Vertical software45% entry signalMarket screen5 sourced figuresOne thing must be trueincumbent vulnerability

Long-Term Care & Senior Living Software

Prepared 2026-09-09

The buyer population — Nursing and residential care facilities

Base industry report for 623 →
Establishments · CanadaA
12,035
with employees
Under 10 employeesA
27%
most common size: 20–49
Establishments · USA
95,137
Employment · USA
3,195,722
34 per establishment
Payroll · USA
$126.5B
$40k per employee

Of 12,035 Canadian establishments with employees, 27% have fewer than ten — an industry where large establishments carry real weight. Each of those is one potential account, before any filter for size or fit.

Entry signal — what decides who wins here

One thing must be true
Structure decides One thing must be true Execution decides

Entry turns on a single condition that can be named and tested before much is spent. Clear it and this becomes an execution question; fail it and no amount of operating skill helps.

What you would have to beat

Displace an incumbent the screen found well defended — payments attached to the workflow, data that does not leave, a contract that renews itself. Share here means giving a buyer a reason to break something that currently works, which is a higher bar than being better.

How it was read
Binding constraintUNVERIFIEDincumbent vulnerability — Executional — a better operator can move it.
Measured inputsUNVERIFIEDnot applied — This is a software market. The industry’s business counts describe its BUYERS, not the market being entered, so they are left out of the signal.
How many new establishments are still tradingA
Health Care and Social Assistance, US · opened 2020
84%
1 year
65.3%
3 years
52.6%
5 years
36.4%
10 years
opened 2015

Measured, not forecast: the share of US establishments opening in one year that were still active later. It counts good operators and bad ones together, which is exactly why it is the honest answer to “what are the odds”. It is for the whole sector rather than this market, and the ten-year figure comes from an older cohort because no younger one has reached ten years.

This is not a probability of success, and it is not a verdict on you. No survival probability is published per market, and inventing one would be worse than saying so. What the bar reads is how much of the outcome sits inside an operator's control: green means the hurdles are ones a better operator clears, red means the binding constraint is capital, an asset or a permission rather than execution. Someone arriving with an advantage this screen did not assume can win a market shown in red.

Companies named in this market · 8

The binding constraint — incumbent vulnerability

Unusually fragmented for healthcare software — the top ten vendors hold roughly a quarter of revenue — which normally reads as opportunity. It is not, for the reason established in the home care study: the leaders reached the buyer first and the buyer's margins are set by Medicaid and provincial funding rather than by willingness to pay. PointClickCare is also the strongest Canadian vertical-SaaS outcome in this research and worth studying as a model rather than a target.

Angel-backed companies1
in the Canadian portfolio dataset
Province mixQC 1

Sectors joined: 3D Imaging

[UNVERIFIED] Sector-to-NAICS mapping is analyst judgment — see data/angel-sector-map.json. Counts are a per-record cross-reference and are not additive across records.

I

The incumbent

Who owns this market and who is coming for it. Fields a screen never reached say so rather than guessing.

Incumbent
PointClickCare
Scale
Canadian (Mississauga). The reference LTC platform in North America — EHR, billing and operations for skilled nursing and senior living
Share
Top 10 vendors hold only ~25% of market revenue (2024)
Challengers
MatrixCare (ResMed), WellSky, McKesson, Allscripts/Veradigm, eClinicalWorks, Yardi Senior Living
Lock-in mechanism
Not assessed — screened before diligence
Price movement
Not assessed
Is the buyer consolidating?
No
F

Financials & market size — sourced

Figures that came from a filing, a results release or reputable reporting, each carrying its evidence tier.

Long-term care software market, 2025B $5.6B
Projected 2033B $10.2B, 7.7% CAGR
Alternative estimate, 2026B $6.29B → $9.97B by 2033, 8.0% CAGR
Top-10 vendor concentration (2024)B ~25% of market revenue
R&D intensity of leadersC >10% of annual revenue
V

The field

Every vendor named on this record, and what each one discloses. Most disclose nothing, which is why the market is not sized.

