Skilled Nursing Occupancy Continues to Hover Around 81%

NIC MAP Vision released its latest Skilled Nursing Monthly Report on August 3, 2023. The report includes key monthly data points from January 2012 through May 2023.

NIC MAP Vision released its latest Skilled Nursing Monthly Report on August 3, 2023. The report includes key monthly data points from January 2012 through May 2023.   

Here are some key takeaways from the report:

Occupancy

Skilled nursing property occupancy decreased 3 basis points from April to end May at 81.0%. Occupancy is up 97 basis points from one year ago in May 2022 as it continues to recover since the pandemic low of 74.7% set in January 2021. However, occupancy is down 8 basis points from January 2023 as challenges do persist with staffing shortages that continue to create difficulties within skilled nursing properties limiting the ability to admit new residents in some markets. The current occupancy trend over the past year does suggest that demand for skilled nursing properties is recovering. Occupancy remains low compared to February 2020 pre-pandemic levels of 88.9% (7.8 percentage points).

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Managed Care

Managed Medicare revenue mix increased 11 basis points from April to end May at 11.4%. It has declined 111 basis points since its recent high of 12.5% in February 2022, but it is up by 219 basis points from the pandemic low set in May 2020 of 9.2%. Expectations are that it will continue to increase over time with the continued growth of managed Medicare. Meanwhile, Managed Medicare revenue per patient day (RPPD) declined 0.4% ending May at $483 and it is down 0.8% from last year in May 2022It has decreased $125 (20.5%) since January 2012 and continues to pressure some operators’ revenue as managed Medicare enrollment grows around the countryHowever, some operators see managed Medicare as an opportunity for growth in patient volume.  

Medicaid

Medicaid patient day mix increased 52 basis points to 65.8 % in May. It has increased 268 basis points from the pandemic low of 63.1% set in February 2022. In addition, Medicaid revenue mix increased in February, representing over half of property revenue at 51.1%. It has increased 230 basis points from the pandemic low of 48.8% set in February 2022. Meanwhile, Medicaid revenue per patient day (RPPD) decreased to $269 in May. It increased 3.0% from $261 one year ago in May 2022. 

Medicare

Medicare revenue per patient day (RPPD) increased slightly from April to end May 2023 at $592. It has increased 2.7% since September 2022. Most of this increase in reimbursement is likely a result of the increase in Medicare rates to skilled nursing properties for fiscal year 2023 and potentially higher acuity patients, which also increases RPPD to care for more complex patients. Meanwhile, Medicare revenue mix decreased for the second month in a row. It decreased 98 basis points from April to end May at 20.6%. It is down from one year ago as well, decreasing 34 basis points from May 2022. 

 

To get more trends from the latest data you can download the Skilled Nursing Monthly Report. There is no charge for this report.

The report provides aggregate data at the national level from a sampling of skilled nursing operators with multiple properties in the United States. NIC continues to grow its database of participating operators to provide data at localized levels in the future. Operators who are interested in participating can complete a participation form on our website. NIC maintains strict confidentiality of all data it receives. 

 

NIC MAP Vision 2Q23 Key Takeaways: Eighth Consecutive Quarter of Senior Housing Occupancy Gains

NIC MAP Vision clients attended a webinar in mid-July on key senior housing data trends during the second quarter of 2023. Findings were presented by the NIC Analytics research team.

NIC MAP Vision clients, with access to NIC MAP® data, attended a webinar in mid-July on key senior housing data trends during the second quarter of 2023. Findings were presented by the NIC Analytics research team. Key takeaways included the following: 

Takeaway #1: Senior Housing Occupancy Rose 0.6 Percentage Points in 2Q 2023 

  • The occupancy rate for senior housing—where senior housing is defined as the combination of the majority independent living and assisted living property types—rose 0.6 percentage points to 83.7% from the first quarter of 2023 to the second quarter for the 31 NIC MAP Primary Markets. This marked the eighth consecutive quarter of occupancy increases, so we have now seen two years of occupancy gains.
  • At 83.7%, occupancy was 5.9 percentage points above its pandemic-related low of 77.8% recorded in the second quarter of 2021 and was 3.4 percentage points below its pre-pandemic level of 87.1% of the first quarter of 2020.
  • Demand as measured by the change in occupied inventory or net absorption totaled nearly 5,100 units in the Primary Markets. Demand has been positive over the past nine quarters, which has helped occupancy to improve.

