In this article, the author highlights two main efforts in line with the historic twentieth annual status report on for profit child care. These includes: (1) adding new players in the "Exchanged Top 40" list; and (2) focusing on regional chains, organizations providing early childhood services in more than 20 locations in two or more states. The author further discusses how regional chains got started and provides a list of responses from CEO's of different companies regarding their vision for the future of their organization.