Signature Healthcare

What Signature Healthcare does

Signature Healthcare is a privately-held, for-profit family-based healthcare company headquartered in Louisville, Kentucky, founded in 2007 by E. Joseph Steier, III. It operates 115 skilled nursing, rehabilitation, and assisted living facilities across 10 southeastern and mid-Atlantic states, supplemented by home care (Silver Angels of Tennessee), behavioral health (Serenity HealthCARE), pharmacy services through a Clearway Health joint venture, and a hospital operation in Brockton, Massachusetts. The company employs between 17,000 and 24,000 stakeholders depending on source and serves short-term rehabilitation patients, long-term care residents, assisted living residents, memory/cognitive care patients, and home care recipients. Revenue is generated through Medicare, Medicaid, managed care, private pay, and Veterans benefits, with no publicly disclosed pricing; the go-to-market relies on hospital and physician referrals, managed care network relationships, and direct family admissions.

The technology stack consists of a fully deployed MatrixCare electronic health record platform providing evidence-based clinical decision support across all facilities, and the proprietary SmartCare Community platform that integrates Amazon Echo Dot and Fire Cube devices to give residents voice-activated access to scheduling, entertainment, and caregiver communication. The operating model is organized around three pillars — Signature Learning (career ladder programs including the 1,000+ graduate Pinnacle CNA program), Signature Spirituality (values and quality-of-life culture), and Signature Innovation (technology initiatives and partner sub-brands). Quality infrastructure is anchored by 103 Providigm QAPI accreditations, Eden Alternative Registry membership at more than 50 locations, and 16 AHCA National Quality Awards.

The business model is multi-stream: per-diem skilled nursing and rehab billing through government and commercial payers, recurring non-medical home care subscription-style revenue in Tennessee, professional services revenue from rehabilitation, and emerging pharmacy revenue through the Clearway Health joint venture. Real estate is largely financed through capital partners including Omega Healthcare Investors, Sabra Health Care REIT, and Sector Financial, who historically provided critical support through a corporate reset period involving a U.S. Department of Justice therapy investigation and a malpractice caseload exceeding 350 cases.

Name

Signature Healthcare

Legal name

Signature HealthCARE, LLC

Website

https://ltcrevolution.com

Company type

Private

Founded year

2007

Operating status

Operating

Headcount range

5,001–10,000 employees

Ownership category

akta.pro rank

Product category

Skilled Nursing & Rehabilitation Services

NAICS

Nursing Care Facilities (Skilled Nursing Facilities) (623110), Nursing Care Facilities (Skilled Nursing Facilities) (62311), Continuing Care Retirement Communities and Assisted Living Facilities for the Elderly (6233), Nursing and Residential Care Facilities (623)

SIC

Services-Skilled Nursing Care Facilities (8051), Services-Nursing & Personal Care Facilities (8050), Services-Home Health Care Services (8082)

akta.pro primary industry

Continuing Care Retirement Communities (CCRC) with Memory Care (HLADACAD)

Keywords

• Skilled nursing care
• Rehabilitation services
• Assisted living facilities
• Home health care
• Memory care services

Headquarters

HQ city

Louisville

HQ country

United States

HQ region

North America

Offices6 records

Markets served

GTM type

B2C

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Infrastructure, Marketing or Sales, Supply Chain

Revenue model

1. Skilled Nursing Care: Post-acute and long-term skilled nursing care services provided to residents. Revenue generated through Medicare, Medicaid, managed care organizations, and private pay. Operates 115 skilled nursing, rehabilitation, and assisted living facilities across 10 states.
2. Rehabilitation Services: Physical, occupational, and speech therapy services for short-term rehabilitation patients and long-term residents. Services provided as part of the continuum of care across facilities.
3. Home Care (Silver Angels): Licensed non-medical home care agency operating 7 locations across Tennessee serving 49 counties. Services include in-home personal care, companion care, home delivered meals, personal emergency response systems, in-home respite, medication reminders, and prescription pick up. Accepted payment sources include Veterans benefits, long-term care insurance, and self-pay.
4. Pharmacy Services: Partnership with Clearway Health to operate pharmacies improving medication access in response to regional pharmacy closures. First pharmacy opened in East Bridgewater, MA in March 2026.