Takeaway #2: Majority Assisted Living Occupancy Closest to Returning to Pre-Pandemic Levels 

  • The chart below shows the pace of recovery to date for each property type and the gap remaining to reach pre-pandemic 1Q 2020 occupancy levels.
  • Assisted living has recovered roughly three-fourths of its occupancy losses, while nursing care has recovered nearly two-thirds of its occupancy losses, and each had a second quarter occupancy rate of approximately 82%.
  • Independent living has recovered only half of its occupancy losses, but its current occupancy rate is still highest among these segments.

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Takeaway #3: 2Q23 Inventory Growth Lowest in the Time Series

  • Inventory growth continued to be relatively slow, increasing by roughly 1,100 units in the second quarter, which was the lowest level observed since the beginning of the time series in 2006.
  • As you can see in the chart below, inventory growth has generally trended down from its high point of nearly 6,300 units in mid-2019. 

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Takeaway #4: Units Under Construction Least Since 2015 

  • The number of senior housing units under construction in the 31 NIC MAP Primary Markets also continued to decline and stood at 34,401 units in the second quarter of 2023, which was its lowest level since 2015.
  • Since 2011, the number of units under construction for assisted living has exceeded the number for independent living. In recent quarters, however, the gap between the two property types has narrowed with Majority Assisted Living comprising 52% of units under construction in the second quarter of 2023 and Majority Independent Living comprising 48%, so each made up roughly half of construction. In comparison, Majority Assisted Living comprised more than 70% of units under construction in 2013, which was its peak share.
  • For assisted living, there were a bit under 18,000 units under construction. As a share of existing inventory, this totaled 5.2% which was well below its peak of 10.2% in 2017.  
  • For independent living, there were 16,500 units under construction in the second quarter, equal to 4.6% of existing inventory and down from its peak of 6.5% in 1Q 2020. 
  • Overall, while construction has slowed sharply from its peak levels, there is still construction underway. Furthermore, much of it is concentrated within several individual metro markets. 

Interested in learning more?

The data featured in this article derives from NIC’s analysis of NIC MAP Vision’s Senior Housing Market Fundamentals Data Release. NIC MAP Vision clients with access to NIC MAP data also receive an exclusive invitation to a market fundamentals webinar led by NIC’s Research team where they review each quarter’s trends in context with historical data and current events. To get a better idea of what’s covered, watch an abridged version of the webinar. To learn more about NIC MAP data, powered by NIC MAP Vision, and accessing the data featured in this article, schedule a meeting with a product expert today.

The Power to Revolutionize Care, Empower Older Adults, and Propel Senior Housing & Care Forward Resides in Data and Analytics

Data is more prevalent than ever, but are you confident that you know which data to focus on and how to pull insights to make the best business decisions?

Omar ZahraouiData is more prevalent than ever, but are you confident that you know which data to focus on and how to pull insights from the data to make the best business decisions? If not, I encourage you to join me and other peers at the NIC Data & Analytics Conference. 

In this blog, we will venture beyond the numbers to the heart of the matter—the invaluable role that data and analytics plays in illuminating the path for senior housing and care professionals, guiding them from uncertainty to informed decision-making, and ultimately, to exceptional outcomes. 

Recognizing the significant changes facing the sector and the importance of understanding how to best utilize data for desired business outcomes, NIC is launching its inaugural Data & Analytics Conference. The conference, to be held on Wednesday, September 27 and Thursday, September 28 at the Minneapolis Marriott City Center, will mark the industry’s first exclusive event focused on the intersection of data and analytics with senior housing and care. 