Competitor set · 4 named · 0 disclose revenue

NameRevenueShareNote
PointClickCareC not disclosed — Private (Mississauga, Canada); revenue not disclosed
MatrixCare (ResMed)C not disclosed — Not separately disclosed
WellSkyC not disclosed — Private (TPG/Leonard Green)
McKesson / VeradigmC not disclosed — McKesson does not break out the post-acute line; Veradigm was delisted in 2024 and no longer files

Nobody here publishes revenue. The market is not sized for that reason — an estimate built on nothing would only look like knowledge.

S

Startups & challengers

Newer and smaller vendors going at the incumbent — funded challengers first. Named, not researched to the depth of the field above; a company with a page here links to it.

CompanyStageWhat it doesRaised
Exacare Funded challenger AI for referrals, admissions and reimbursement at nursing, home health and hospice providers. —
Relias Funded challenger Training and compliance learning for healthcare and human-services staff. —
banquet health Startup Dining and nutrition management software for senior living and long-term care kitchens —
CurveHealth Startup Telemedicine and behavioral health services for skilled nursing facilities. —

Evidence

Evidence. Incumbent financials and market-share figures on this record ARE sourced (tier A/B, see the financials block). The cut factor and reasoning remain analyst judgment and were not tested against customers.

#

Where the industry talks

The associations, forums and events where people in this trade actually talk shop — where to listen before entering, and where the first customers are found. Each link was opened on the date shown.

AssociationCanadaA
Canadian Association for Long Term Care
caltc.ca

National voice for LTC; members are provincial/territorial LTC associations and corporate providers. Member count not stated.

Checked 2026-09-22
AssociationOntarioA
Ontario Long Term Care Association
oltca.com

Provincial association of LTC home operators; runs the This is Long Term Care conference. Member count not stated on home page.

Checked 2026-09-22
AssociationUSA
AHCA/NCAL
ahcancal.org · 15,000 members (2026-09)

Member facilities ('over 15,000-strong membership'), per its home page. Skilled nursing and assisted living providers; convention DS26 Oct 11-14, 2026, Boston.

Checked 2026-09-22
AssociationUSA
Argentum
argentum.org

National trade association for senior living community owners and operators; Senior Living Leadership Summit Nov 16-18, 2026.

Checked 2026-09-22
AssociationUSA
LeadingAge
leadingage.org · 5,300 members (2026-09)

Nonprofit aging-services provider members ('over 5,300'), per its home page.

Checked 2026-09-22
PublicationUSA
Senior Housing News
seniorhousingnews.com

Daily trade news for senior living operators; articles dated Sept 22, 2026.

Checked 2026-09-22
PublicationUSA
Skilled Nursing News
skillednursingnews.com

Daily trade news for skilled nursing operators; articles dated Sept 22, 2026.

Checked 2026-09-22
PublicationUSC
McKnight's Long-Term Care News
mcknights.com

Long-running LTC trade publication; Sept 2026 stories found in search. Blocked automated access.

Checked 2026-09-22
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The businesses it sells to

Operating-business records filed along the same branch of NAICS — the customers of this software, screened as businesses in their own right.

Operating businessScreenedfiled at 623110
Retirement & Long-Term Care Home AcquisitionStructure decides
binding constraint: capital intensity

This is the rare traditional market where demand is proven by the operators' own numbers — Chartwell ended 2025 at 95.2% occupancy with property revenue up 34.9%, and Extendicare's long-term care segment ran at 98.0% occupancy on $892.1M — and it is still a screen, because the margin is regulated and the entry ticket is a building. Extendicare's LTC adjusted NOI margin was 10.9%: a thin, provincially funded return on an asset requiring tens of millions of capital, ongoing capex and licensed staffing a new entrant cannot recruit at scale.

