Why Small and Mid-Sized Operators Are Shaping the Future of Senior Housing

As a local or regional senior housing operator with a handful of communities under your belt — maybe 3, 6, or even 25 — you’re facing a turning point. Growth sounds exciting. Expansion sounds like success. But the reality of scaling your business comes with a long list of challenges: financial, operational, structural, and strategic. That’s where the NIC Growth Conference comes in.

Scheduled for May 7–8 in Indianapolis, this highly-focused new conference was created specifically for you — the growth-minded operator who’s ready to take the next step but needs the tools, roadmap, and connections to do it right. If you’re wondering whether it’s worth your time and budget, the answer is simple: to grow and scale successfully — without losing what makes your communities special — you need to be here.

The Growing Pains You’re Feeling — or Will Feel Soon

Growth isn’t just a matter of signing a deal or opening another building. With each new property comes new complexity — and a different set of questions:

  • Should I grow as an owner, a third-party manager, or a joint venture (JV) partner?
  • When should I bring on a regional manager, HR support, or a CFO?
  • How do I find capital that supports my long-term vision, not just the next deal?
  • Can I still maintain the culture and hands-on service we’re known for with 10, 15, or 30+ properties?

These aren’t hypotheticals — they’re real challenges being faced by operators across the country. According to NIC MAP, more than 50% of senior housing communities are operated by providers with fewer than 10 properties. These operators are the backbone of the industry — but they often don’t have access to the same resources, capital, or networks as larger players.

That’s what makes growth so risky. It’s not just about getting bigger — it’s about growing well.

Growth Done Right: What You’ll Get at the NIC Growth Conference

The NIC Growth Conference is not a generalist event. Every session, speaker, and networking opportunity has been built around one core goal: helping local and regional operators scale successfully.

Here’s what you can expect:

1. Answers to Your Toughest Growth Questions

  • Learn the pros and cons of different growth paths — third-party management vs. ownership vs. JV partnerships.
  • Hear directly from operators who’ve successfully scaled from 3 to 6, 10 to 20, and 25 to 50 properties.
  • Understand how and when to adjust your staffing model — and avoid costly missteps in hiring too early or too late.
  • Get insight into streamlining reporting and financial oversight as your operations get more complex.

2. Access to Capital

Scaling takes funding — but not all capital is the same. At this conference, you’ll:

  • Meet capital providers actively looking to partner with growing operators.
  • Learn how to structure deals that align with your growth strategy and long-term goals.
  • Understand the type of data and performance benchmarks capital providers want to see before saying “yes.”

3. Operational Best Practices for Scaling

  • Identify where you can gain efficiencies across staffing, technology, reporting, and back-office operations.
  • Learn how to leverage data to improve decision-making and demonstrate value to investors.
  • Get guidance on building the right infrastructure that supports growth without sacrificing quality.

You Don’t Have to Grow Alone

One of the most valuable parts of the NIC Growth Conference is the opportunity to connect with other operators who’ve been in your shoes. Growth can feel isolating — especially if you’re one of the few regional operators in your market. But at this event, you’ll be in a room full of people who understand the same challenges, have faced the same decisions, and are willing to share what worked (and what didn’t).

Whether you’re looking for new capital partners, a peer sounding board, or inspiration from someone who’s built what you’re building, the networking opportunities at this conference are unmatched.

A First-of-Its-Kind Event for a Critical Sector of the Industry

There’s never been a NIC event quite like this. The programming has been meticulously curated for local and regional senior housing operators — not as an afterthought, but as the central focus.

Because the truth is, the future of the senior housing industry depends on your success. Small and mid-sized operators are often the ones most embedded in their communities, most attuned to resident care, and most committed to quality. But without the right knowledge, structure, and capital, growth can threaten the very culture and service you’ve worked so hard to build.

That’s why this conference matters.

Invest in Your Growth. Invest in Your Future.

We know your time is precious. And we know that stepping away from your operations for two days isn’t easy. But this isn’t just another event — it’s an investment in your future. You’ll walk away with insights, connections, and actionable strategies that can fundamentally shift your growth trajectory.

Take the next step in growing your business the right way — with clarity, support, and confidence. Join us in Indianapolis, May 7–8.