Unlocking the insights hidden within data, senior housing and care professionals equipped with analytics have the power to revolutionize care, empower residents, and drive the future of senior housing and care. 

If you have come across my articles in the past, you may have noticed a common thread—a strong focus on analytics, numbers, and data-informed insights. While these topics have formed the core of my previous writings, this journey is not merely about numbers and statistics, the heart of my exploration of analytics in the senior housing and care space is driven by the desire to make a meaningful impact and contribute to shaping a better future for older adults, including my future self. My passion is fueled by the vision of promoting healthier aging, and providing individuals with choices that enrich their later years. 

As a data-oriented professional, I am acutely aware of the value of collaborating with colleagues in the industry. We often find ourselves seeking best practices, shared knowledge, and applied learning from those who share our passion for data analytics.  

The NIC Data & Analytics Conference offers a rare opportunity to connect with hundreds of like-minded individuals and data enthusiasts, all coming together with their own unique perspectives and approaches to analytics, whether they are operators or capital providers. It’s an environment where data and analytics questions can be answered in multiple valuable ways, fostering rich discussions and facilitating the exchange of diverse insights. Imagine being in a place where the collective wisdom of the attendees can help shape and enhance your own analytics journey, propelling you and your organization towards even greater success in the senior housing and care industry. 

Bottom-up insights for senior housing and care 

While typical senior housing conferences follow a top-down approach, where industry leaders share their thoughts and best practices based on broader trends, the NIC Data & Analytics Conference takes a refreshing bottom-up approach. This unique conference brings together senior housing professionals specializing in data and analytics, creating a platform where insights and trends are built from the ground up.  

Attendees will have the opportunity to learn directly from professionals who are immersed in the data-driven aspects of the industry, gaining access to cutting-edge best practices and innovative strategies driven by analytics. By combining the wisdom and experience of senior housing leaders with the data-driven and outside-the-box thinking of professionals focused on analytics, the NIC Data & Analytics conference fosters the creation of powerful synergy. The result is a collaborative environment where the latest industry trends and data-driven insights converge.  

Sharing best practices and drawing lessons for a better future 

Throughout history, we have witnessed transformations in various industries when data-driven insights and best practices are shared and embraced: such examples include the automotive industry’s adoption of lean principles, the aviation industry’s focus on safety measures after the Tenerife airport crash, and the healthcare sector’s efforts to reduce hospital-acquired infections (HAIs) in the early 2000s, and the application of predictive analytics using big data.  

  • The automotive industry showcases the transformative power of sharing best practices, as Japanese automakers introduced innovative manufacturing practices that were adopted by American counterparts, leading to enhanced productivity and efficiency 
  • The aviation industry serves as a testament to the transformative power of shared knowledge, as collaboration and implementation of best practices significantly improved safety measures, leading to a remarkable reduction in accidents and increased passenger trust.  
  • In the healthcare industry, the application of data analytics has revolutionized patient care and outcomes by using predictive analytics to identify high-risk patients for readmission. 
  • Additionally, the healthcare sector’s sharing of best practices in addressing hospital-acquired infections (HAIs) resulted in reduced infection rates, improved patient outcomes, and cost savings. 

These historical examples serve as powerful testaments to the positive impact of sharing best practices, emphasizing the value that can be unlocked when professionals come together to exchange data insights and knowledge. By drawing upon these success stories, senior housing professionals can harness the power of analytics to drive positive change, enhance resident outcomes, and create a future where data-informed decision-making becomes the norm in senior housing and care settings. 

The conference provides a dynamic learning environment through interactive sessions, workshops, and panel discussions. This collaborative environment encourages attendees to learn from one another, enabling the creation of a collective intelligence that will shape the future of senior housing and care. 

