Walk into almost any assisted living community, and the people running the floor are women. They’re the nurses, the care aides, the activity directors, and very often the executive directors holding the whole building together. Head to the corporate office, though, and the picture changes. The industry that depends most on women’s work still hands most of its top jobs to men.
That gap matters for more than fairness. Senior living is heading into a heavy leadership turnover cycle, demand for care keeps climbing, and operators are under pressure to hire executives who actually understand the work. For women already inside the industry, that combination creates an unusual opening. The catch is that it mostly rewards the ones who understand how top seats really get filled.
Photo credit: Pavel Danilyuk on Pexels
The Numbers Behind the Gap
Women make up roughly 80% of the senior living workforce and hold about 70% of its senior management positions, compared with about 56% across U.S. industries overall. Those figures come from Argentum’s research on women in leadership, which also found that only 17.5% of the 115 largest senior living providers had a woman as CEO. In other words, the industry built a deep bench of women managers and then stalled at the final step. The same research flagged that about 40% of multi-site senior living CEOs were nearing retirement age, which turned the gap into a succession problem as much as an equity one.
There’s been progress since then. The Argentum and Lument Largest Providers Report found that the share of top providers led by women chief executives grew from 8% in 2014 to 19% in 2021, with women running three of the ten largest companies. That’s real movement, but it still leaves the top of the industry looking nothing like its workforce. A sector where four out of five employees are women shouldn’t need most of a decade to reach one woman CEO in five.
Where the Pipeline Narrows
Broader workplace research points to a few likely culprits. The 2025 Women in the Workplace report from McKinsey and LeanIn.Org found that women hold just 29% of C-suite roles in corporate America and that only 93 women were promoted to manager for every 100 men. It also found that employees with sponsors were promoted at nearly twice the rate of those without, yet women were less likely than men to have a sponsor at every career level. Senior living shares that pattern, and its huge female workforce can make the problem easy to miss.
In senior living, the narrowing usually happens at the jump from community leadership to corporate roles. Clinical leaders and executive directors build deep operating expertise, but roles like CFO, COO, and chief strategy officer tend to go to people with portfolio-level P&L ownership, capital markets exposure, or acquisition experience. Harbor Retirement Associates CEO Sarabeth Hanson told Senior Housing News that she left a larger company for a smaller one so she could write pro formas and handle site selection, work that would’ve gone to specialists at a bigger operator. That kind of lateral move rarely looks like a promotion on paper, but it’s often what turns a strong operator into a credible chief executive.
How the Top Seats Actually Get Filled
Most C-suite openings in senior living never show up on a job board. Firms that specialize in recruiting C-suite senior living executives describe the qualified talent pool as an iceberg, where only a small share of candidates are actively looking, and the rest are passive leaders who’d move for the right role. Boards typically hire those firms on a retained basis, and the search starts with defining what the new executive must accomplish in the first 12 months, whether that’s census growth, margin improvement, stronger survey results, or a completed acquisition. If a woman’s record can’t be mapped to outcomes like those, she won’t make the shortlist, no matter how respected she is inside her own building.
That process has practical consequences for anyone hoping to be on the list. Recruiters check CMS Care Compare history for the communities a candidate has overseen, and they increasingly call former direct reports instead of relying only on former bosses. Interviews lean on specifics, such as how a candidate sets census targets or what she did when a community missed them three months running. A leader who’s tracked her own numbers for years walks into that conversation with an advantage, while one who’s relied on her reputation has to rebuild the evidence on the spot.
Moves That Close the Gap
The first move is to quantify everything. Occupancy gains, labor cost reductions, survey deficiency trends, and staff turnover rates are the language boards use to compare candidates, so it’s worth keeping a running record for every community and team you’ve led. Turnover deserves special attention, because leaders who’ve mastered the basics that keep people happy at work tend to post retention numbers that stand out in a staffing-strained industry. A documented drop in caregiver turnover is one of the most persuasive lines a senior living leader can put in front of a board.
The second move is to protect time for visible, strategic work. Women in operations often absorb the extra committee, the extra survey prep, and the extra late-night crisis call because they’re dependable, and that work rarely shows up in a C-suite candidate profile. Getting comfortable with saying yes when you really mean no frees up room for the assignments that do count, like leading a turnaround, sitting in on capital planning, or owning a new community opening. Each of those builds the portfolio-level experience that search committees screen for.
The third move is to turn mentors into sponsors. A sponsor is the person who puts a name forward when a search firm calls or a board starts succession planning, and McKinsey’s finding that sponsorship nearly doubles promotion rates shows how much that advocacy is worth. Argentum launched its Women in Leadership initiative partly to build those connections, and executives who’ve already made the climb are often more willing to advocate than aspiring leaders assume. Since recruiters lean so heavily on referrals to reach passive candidates, being known to the right three or four people can matter more than any job application.
The Window Is Open Now
Senior living’s demographics are working in favor of women who prepare. A generation of founders and long-tenured CEOs is stepping back, operators are consolidating and expanding, and boards increasingly want leaders who’ve actually run communities. Kendal, the nonprofit senior living network, has reported that women now serve as CEOs at 11 of its affiliates, which shows how quickly a leadership bench can change once an organization commits to it. The women who’ll fill the next round of C-suite seats are mostly already in the industry, and what will set them apart is being visible, measurable, and connected when the search begins.
Melissa Stewart is the founder of SheOwnsIt.com. She is a Purveyor of Possibility, Entrepreneur Advocate and Coffee Addict. She believes that behind every successful woman is her story. What’s your story?
