The set-up of elder care in the Netherlands is unique. This is true in terms both of the government’s role and of the inexplicable regional differences in elder care and the proportion of inpatient and outpatient care. 2010 was a unique year with limited growth, growing consolidation, good cost management and a strong dynamic between institutions, especially those focusing on outpatient care. This study paints an overview of the performance in 2010 of more than 400 elder care institutions and positions them within the larger European perspective.