities and one home health agency. After North Carolina, Kentucky represents the trust’s second-largest market with 20 facilities, followed by Florida (12), Tennessee (10), and Virginia (2).
Ownership Structure
The trust employs a strategic ownership approach, maintaining partial ownership stakes across its portfolio. According to CMS data, none of its facilities are fully owned, with 17 facilities having ownership percentages between 50-99% and 65 facilities between 5-49%. The most common ownership percentage is 47.5%.
Regulatory Environment
North Carolina’s skilled nursing facilities operate under strict regulatory oversight from both state and federal agencies. All facilities must be certified by the NC Division of Health Service Regulation and comply with state and federal rules. The state’s Medicaid program implemented changes to the Skilled Nursing Facility Fair Rental Value reimbursement methodology in October 2021, affecting facility finances.