Go-to-market motion1 record

Distribution channels5 records

Marketing channels6 records

Core offering

Signature HealthCARE operates 115 skilled nursing, rehabilitation, and assisted living facilities across 10 states, delivering short-term post-acute rehabilitation, long-term skilled nursing, assisted living, memory/cognitive care, dialysis, and non-medical home care (Silver Angels). Behavioral health services are delivered through the Serenity HealthCARE division, and pharmacy services are offered through a partnership with Clearway Health. The company supports its clinical operations with the MatrixCare EHR platform and a SmartCare Community technology featuring Amazon Echo voice integration for residents.

Product overview

Signature Healthcare operates a multi-facility skilled nursing and rehabilitation network across the southeastern United States, offering a continuum of care through its core skilled nursing facilities supplemented by specialized service pillars. The core product portfolio includes skilled nursing, rehabilitation services (physical, occupational, speech therapy), assisted living, dialysis, home care (via Silver Angels subsidiary), secured memory care units, and cognitive care programs. Supporting these clinical services are three organizational pillars: Signature Innovation (encompassing Silver Angels home care and Serenity Healthcare behavioral health), Signature Learning (employee development including Pinnacle CNA program and CEO DON School), and Signature Spirituality (values-based culture initiatives). Technology-enabled care is supported through the MatrixCare electronic health record platform and SmartCare Community voice assistant system using Amazon Echo devices.

Differentiator

Problem solved

Functional benefit

Products and services

• Skilled Nursing Core long-term and short-term skilled nursing care providing 24-hour nursing care for residents requiring medical supervision and daily clinical support, delivered across 115 facilities in 10 states and reimbursed through Medicare, Medicaid, managed care, and private pay.
• Rehabilitation Services Physical, occupational, and speech therapy services delivered to short-term rehabilitation patients and long-term residents to help them regain strength, mobility, and independence after surgery, illness, or injury.
• Assisted Living Residential services providing support with daily activities while promoting independence in a homelike setting, delivered at standalone facilities and within skilled nursing campuses (including the 60-apartment Princeton Transitional Care partnership with Ballad Health).
• Dialysis On-site dialysis services for residents with kidney disease, delivered within Signature facilities to eliminate the need for transportation to external dialysis centers.
• Home Care (Silver Angels) Non-medical in-home personal care, companion care, home-delivered meals, personal emergency response systems, medication reminders, prescription pick up, light housekeeping, and in-home respite delivered through Silver Angels of Tennessee to seniors and disabled adults. Accepted payment sources include Veterans benefits, long-term care insurance, and self-pay.
• Secured Units (Memory Care) Specialized secured memory care units providing enhanced safety measures and specialized programming for residents with cognitive impairments such as Alzheimer's and dementia.
• Cognitive Care Specialized care programs for residents with dementia, Alzheimer's disease, and other cognitive disorders using person-centered approaches focused on quality of life.
• Care Navigation 24/7 Care Navigation Service providing families with guidance and support for navigating healthcare options and coordinating care transitions, launched as a standalone service in 2021.
• Serenity HealthCARE (Behavioral Health) Behavioral health division providing specialized mental health services and programs for residents with neuro-cognitive and mental health conditions, including depression, anxiety, and dementia-related symptoms, led by Dr. Jeff Beaty and empowering caregivers with holistic assessments and evidence-based tools.
• Pharmacy Services (Clearway Health Partnership) Retail pharmacy services operated through a joint partnership with Clearway Health, improving medication access in regions affected by pharmacy closures with locations including the East Bridgewater, MA site opened in March 2026.
• SmartCare Community Voice-activated technology platform integrating Amazon Echo Dot and Amazon Fire Cube to empower residents with concierge services such as accessing schedules, entertainment, family communications, and direct caregiver alerts, improving care efficiency.

Quantifiable outcome

• 103 locations recognized with Providigm QAPI accreditation (83 advanced, 20 basic)
• +5 more outcomes

Named customers8 records

Segments6 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability4 records

Feature5 records

Partnerships

Seven partnerships are on record, tiered core.