At the core of this conference lies a distinguished lineup of experts who are trailblazers in the intersection of data analytics and senior housing. These professionals bring invaluable insights, experiences, and expertise to the table, making this event a must-attend. Attendees will have the unique opportunity to learn from these industry visionaries, gaining practical knowledge and insights into the latest advancements in data analytics, artificial intelligence applications, innovative technologies, and emerging data trends within the sector. The industry-specific content allows attendees to walk away with practical, actionable takeaways they can implement in their organizations. 

This conference is dedicated to empowering you and your team by harnessing the full potential of data and analytics in senior housing and care, leading your organization to new heights of success and growth. We hope you will join us! Learn More.

 

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Joe Jedlowski of Distinctive Living Strives for Thoughtful Development Amid a Challenging Senior Housing Landscape

You could say Joe Jedlowski’s career as a successful senior housing developer and operator began when he was a 15-year-old working in a skilled nursing facility.

Joe Jedlowski

You could say Joe Jedlowski’s (image left) career as a successful senior housing developer and operator really began when he was a 15-year-old working in the kitchen of a skilled nursing facility. Raised by his paternal grandmother in New Jersey, he grew up watching her work at senior housing properties and eventually followed in her footsteps trying his hand at various industry positions. 

Jedlowski was a CNA and administrator at a skilled facility, and later head of operations for one of the largest senior housing providers. Fourteen years ago, he joined as the President of Milestone Retirement Communities, which began with six small properties primarily in the Pacific Northwest and ultimately transformed into a 100-asset powerhouse operating in 22 states.  

His wide-ranging, hands-on experience has helped Jedlowski bring balance to the organizations he founded two-and-a-half years ago, Distinctive Living and Distinctive Living Development. “Because I have been in these roles before, I know where to push, and can recognize where to pull back,” he says. “I don’t have unrealistic expectations, but I also don’t accept status quo.”    

“I don’t have unrealistic expectations, but I also don’t accept status quo.” 

Since its inception, Distinctive has been in growth mode. In addition to the 27 assets currently under ownership, 21 more properties are under development. Most of the company’s portfolio is along the Eastern seaboard, from Florida up to Connecticut. The team is also in the process of acquiring operations of 13 other properties. 

Having grown up in tandem with the evolving industry, Jedlowski has gained invaluable insights about the business. More importantly, he developed a passion for the work, and dedication to fellow employees and the residents they serve.  

I sat down with Joe to discuss what gives Distinctive an edge, how he approaches growth amid such an uncertain market, and how past experiences inform his work in the senior care space today. 

Zuccari: What’s driving Distinctive Living in today’s tumultuous development environment? 

Jedlowski: We are in growth mode, but from my perspective, it has to be very thoughtful, structured, and well-informed. We’re also very focused on our own book of business and growing internally. At a high level, we’re opportunistic. It has to be the right deal with the right metrics and the right rents.  

There’s no denying that the industry is going through a hard time right now. And I think it’s going to get harder over the next six months. But now that the Feds have hinted at stabilizing rates, I feel like we’ll have some pressure relieved in Q1 going into Q2 next year.  

“We are in growth mode, but from my perspective, it has to be very thoughtful, structured, and well-informed.”

Zuccari: Due to these tough times, many companies are holding off on development. How do you balance your growth ambitions with the current state of the market? 

Jedlowski: Our approach is based on a few factors that have worked well for us in the past. 

The first is site selection. We spend time looking at sites mostly in mid-to-high barrier to entry markets. Secondly, we do significant market intelligence on these locations to determine how we can maximize our revenue structure. Throughout the process, we’re asking pointed questions: What’s the right amenity space for these assets? What’s the right cost expense load? 

From a development standpoint, we kill around 95 to 98 percent of all of the deals we look at because they’re either too expensive, not enough demand, or we can’t get a good rate. If the market and the demand are good, we then proceed to our capital partners and begin the equity raise into the projects.  

We’re fortunate to have solid equity partners who have deep pockets, but also don’t have senior housing investor fatigue. Many of them are newer to the space and like the market demographics they see—future demand, absorption, and lack of supply.  

