Zanziper Family Trust has established itself as the largest skilled nursing facility operator in North Carolina, controlling 38 facilities across the state according to the latest CMS data from January 2025. This significant presence in North Carolina represents nearly half of the trust’s nationwide portfolio of 82 healthcare facilities.
Portfolio Overview and Ownership Structure
The trust’s healthcare holdings extend beyond North Carolina, with a presence in Kentucky (20 facilities), Florida (12 facilities), Tennessee (10 facilities), and Virginia (2 facilities). While primarily focused on skilled nursing facilities with 81 properties in this sector, Zanziper Family Trust also has a presence in the home health sector with one facility in Florida.
Of Zanziper Family Trust’s 82 total facilities, only one is fully owned (100% ownership), while 16 facilities fall within the 50-99% ownership range, and the majority (65 facilities) are held with ownership stakes between 5-50%.
Market Context
The trust’s significant presence in North Carolina comes amid important regulatory developments in the state’s skilled nursing sector. Recent Medicaid rate increases implemented in July 2023 provided a permanent increase of $37.74 per patient day for SNFs, replacing a previous temporary increase. Additionally, provider assessment rates were adjusted downward in October 2024, potentially improving operating margins for facility owners.
