The US Senior Living Local Presence Index

Four senior living operators, twenty-four communities, and one uncomfortable number: families choosing where a parent will live are doing it on fewer reviews than they would read before booking a restaurant.

4operators ranked
24communities audited
917public reviews read
38reviews per community, on average

A daughter has three weeks to decide where her father will live. She opens her phone and types four words.

Assisted living near me. What happens next commits a family to somewhere between fifty and a hundred thousand dollars a year, and commits a parent to the place he will most likely die. It is among the highest-stakes consumer decisions anyone makes.

And she will make the shortlist from three results on a map — a name, a rating, a distance, a review count. Before any tour, any brochure, any conversation.

So we read what she reads.Twenty-four communities across four US senior living operators, seen exactly as a family would see them. The average community carries 38 reviews. A neighbourhood coffee shop carries more. This report is what that costs, and what else we found.

4 operators are in this study. They are anonymised, and the letters are deliberately not in rank order — so if you work in this industry, there is a reasonable chance one of these scorecards is yours and you will not know which until you reach the end.

If you run marketing or sales

Read this as a list of things you can fix. Occupancy in this industry is won at the shortlist stage, and the shortlist is built on a screen before anyone picks up a phone.

  • Most of what we found, you can fix yourself. Naming, hours, duplicates — a fortnight of attention and no budget. We tell you exactly what they are, free, and we would rather you just did it.
  • The part that does not stay fixed is review volume. Part Seven shows why: the same three bad reviews do twenty-five times more damage to a thin location than a rich one.
  • And every new location starts thin. Zero reviews beside siblings with hundreds, on a site you have just paid to open.
Full detail in Part Nine

If you sit on the executive team or the board

Read this as a list of things to ask about. One operator here has its corporate office absorbing complaints meant for the company, and another is publishing a community under a brand it no longer uses.

  • This is externally assessable, with no cooperation required. Everything here was visible to any customer with a browser — which also makes it checkable before you buy something.
  • The repair cost is fixed and the exposure is not. Twenty-seven five-star reviews to recover from three bad ones, at any volume. Thin locations take the damage; everyone pays the same bill.
  • Nobody in the org chart owns it. It sits across marketing, operations and whoever opens new sites, which is why it appears on no dashboard.
Full detail in Part Nine

Who published this, and why you should factor that in

Amplispot sells digital presence management, including a review and listings product called ReviewSpot. We have an obvious commercial interest in a report concluding that local presence is mismanaged, and you should read it with that in mind.

What we have done to make it checkable anyway: the scoring formula and full deduction schedule are published, so you can recalculate any score yourself. Every figure came from public Google listings, so any claim can be independently verified. No operator was contacted before publication, paid for inclusion, or given advance sight of its score. ReviewSpot is not mentioned again in this document.

What follows

  1. The shortlist happens before the tourWhy the listing decides who gets visited.
  2. Thirty-eight reviewsThe evidence gap in a six-figure decision.
  3. How we lookedOur method, our selection, and what it cannot see.
  4. One operator is not where you would expectWhat separates the top of this table.
  5. A measuring stickFour components, 100 points, published in full.
  6. The rankingAll 4 operators, scored.
  7. What the ranking revealsWhere the real separation lives.
  8. The scorecardsEvery operator, every defect.
  9. What to do about itOne reading for marketing, another for the executive team.
  10. Which operator are youWe will tell you privately.
Part One
The shortlist happens before the tour

Nobody tours six communities. They tour three.

Senior living is sold on the tour. Everyone in the industry knows this. What the industry has been slower to accept is that the tour is not where the decision narrows — the search result is.

What a family actually judges

A daughter comparing options forms a shortlist in under a minute from four things: whether the name reads as a real, specific place; whether the rating is above the two communities beside it; whether enough other families have been there for that rating to mean anything; and whether it looks open and active.

Each can be silently wrong. A community can trade under a name it abandoned years ago, so families searching the group brand never find it. A corporate office can be listed as a public destination and quietly collect complaints intended for the company. Two communities in one town can publish names so similar that reviewers confuse them.

Why the stakes are unlike any other category we have audited

Because of what the reviews contain. A restaurant listing carries opinions about dinner. A senior living listing carries families describing a parent's final months — sometimes gratefully, sometimes not. Those accounts sit permanently at the top of the result the next family reads, and they are written at the most emotionally charged moment of that family's life.

We have deliberately kept the substance of those reviews out of this report. What we are measuring is the infrastructure they sit on, not the care they describe.

