In most western countries, the majority of elderly care facilities are freestanding, but they may also be part of a continuing-care retirement community, seniors apartment complex, or wing or floor of a nursing home. Ownership and operations vary, too. In the United States, most of the largest multi-facility providers are publicly held and managed as for-profit businesses. There are exceptions; the largest operator in the US is the Evangelical Lutheran Good Samaritan Society, a not-for-profit organization that manages 6,531 beds in 22 states, according to a 1995 study by the American Health Care Association.

Elderly Care is focused on satisfying the expectations of two tiers of customers: the resident customer and the purchasing customer, who are often not identical, since relatives or public authorities rather than the resident may be meeting the cost of care. Where residents are confused or have communication difficulties, it may be very difficult for relatives or other concerned parties to be sure of the standard of care being given, and the possibility of elder abuse is a continuing source of concern.