Our investor base and team as a whole feel very strongly that, since there has been limited development in the past four years because of COVID, when our projects come out in the next 24 to 36 months, there’s going to be significantly less new supply.  

Occupancy continues to climb in all of the U.S. primary market areas, which has made us more willing to take on extra cost burden as we look to the future. Ultimately, we feel like right now is the time to put the pedal to the metal because of future demand projections and lack of supply to meet them.  

“Ultimately, we feel like right now is the time to put the pedal to the metal because of future demand projections and lack of supply to meet them.”   

Zuccari: Is there a ceiling to your growth ambitions? 

Jedlowski: This is a question I’ve been asked a lot. For me, if all Distinctive could do well is what we’re doing today, then I would be content. We certainly want to grow, but whatever project we take on, whether it’s development or operations, we want to be able to adequately live up to the expectations of our capital and also meet the expectations of the employees and residents that we serve.  

The bottom line is if we can’t do it well then we’re not going to do it. If we have confidence we can do it, we’re going to go in and hit it head on.   

Zuccari: How are you innovating in the senior care development vertical? 

Jedlowski: The first part of the development phase is looking at a piece of dirt and determining what you can build on it. Distinctive strategically partners with an architectural firm based in D.C. Part of their company is located in Vietnam, which gives us a competitive advantage and saves us a lot of money. We can have a project brought to us by noon today, and by tomorrow, have a very rough concept plan of what this project will look like. We’re able to present site details including how many stories and units to build, if there are setbacks on the land, and how the property will fit spatially on the land—all while staying compliant with city requirements.  

These site plans can often take up to two weeks, so speeding up the architectural programming phase of the design and development has given us an invaluable edge over other developers in the space. 

Zuccari: Is there anything else that sets you apart from traditional senior care development companies? 

Jedlowski: We have a fully vertical platform. Distinctive has an interest in a general contracting company, which allows us to control construction costs. It also gives us insight into what’s going on behind the curtain as it relates to supply and labor costs. Additionally, we’re able to put up completion guarantees.  

Our operating and development platform really work in unison. We can holistically look at a project and decide if we can push rates, or figure out how to value engineer an asset. I think that whole complement of our interdisciplinary team members is critical to our success.  

“I think that whole complement of our interdisciplinary team members is critical to our success.”

Zuccari: When you’re considering taking over an asset, what’s the first thing you do? 

Jedlowski: Our first point of business is pulling market demographics and data. Sometimes we’ll get a call from owners saying they’re unhappy with their management. When we go and look at the market and realize that it’s not the operator that’s the problem. Oftentimes, we come to the conclusion that we likely won’t be able to do any better than the company currently in place.  

The second part, and probably the most important, is team evaluations. Like any business, employees dictate the success of a building. If the team isn’t strong, we’ll go and put the right team in place.  

Lastly, we drop in all of Distinctive’s signature programs: memory care, Distinctive dining, and others. The combination of those elements—good team, good market, good programs—typically yields us good results.   

” The combination of those elements—good team, good market, good programs—typically yields us good results.”   

Zuccari: How has your past experience informed how you do business today? 

Jedlowski: In this business, we tend to prioritize the residents above all else. For me, my partners, and our organization, we lean very much into our employees because we believe that will trickle down to the residents.  

I remember one boss, a director of nursing at a facility, who treated me like absolute trash. I often think about how that made me feel and remind my senior leadership—you get from our team members what you put in.   

That’s a huge part of our company culture. The folks who probably work the most, make the least, and have the greatest obligations at home, are the people foundational to our business. Regardless of all the bells and whistles and the snazzy names we put on programs, taking care of people is the core of what we do. 

“The folks who probably work the most, make the least, and have the greatest obligations at home, are the people foundational to our business.”