Register now at growthconference.nic.org

NIC Shares Credit & Investment Outlook

More than 630 professionals registered for a recent NIC Senior Housing Credit & Investment Outlook webinar held on March 26th. Attendees received updates on the latest sector market fundamentals supporting a positive outlook along with insights on loan maturities, delinquency rates, and investment performance. NIC staff shared the latest data points and guest panelist, Aaron Becker, Senior Managing Director, Head of Seniors Housing & Healthcare Production with Lument, provided perspective on the momentum their firm is seeing with transaction activity and new investors entering the space.

Key takeaways from the webinar include:

  • Short Term Outlook: Positive
    • The senior housing sector can anticipate rising occupancy throughout the year with limited new competition coming onto the market. These tailwinds will continue to boost NOI margins.
  • Medium-Term Outlook: Positive, but Guarded
    • Beyond this year, forecasts are for continued rising occupancy and strong demand as development activity will likely remain muted. Both of these support ongoing boosts to NOI margins.
    • The guarded sentiment reflects uncertainty related to economic unknowns, many related to changes related to actions of the current administration (e.g. tariffs).
  • Long-Term Outlook: Positive
    • The strong demand for senior housing and care will be sustained by significant growth in the aging population. This outlook is positive, assuming supply and demand remain balanced. Undisciplined, rapid growth following the current period of record-low construction could be disruptive. 
  • Active Adult, while currently much smaller in inventory than senior housing overall, has the opportunity to expand penetration rates for senior housing options.
  • NIC forecasts occupancy across the primary and secondary markets to be roughly 91% by the end of 2026.
  • There is an estimated $10.94 billion in senior living loan maturities in 2025.
  • The delinquency rate on senior housing CMBS loans was 2.1% in February, below multifamily overall, but higher than the 1.66% delinquency rate in September 2024.
  • Senior housing investments outperformed the broader NCREIF Property Index in the fourth quarter of 2024.

Visit NIC.org to watch a replay of the webinar.

Introducing the Financial Benchmarking Initiative: Elevating Asset and Deal Management

We are excited to introduce the NIC MAP Financial Benchmarking Initiative, originally launched by NIC in 2018 to establish transparent financial benchmarks for the senior housing sector.

Now redesigned, the initiative leverages NIC MAP’s cutting-edge AI technology and the newly standardized Seniors Housing Industry Chart of Accounts. This program empowers NIC MAP clients to gain deeper insights into their financial performance, comparing their properties against a market cohort to make more informed decisions.

Participation is simple. Contributors submit detailed income statements on a quarterly basis, and they can submit in their own chart of accounts – NIC MAP’s unique AI technology maps the submitted statement to a standard chart of accounts. Furthermore, to protect submitter confidentiality, NIC MAP anonymizes the statements before ingesting them. Once benchmarking is complete, NIC MAP’s reports provide insights into key metrics like revenue, expenses, and profitability, allowing stakeholders to identify areas for operational improvement and strategic growth. By distinguishing between market-driven performance changes and property-specific issues, the NIC MAP Financial Benchmarking Initiative enables operators, owners, and investors to optimize portfolio performance, reduce costs, and drive stronger financial outcomes in an increasingly competitive landscape.

Learn more.

Senior Housing Occupancy Continues Climbing in First Quarter 2025

The NIC Analytics team presented findings during a webinar with NIC MAP clients on April 10 to review key senior housing data trends during the first quarter of 2025. Steve Proffer, Director at Harrison Street, joined the webinar to share an update on the outlook for the year ahead and perspectives from one of the leading investment management firms in senior housing.

Key takeaways included the following: 

Takeaway #1: Occupancy Rate Continued Climbing 

  • The occupancy rate for the 31 NIC MAP Primary Markets rose 0.3 percentage points to 87.4% in the first quarter, driven by net absorption of senior housing units outpacing the number of new units arriving online.

Takeaway #2: Independent Living Occupancy Gains Outpacing Assisted Living in Recent Quarters

  • By property type, occupancy rates for independent living have made slightly higher gains in recent quarters than assisted living, which is a reversal of trends in 2022 and 2023.
  • In the first quarter, independent living increased to an average occupancy rate of 89.0%, while assisted living increased to 85.8%.

Takeaway #3: Assisted Living Inventory Growth Was Up Slightly, While Independent Living Growth Continued to Edge Downward 

  • Turning to supply, assisted living inventory growth has ticked up slightly the past two quarters, while independent living inventory growth has declined, which may be driving some of the changes in occupancy rate gains for the two property types.
  • Overall, however, inventory growth for both assisted living and independent living remained low historically.