NAICS 6231103 vendors named11 sourced figuresOpen →
Operating businessScreenedfiled at 6232
Group Home & Supportive Living OperationStructure decides
binding constraint: growth quality

The pre-screen called this a genuine operator business, and the count agrees: 4,091 establishments, 2,511 of them with 10 to 49 staff — which is what a house or a small cluster of houses with round-the-clock shifts looks like. Unlike the retirement and long-term care homes screened at 623110, the ticket is not a purpose-built building; a group home is an ordinary house, often leased. And the funded rate is substantial. Ontario's Financial Accountability Office puts developmental-services supportive living at $2,262 million in 2023-24 for approximately 18,000 people — $123,826 per client [A]. The cut is what that money is growing into. The FAO projects spending rising 4.4% a year to $2,804 million by 2028-29 with no growth in the number of clients served: the whole increase is cost per placement [A]. Meanwhile 28,128 people were waiting for a placement, up from 18,152 in 2017-18 [A]. Demand that large beside volume that flat means the payer has decided not to buy more places, and an entrant's growth can only come from taking an existing placement from an incumbent agency — agencies that hold their funding through long-standing transfer-payment agreements and, being largely non-profit, have no reason to sell. Growth that is pure wage pass-through is not growth an operator keeps. This is not a clean kill. It is an Ontario finding; a full study would test the provinces that contract for-profit providers more freely, and the private-pay addiction and mental-health residences that share this code and were not examined.

NAICS 62324 vendors named10 sourced figuresOpen →
Operating businessScreenedfiled at 6233
Retirement Residence OperationStructure decides
binding constraint: capital intensity

Private-pay retirement living is the part of elder care where the operator, not a ministry, sets the price — and demand is as certain as demography gets. The 623110 record screens the funded long-term-care acquisition; this is the other side of the building, and the numbers explain both why it attracts capital and why it is not an ordinary entrant's market. Chartwell, one of the largest Canadian operators at about 25,000 residents in four provinces, reported 2025 property revenue of $1,079.0M, up 34.9%, with same-property occupancy of 95.2% at year-end and a same-property adjusted operating margin of 41.7% [A]. That margin is earned on a real-estate base: Chartwell completed or announced more than $1.7B of acquisitions in the year [A], which is the price of growing in this industry. The business count says the same thing in another way — only 22% of the 3,493 Canadian establishments have fewer than ten employees, and 300 employ a hundred or more [A]. A residence is a purpose-built, licensed building staffed around the clock; it is financed like an apartment tower and operated like a hotel with a care obligation. The cut is the building. A small operator can lease or manage, but then the landlord holds the asset the margin is earned on.

NAICS 62336 vendors named14 sourced figuresOpen →
Operating businessScreenedfiled at 6239
Group Home & Residential Care OperationOne thing must be true
binding constraint: willingness to pay

Group homes, transition houses and residences for people with disabilities are small by design — a house on a residential street, staffed in shifts — and that makes the industry look reachable: 37% of the 2,028 Canadian establishments have fewer than ten employees [A]. The cut is who pays and how. Almost every bed is funded by a provincial ministry or a regional authority under a per-diem or a service agreement, so the operator's revenue is a rate it does not set, revised on the funder's schedule rather than when wages move. The cost side is nearly all labour: the US counterpart runs about 21 employees per establishment on a payroll of roughly $41,000 each [A], which is what round-the-clock direct care costs. An entrant therefore buys a house, carries staffing at a ratio fixed by licence, and is paid a rate negotiated by someone whose incentive is to hold it down. The 6243 record found the same mechanism in vocational rehabilitation: the contracts do not fund the service, and the organisations doing the work cover the gap from revenue earned elsewhere. Here there is no such arm to lean on. Operators that do well are non-profits with fundraising, or multi-site providers who spread overhead across dozens of homes.

NAICS 62394 vendors named10 sourced figuresOpen →