None of this is visible from inside the building. Nobody on your team searches for their own community. That is the entire reason this report contains anything you did not already know.

If the shortlist is decided this early, the obvious question is how much evidence a family actually has to go on. The answer is startling.

Next, Part TwoThirty-eight reviews
Part Two
Thirty-eight reviews

A six-figure annual decision, made on thirty-eight reviews.

Across twenty-four communities we found an average of 38 reviews each. The thinnest operator in this study averages 27. Two individual communities carry fewer than ten.

38

Average reviews per community

Across the whole study. For comparison, multi-site veterinary clinics we audited on the same method averaged 154 to 1,628.

27

Thinnest operator average

At that volume, three unhappy families visibly move a community's public rating.

<10

Reviews at two communities

Whose ratings are therefore statistically meaningless, while appearing on screen exactly as authoritative as any other.

Why this matters more than the ratings do

Every operator here rates between 4.28 and 4.71. On sentiment, families are broadly satisfied and nobody is losing. But a 4.7 built on seven reviews is not a competitive advantage — it is a coin toss that happened to land well, and it will move the first time a family has a bad month.

Thin estates are fragile in both directions. They also rank poorly, because review count feeds local placement independently of score. An operator can be beaten in search by a lower-rated competitor with more families on record.

Four operators are the subject of this study. Before the numbers, here is precisely how we selected them and what our method genuinely cannot see.

Next, Part ThreeHow we looked
Part Three
How we looked

Everything here was visible to anyone with a browser.

No operator gave us data. None was contacted before publication. Every finding was equally available to the operator itself.

Step 1 · Find the communities

We searched each operator by brand name across the state or metropolitan area where it is most concentrated, so that communities are compared against genuine local peers.

Step 2 · Record what the listing says

For every communitie we captured the listing name, street address, telephone number, published opening hours, star rating, total review count, and the review text Google displays.

Step 3 · Compare communities against each other

Most defects only appear across a whole estate — a name that differs from every sibling, a shared contact route, a listing with no reviews at all. This is why internal teams miss them.

Step 4 · Score it mechanically

Components were calculated from the captured figures using the formulas and deduction schedule in Part Five. No judgement was applied afterwards.

What this method cannot see

  • We sampled one principal market per operator rather than a national census. Every operator here operates far more communities than shown. Per-communitie figures are unaffected; totals are floors, not counts.
  • This is a small sample. Four operators is enough to establish a pattern in review density but not enough to characterise an industry, and we would rather say so than imply otherwise. Edition 02 will widen it.
  • A single point in time. Ratings and listings drift, and some defects may already be fixed.
  • We did not measure owner response rate. The public data source does not expose owner replies as a retrievable field, so rather than estimate it, we left it out.
  • We hold no internal data from any operator, and we have deliberately excluded the substance of care-related reviews from this report.

One operator in this study is doing something structurally different from the other three, and it is not what we expected.

Next, Part FourOne operator is not where you would expect
Part Four
One operator is not where you would expect

The best-performing estate is not the best-rated one.

The operator that finishes first on our index does not have the highest member rating in the study. It wins on volume — 62 reviews per community against a study average of 38 — and on having no structural defects at all.

That is the whole argument of this report in one line. Sentiment is not the variable. Every operator here is well-rated. The separation comes from how much evidence exists and whether the estate is correctly represented.

What the bottom of the table has in common

The two lowest-scoring operators both carry a structural defect that has nothing to do with the quality of their communities. One publishes a community under a brand name it no longer uses, so families searching the group name cannot find it. The other has its corporate office listed as a public destination, where it has accumulated the lowest rating in its estate by absorbing complaints intended for the company rather than any community.

Both are administrative problems. Both are visible to every prospective family. Neither, as far as we can tell, is on anyone's dashboard.

One finding we are reporting carefully

On one operator's estate, identical review text appears verbatim on more than one listing, including the corporate office. We cannot determine from outside whether this is a disgruntled individual, a coordinated action, or something else entirely — and we are not going to speculate. What we can say is that it moves several ratings simultaneously and nothing suggests anyone is monitoring for it. If that operator contacts us we will send the specific listings immediately and free of charge.

That is one component of four. Here is the full measure, published so you can recalculate your own score.

Next, Part FiveA measuring stick
Part Five
A measuring stick

Four things, 100 points, no black box.

An index you cannot audit is a marketing device, not a measurement.