___

Executive Survey Insights | June 2023

June 2023 ESI asked respondents to identify the share of full-time positions across their organization that are currently open- responses indicate there has been improvement

“The June 2023 ESI again asked respondents to identify the share of full-time positions across their organization that are currently open. The responses indicate an improvement in the number of open positions that are impacting communities.
In April 2023, only 5% of organizations reported having between 0% and 5% of full-time positions open. In June 2023, 20% or one-fifth of owners and operators report having the same lowest range of openings across full-time positions. This represents a four-fold increase over the past two months in the number of organizations reporting the lowest range for vacancies in full-time positions.
 

As staffing challenges can limit the number of new residents a community can intake, the anticipated occupancy recovery timeframes of respondent organizations are noteworthy. Almost half of respondents indicate that occupancy in their independent living (47%) and nursing care segments (44%) have returned to pre-pandemic levels, with approximately one-third of their memory care (37%) and assisted living care segments (30%) having returned to pre-pandemic occupancy levels.” 

–Ryan Brooks, Senior Principal, NIC 

This Executive Survey Insights (ESI) survey includes responses from June 1 to July 5, 2023, from owners and executives of 39 small, medium, and large senior housing and skilled nursing operators across the nation, representing hundreds of buildings and thousands of units across respondents’ portfolios of properties. More detailed reports for each “wave” of the survey and a PDF of the report charts can be found on the NIC COVID-19 Resource Center webpage under Executive Survey Insights 

Questions in the June 2023 ESI focus on the current staffing and labor environment, including the scope of staffing shortages and the driving factors behind them, the share of full-time open positions across respondent organizations, and expectations on when staffing challenges will improve. Responses across a number of these staffing and labor related questions – including whether or not an organization is experiencing a staffing shortage and the current share of full-time, open positions – indicate improvements are being realized.   Staffing Shortage Pie Chart, left pie chart indicates 82% are shortstaffed, right pie chart indicates what percent of properties across portfolio are experiencing a staffing shortage, with 44% responding 'up to 50% of our properties', 33% responding 'up to 25%', 11% responding more than 50%, and remaining 11% responding 'all of our properties

 

For the surveys of the prior 18 months, between 90% and 99% of organizations consistently reported experiencing a staffing shortage within their organization. In June 2023, four-fifths of organizations (82%) report a staffing shortage at their organization. While this represents a considerable portion of senior housing and care communities undergoing a staffing shortage, seeing improvement in this metric is noteworthy.  

Of organizations experiencing a staffing shortage, one-third of respondents (33%) are experiencing the shortage in up to 25% of their properties and two-fifths (44%) are experiencing the shortage in 26% to 50% of their properties. One-tenth of respondents are experiencing a staffing shortage in more than half of their properties and another one-tenth are experiencing a staffing shortage across all of their properties. 

When asked about the two top factors driving the existing staffing shortages, an inability to hire nurses was cited by almost half of respondents (48%), followed by an inability to hire nursing aide positions (42%), wage competition (35%), and staff turnover rates (29%). 

 Reason for Staffing Shortage, ranked at number 1 with 48% of respondents claiming 'inability to hire nurses, with 42% 'inability to fill nursing aide positions, 35% wage competition, 29% staff turnover rates, 26% individual market conditions, 13% competition from staffing agencies, 3% competition from other industries 

The June 2023 ESI again asked respondents to identify the share of full-time positions across their organization that are currently open. Responses indicate there has been improvement in the number of open positions that are impacting communities. In April 2023, only 5% of organizations reported having between 0% and 5% of full-time positions open. In June 2023, 20% or one-fifth of owners and operators report having the same lowest range of openings across full-time positions. This represents a four-fold increase over the past two months in the number of organizations reporting the lowest range for vacancies in full-time positions. 

 Current Share of Full-Time Open Positions comparison from April 2023 to June 2023, the responses indicate there has been improvement in the number of open positions that are impacting communities.

 

Conversely, in April 2023, one-fifth of respondents (19%) reported their range of open full-time positions to be greater than 20%. In June 2023, the proportion of respondents reporting vacancies within that range decreased to only one-tenth. 