Takeaway #4: Inventory is Shrinking in Five Markets 

  • Senior housing inventory is shrinking in several markets where property closures or units being converted to other uses outweigh the number of new communities or units replacing them.
  • San Antonio, TX has nearly 4% fewer units today than it did three years ago, while inventory has declined by nearly 2% in Riverside, CA, Pittsburgh, PA, and Sacramento, CA.

Takeaway #5: Secondary Market Construction Starts Fell to Historic Lows

  • The current trend of low or negative inventory growth is unlikely to reverse in the near term as construction starts in the first quarter continued to decline, with the fewest units breaking ground in the 31 Primary Markets since 2009 during the Global Financial Crisis, and the fewest units ever breaking ground in the Secondary Markets since NIC MAP began tracking this data in 2007.

Takeaway #6: Construction Starts Remain Below Inventory Growth

  • The number of new units breaking ground has been less than the number of new units being delivered for four consecutive quarters, a trend that last occurred in 2021 and, before that, in 2009 during the Global Financial Crisis.

What’s the Difference Between an Operator and a Manager?

Adding Clarity to Attract Capital Sources

Unlike many other commercial real estate sectors, senior housing requires access to capital that goes beyond funding the real estate investment in order to grow and sustain quality operations. This need for operational funding necessitates attracting new sources of capital to the sector.

In a previous article, we highlighted the critical importance of having a flow of capital investments for growing operations as a cornerstone for quality and sustainable growth in the senior housing sector. Recognizing that clarity and consistency in terminology are foundational to attracting new sources of operational capital, NIC’s Capital for Operations (CFO) Definitions Subcommittee has finalized key definitions central to this conversation. This article highlights the work of this subcommittee and the unveiling of these foundational definitions.

Why Clear Definitions Matter

Clear and commonly agreed-upon terminology is essential to effectively communicate with external investors who may not fully understand the core stakeholder groups in senior housing. By establishing precise definitions, the sector can more easily attract diverse capital sources—especially those focused on operational excellence and enterprise growth rather than solely real estate-backed investments. This clarity helps investors better understand the distinct roles and responsibilities within the senior housing ecosystem, ultimately facilitating more informed investment decisions.

Defining the Landscape: Key Terms Established

To facilitate clear communication among stakeholders—including lenders, investors, operators, and managers—the Definitions Subcommittee has adopted the following definitions.

Looking Ahead: Defining “Integrated Enterprise”

While significant progress has been made to establish these key terms, important work remains. The Definitions Subcommittee is now turning its attention to defining more complex concepts as it relates to enterprise.

For instance, consider a fully integrated company in senior housing that includes multiple entities:

  • Real Estate Owner (either fully owned or joint venture)
  • Operator (fully owned or joint venture)
  • Manager (fully owned)

Does this integrated structure that has established brand identity equate to greater enterprise value? Clearly defining these terms will help stakeholders better understand how integration, brand strength, and operational excellence contribute to overall valuation.

Conclusion: Building on Clarity for Sustainable Growth

As the sector continues to navigate a rapidly evolving landscape shaped by demographic shifts and increasing demand for high-quality senior housing services, clarity around key terms is not merely academic—it is foundational. Standard definitions lead to better communication; better communication leads to increased investor confidence; increased investor confidence unlocks broader access to operational capital.

Ultimately, the sector’s future success will depend upon our collective ability to clearly articulate value—not only through physical assets but also through exceptional operations that enhance resident experiences and drive sustainable growth.

Special thanks to members of NIC’s Capital for Operations Definitions Subcommittee, Michelle Kelly of National Health Investors, Madisen Medley of Merrill Gardens, Leigh Ann Barney of Trilogy Health Services, Dan Ogus of HumanGood, and Bill Kauffman of NIC.

Definitions:

Capital for Operations: Any capital (debt or equity) used in senior housing and nursing care that invests in or lends to a real estate owner, operator, or manager, and is not secured by real estate.

Manager: Entity responsible for oversight and management of day-to-day business as outlined in a management agreement.

Operator: Entity (often called an OpCo) that assumes business risks and benefits.

Real Estate Owner: Entity (often called a PropCo) that owns the fee simple real estate.