Component 01

Review density

Reviews per communitie. Count is a ranking input in its own right, not just a confidence signal for humans. Log-scaled.

35 points
Component 02

Listing integrity

Whether the estate is correctly represented. Starts at full marks and loses points for each defect found.

35 points
Component 03

Rating

Volume-weighted average across the estate, scaled 3.0 to 4.9.

20 points
Component 04

Consistency

The gap between the best and worst communitie. A wide spread usually means nobody is watching at communitie level.

10 points

The deduction schedule, in full

Integrity begins at 35 points. Each defect costs the following:

  • Acquired or renamed communities not migrated to the group brand−10
  • Listing names inconsistent, or missing a location qualifier−8
  • Live listing with no reviews, or no published hours−8
  • Identical review text appearing across multiple listings−8
  • Corporate headquarters listed as a public destination−6
  • Shared national contact number across the estateobserved, not scored
  • Unusually wide rating variance between communitiesreflected in consistency

Applied to 24 communities, that measure produces a table that looks very little like a ranking by size.

Next, Part SixThe ranking
Part Six
The ranking

All 4 operators, scored.

#OperatorCommunities ReviewsPer communitieRatingDefects Score
1Operator D6369624.67181
2Operator A6170284.71264
3Operator B5192384.32258
4Operator C7186274.28256

Size does not predict position

The largest operator in this study by community count finishes last. The operator in first place has no structural defects and the strongest review volume, and is not the best-rated. Scale gives you more communities; it does not give you a findable one.

Two variables drive nearly all of that separation. Neither has much to do with quality of care.

Next, Part SevenWhat the ranking reveals
Part Seven
What the ranking reveals

Volume separates. Ratings do not.

Finding one: review volume

From 27 reviews per communitie to 62.

Operator D62
Operator B38
Operator A28
Operator C27

A more than twofold gap between the strongest and weakest estate. Because volume feeds local ranking independently of score, an operator at the bottom of this chart can be outranked by a lower-rated competitor with more families on record — losing the shortlist described in Part One before a tour is ever booked.

Why review volume is insurance, not marketing

Take a location sitting at 4.6 stars. In one difficult month it receives three one-star reviews — a staffing gap, a bad week, one genuinely poor experience shared by a family or a group. Nothing unusual.

What that costs depends entirely on how many reviews were already on file.

Reviews already on fileRating after DropFive-star reviews to recover
404.35−0.2527
1004.50−0.1027
2504.56−0.0427
5004.58−0.0227
1,0004.59−0.0127

Two things in that table matter more than anything else in this report.

The same three reviews do twenty-five times more damage at a thin location than a rich one. And the recovery cost — 27 five-star reviews — is identical at every volume. It does not get cheaper because you are large. It is fixed by arithmetic.

So a thin estate takes visible hits and pays the same repair bill. That is why volume behaves like insurance rather than marketing: you cannot prevent bad reviews, you can only dilute them, and dilution has to be running before the bad month, not after it. The average community in this study carries 38 reviews. That is the top row of this table — the most exposed position in the whole category.

Finding two: ratings

From 4.28 to 4.71.

Operator A4.71
Operator D4.67
Operator B4.32
Operator C4.28
4.3★4.5★4.7★

A 0.43-star spread across four operators. To a family comparing two communities that difference is invisible. This is what a category looks like where everybody has already solved the obvious problem, and where the remaining advantage lies somewhere else entirely.

Below is every operator, with its component scores and each defect we found, described generically.

Next, Part EightThe scorecards
Part Eight
The scorecards

Operator by operator.

#1

Operator D

81/100Strong
6communities
369reviews
62per communitie
4.67★rating
1defects
Review density21/35
Listing integrity35/35
Rating18/20
Consistency7/10
  • Thin volumeThe strongest review volume in this study, and still an order of magnitude below other high-consideration purchase categories.
#2

Operator A

64/100Fair
6communities
170reviews
28per communitie
4.71★rating
2defects
Review density12/35
Listing integrity27/35
Rating18/20
Consistency6/10
  • NamingTwo communities in one town publish near-identical names differing by a single word, and a third internal property name appears in reviews but on no listing.
  • Thin volumeTwo communities carry fewer than ten reviews each, leaving their ratings dependent on a handful of families.
#3

Operator B

58/100Weak
5communities
192reviews
38per communitie
4.32★rating
2defects
Review density16/35
Listing integrity21/35
Rating14/20
Consistency7/10
  • HQ listedThe corporate office is listed as a public destination, carries the lowest rating in the estate, and absorbs complaints meant for the company rather than any community.
  • Cross-posted reviewsIdentical review text appears verbatim across more than one listing in the estate. Whatever the cause, it moves several ratings at once and nothing suggests anyone is monitoring for it.
#4

Operator C

56/100Weak
7communities
186reviews
27per communitie
4.28★rating
2defects
Review density11/35
Listing integrity25/35
Rating13/20
Consistency6/10
  • Legacy brandOne community trades on Google under a wholly different brand name. Every review on that listing refers to the group by its real name; the listing does not.
  • Thin volumeMedian community carries fewer than thirty reviews, for a decision costing families tens of thousands of dollars a year.