• Clearway HealthcoreStrategic or Co-development Partner · 12 March 2026Signature Healthcare partnered with Clearway Health to open a second pharmacy in East Bridgewater, MA on March 12, 2026. The partnership aims to improve medication access in response to pharmacy closures in the region, addressing a 17.1% decline in Massachusetts pharmacies over recent years.
• Ballad HealthcoreStrategic or Co-development Partner · 1 January 2017Signature HealthCARE and Ballad Health partnered to develop Princeton Transitional Care & Assisted Living in Johnson City, TN. The partnership brings a new level of healthcare services to the Tri-Cities area with a 73,000 square-foot facility featuring 60 assisted living apartments and 47 short-term skilled-nursing and rehab private suites. Groundbreaking occurred in 2017 with grand opening in March 2019.
• Silver Angels of TennesseecoreStrategic or Co-development PartnerSilver Angels of Tennessee, LLC is a licensed non-medical home care agency affiliated with Signature HealthCARE. Operating 7 locations across Tennessee serving 49 counties, the company provides in-home personal care, companion care, home delivered meals, personal emergency response systems, and in-home respite. All locations are VA Approved Community Care Provider Facilities.
• MatrixCarecoreTechnology or IntegrationMatrixCare provides the electronic health record platform for all 115 Signature HealthCARE locations. The evidence-based platform helps achieve better clinical outcomes while reducing readmissions. Platform provides real-time insights for decision-making and complete mobile access for managed care delivery. Full transition completed by September 2019.
• Ankura ConsultingcoreImplementation/ SI/ Consulting PartnerReorganization and restructuring experts hired during corporate reset period to help navigate difficult industry challenges and financial restructuring.
• Klee, Tuchin, Bogdanoff & Stern LLPcoreImplementation/ SI/ Consulting PartnerLegal and financial restructuring counsel engaged during corporate reset to address therapy investigation and financial challenges.
• TimeSlipscoreStrategic or Co-development PartnerNon-profit partner for the 'I Won't Grow Up' project bringing creative arts to nursing home residents. Partnership funded by Civil Money Penalty Grant through Kentucky Office of Inspector General and CMS, and National Endowment for the Arts. Creates opportunities for elders with Alzheimer's and dementia to engage through creative storytelling and art.

Scale indicators14 records

Recent moves8 records

Expansion highlights6 records

Direct peers

• The Ensign Group: Operates a large portfolio of skilled nursing and post-acute care facilities across multiple U.S. states. Direct comparable in SNF operating model, geographic spread, and continuum-of-care strategy.
• Genesis HealthCare: One of the largest U.S. skilled nursing and post-acute care providers with hundreds of facilities. Closely comparable to Signature in SNF scale, payer mix (Medicare/Medicaid), and rehabilitation services.
• National HealthCare Corporation: Operates skilled nursing, assisted living, home care, and hospice across the southeastern U.S. Comparable in regional footprint, continuum-of-care model, and senior living services.
• PACS Group: Post-acute and skilled nursing operator with a multi-state facility footprint. Comparable to Signature in SNF operating model, geographic diversification, and growth trajectory.
• Five Star Senior Living: Operates assisted living, memory care, and skilled nursing facilities across multiple states. Comparable in residential senior care offerings, particularly assisted living and memory care.

Broad incumbents

• Brookdale Senior Living: Large national senior living operator with assisted living, memory care, and skilled nursing offerings. Broader portfolio than Signature but overlapping in residential senior care and memory care services.
• Encompass Health: Largest U.S. owner and operator of inpatient rehabilitation hospitals. Comparable to Signature's rehabilitation services arm (physical/occupational/speech therapy) and post-acute positioning.
• Select Medical Holdings: Operates specialty hospitals, outpatient rehabilitation, and post-acute care services. Comparable in rehabilitation focus and post-acute care delivery model.

Regional players

• Addus HomeCare: Provider of personal care, home health, and hospice services with strong presence across the U.S. Comparable to Signature's Silver Angels home care division in non-medical in-home care services.

Emerging players

• Aveanna Healthcare: Home health and hospice provider serving pediatric and adult patients. Partial overlap with Signature's home health and hospice-adjacent offerings through Silver Angels.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/ltcrevolution
• YouTubeyoutube.com/@Signaturehealthcarellc
• Facebookfacebook.com/SignatureHealthCARE
• LinkedInlinkedin.com/company/signature-healthcare
• Instagraminstagram.com/signaturehealthcarellc

Revenue estimate

Valuation estimate

Number of profiles

Profiles22 records

Subsidiaries5 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Signature Healthcare