Additionally, staffing and labor related issues are still cited as challenges, but not as the issues that are currently garnering the most focus and attention. For the second month in a row, rising operator expenses is the most-cited challenge facing respondent organizations (72%). Attracting community and caregiving staff (64%) and staff turnover (59%) are the second and third most cited challenges that organizations are currently facing.  

There also is some optimism expressed around the tempering of the staffing challenges that do remain. When asked when their organization anticipates staffing challenges will improve, almost one-half (44%) anticipate there will be improvement in the remaining six months of 2023. One-sixth of respondents (15%) anticipate improvement in the first half of 2024, and one-quarter (26%) anticipate improvement will come in the second half of 2024. The remaining one-sixth of respondents (16%) expect improvements in staffing challenges to take until 2025 or later.  

Anticipated Staffing Challenges pie chart with 44% claiming second half of 2023 and 26% claiming second half of 2024 

As staffing challenges can limit the number of new residents a community can intake, the anticipated occupancy recovery timeframes of respondent organizations are noteworthy. Almost half of respondents indicate that their independent living (47%) and nursing care segments (44%) indicate their occupancy have returned to pre-pandemic levels, with approximately one-third of their memory care (37%) and assisted living care segments (30%) having returned to pre-pandemic occupancy levels.  

While sizable shares of communities within each care segment have already seen their occupancies recover to pre-pandemic levels, another 20% to 30% of owners and operators across all care segments expect the recovery to take place during the remaining months of 2023. Only a small portion of respondent organizations – between 6% and 11% — anticipate occupancy recovery will take until 2025 or beyond to be realized. 

Anticipated Occupancy Recovery bar graph by care segment broken down by care segment, conveying that sizable shares of communities have already seen occupancies recover to pre-pandemic levels 

June 2023 Survey Demographics 

  • Responses were collected between June 1 and July 5, 2023, from owners and executives of 39 senior housing and skilled nursing operators across the nation. 
  • Owners/operators with 1 to 10 properties comprise just under two-thirds of the sample (62%). Operators with 11 to 25 properties account for roughly one-quarter (23%) and operators with 26 properties or more account for roughly one-sixth (15%) of respondents.  
  • More than one-half of respondents are exclusively for-profit providers (54%), two-fifths operate not-for-profit seniors housing and care properties (41%), and 5% operate both.   
  • Many respondents in the sample report operating combinations of property types. Across their entire portfolios of properties, three-quarters (72%) of the organizations operate seniors housing properties (IL, AL, MC), one-sixth (15%) operate nursing care properties, and one-third (33%) operate CCRCs – also known as life plan communities. 

The July 2023 ESI survey is currently open and will be collecting responses through July 31, 2023. If you are an owner or C-suite executive of seniors housing and care and would like an invitation to participate in the survey, please contact Ryan Brooks at rbrooks@nic.org to be added to the list of recipients. 

NIC wishes to extend a heartfelt thank you to the owners and operators who have contributed to this survey over the past three years. It is remarkable that we have now completed more than 50 waves of surveys. We have surveyed through numerous challenges — COVID-19, threats of a looming recession, labor shortages, inflation, and rising expenses — many of which still persist. As we continue to navigate through these challenges, your input and real-time insights help ensure the narrative on the senior housing and care sector is timely and accurate.  

Special Note on Nursing Care Response Rates: Lower respondent numbers for nursing care communities precludes NIC from highlighting those specific results in our ESI summaries. It is our hope that these survey findings are utilized to bring insights and an improved understanding of current market conditions for each care segment. As such, if you are an owner or operator of nursing care communities, your participation in the ESI surveys is strongly encouraged. Please also feel welcome to invite other nursing care operators to participate by sharing the anonymous survey link or reaching out to Ryan Brooks at rbrooks@nic.org to have them added to the ESI distribution list. Remember, by demonstrating transparency, together we build trust. Thank you!