What you take from this depends entirely on which side of the table you sit on.

Next, Part NineWhat to do about it
Part Nine
What to do about it

Two audiences should read this differently.

For marketing and sales

  • You cannot prevent bad reviews. You can only dilute them. The table in Part Seven is the whole commercial argument: the same three complaints do twenty-five times more damage to a thin location, and the repair cost is identical either way. Dilution only works if it is already running when the bad month arrives.
  • Listings decay. They are not fixed once. Profiles get merged, the public suggests edits Google accepts, staff change hours, new locations arrive unclaimed. Everything in this report is a snapshot of an estate that drifts, which is why monitoring beats a one-off cleanup.
  • Every new location starts at zero and stays exposed for months. That is the top row of the Part Seven table, on a site you have just spent heavily to open — and it recurs with every opening rather than being solved once.
  • Your average conceals your worst location. Nobody sees location-level variance by watching a brand number, and the gaps we found in this study are wide enough to matter.
  • Occupancy is decided at the shortlist. A family narrows to three before any tour. Everything you spend on tour conversion is spent on a pool the listing already selected.
  • Thirty-eight reviews is not a moat. At that volume your rating is one bad month from moving. Volume is insurance as much as marketing, and it is the fastest-moving number in this report.
  • Legacy names cost you the brand search entirely. A community trading under a name you no longer use is invisible to every family searching for you by group name.
  • Ask at the moment families are most grateful. The warmest reviews in this study come from families describing a transition handled well. That moment happens on a known date and nobody is capturing it.
  • These defects are invisible from inside. Nobody on your team searches for their own community, which is why a wrong brand name can persist for years.

For the executive team and board

  • This is a recurring exposure, not a project. A cleanup fixes today's estate. It does not stop profiles drifting, does not protect the next opening, and does not tell you which location slipped last month. Whoever signs off on a one-off fix should understand what it does and does not buy.
  • Thin locations are fragile in a way the average hides. Part Seven quantifies it: three bad reviews move a thin location twenty-five times more than a rich one, and cost the same twenty-seven five-star reviews to repair either way.
  • Nobody in the org chart owns it. Listing and review data sits across marketing, operations and whoever opens new sites. In most organisations that means no owner, no dashboard, and attention only after a complaint reaches somebody senior.
  • Your corporate office may be a public destination. One operator here has its head office collecting the lowest rating in its estate, absorbing complaints meant for the company. That is a five-minute fix nobody has made.
  • Nobody in the org chart owns the listing. It sits across marketing, community operations and brand. In most groups that means no owner, no dashboard, and attention only after a complaint reaches somebody senior.
  • Acquisition and rebranding create the debt. Communities arrive with their own listings and names. Integration covers systems and signage; it rarely covers the profile.
  • Coordinated review activity is a real exposure. One estate in this study shows identical text across multiple listings. Whatever the cause, no operator here appears to be monitoring for it.
  • It is cheap and externally verifiable. One of very few occupancy levers with a hard before-and-after that anyone — including a competitor — can check.

If any of the 4 scorecards looked uncomfortably familiar, there is a straightforward way to find out.

Next, Part TenWhich operator are you
Part Ten
Which operator are you

We will tell you. Privately, and at no cost.

The letters are not in rank order, and that is on purpose.

Operators in this study are anonymised. We hold a private key mapping each letter to its operator, along with a verification code that appears nowhere in this document.

Email us from a company domain and we will confirm your letter, quote your verification code back to you, and send the full underlying detail for your estate — every communitie, every defect, named and specific. No charge, no meeting required, and we will not add you to anything.

audit@amplispot.com
Subject: SLPI 2026 — [your operator name]

We will not confirm any other operator's identity to you, and we will not confirm yours to anyone else. If you believe a defect we recorded is wrong, tell us — corrections are published in the next edition with the correction noted.