This commentary drills deep into recent performance of the Secondary Markets, examining the overall performance and composition of the Secondary Markets in aggregate and in comparison to the Primary Markets.  

The Secondary Markets tracked by NIC MAP Vision have benefited in recent quarters from recovering strength in demand with limited new supply, driving occupancy closer to pre-pandemic levels for the Secondary Markets than that of the Primary Markets. New Orleans, LA (up 13.6%); Knoxville, TN (up 12.4%); and Baton Rouge, LA (up 12.2%), in particular, stand out as markets that have recovered the most following occupancy declines during the pandemic. All three markets were already experiencing negative absorption before the onset of the pandemic, and the health care crisis accelerated this trend. Absorption turned positive in these markets more recently, and the limited new supply arriving online drove occupancy to rebound. 

Source: NIC MAP® Data, powered by NIC MAP Vision

Supply, Demand, and Occupancy Rate Patterns. The exhibit below illustrates the pattern of inventory growth, net absorption, and occupancy for the Secondary Markets in aggregate. The recovery in property market fundamentals for senior housing began in the second quarter of 2021 and has strengthened in recent quarters. In the most recent data available from the third quarter of 2022, net absorption was the second highest on record at 4,655 units. At the same time, inventory growth in these 68 metropolitan markets totaled in aggregate only 473 units, which was the weakest inventory growth in the time series of the data that goes back to 2008. As a result of these improving supply and demand fundamentals, the occupancy rate for the Secondary Markets was only 3.0 percentage points below its pre-pandemic level of 87.0%, better than the 5.0 percentage point spread for the Primary Markets.

Seniors Housing Fundamentals | Secondary Markets | 2Q08 – 3Q22

Source: NIC MAP® Data, powered by NIC MAP Vision

In terms of demand, the number of occupied units for the Secondary Markets fell by 22,950 on a net basis from the first quarter of 2020 through the first quarter of 2021 as the health care crisis weighed on demand for seniors housing. Since the recovery in demand began, however, the number of occupied units has moved beyond its pre-pandemic level and stood at an all-time high of 308,554 units at the end of the third quarter, more than 1,100 units above the previous peak. This robust absorption of units speaks to the value proposition of seniors housing and its appeal to families that need the services and care provided by senior housing. More broadly, the value proposition provided by seniors housing includes socialization, security, engagement, room and board, care coordination, as well as lifestyle and wellness programs that support a high quality of life.

Seniors Housing Occupied Units (Estimated) | Secondary Markets | 1Q08 – 3Q22

Source: NIC MAP® Data, powered by NIC MAP Vision

In terms of new supply, the number of senior housing units under construction at the end of the third quarter in the Secondary Markets stood at 15,669 (152 properties), equivalent to 4.3% of existing inventory. This level of construction is down from a recent peak in the third quarter of 2018 of 23,611 units (253 properties) – which totaled 7.0% of existing inventory at that time – and is lower than the 5.0% of inventory under way in the Primary Markets. Meanwhile, construction starts have also been limited during the third quarter and totaled only 553 units across the entire 68 Secondary Markets. (Note, however, that construction starts data often gets restated as more information is collected and is thus subject to change). 

Units Under Construction and Construction as a Percent of Inventory Seniors Housing | Secondary Markets | 1Q08 – 3Q22

Source: NIC MAP® Data, powered by NIC MAP Vision

Seniors Housing Construction Starts | Secondary Markets | 2Q16 – 3Q22

Source: NIC MAP® Data, powered by NIC MAP Vision
 
Secondary vs. Primary Markets Comparisons. When evaluating existing inventory, the share of non-stabilized inventory¹ (a measure of how much recent inventory is not yet filled) is lower for the Secondary Markets (3%) than the Primary Markets (5%).  This is due to the fact that a larger amount of new supply that has been delivered in the Primary Markets in recent quarters. 

Seniors Housing Stabilization Status by Percent of Units | 3Q22

Source: NIC MAP® Data, powered by NIC MAP Vision

Separately and interesting to note is that the penetration rate for the Secondary Markets in the third quarter is higher than the Primary Markets at 11.6% versus 10.8%, respectively, indicating that seniors housing among households age 75+ is possibly slightly more accepted within the Secondary Markets than within the Primary Markets. 

Meanwhile, many other measures of seniors housing inventory indicate that the Secondary Markets are quite comparable to the Primary Markets. For example, the distribution of properties by age is comparable to that of the Primary Markets, with roughly 46% of units within the Secondary Markets 25 years or older, compared to 43% of the Primary Markets’ inventory. Properties 2 to 10 years and 10 to 17 years comprise roughly 20% and 10%, respectively, for both Secondary and Primary markets.

The property type distribution of the Secondary Markets is also similar to the Primary Markets when comparing the percent of inventory that are majority independent living at roughly 30%, majority assisted living at roughly 25%, and majority nursing care at roughly 45%. Additionally, the payment type is similar at roughly 22% entrance fee versus 78% rental. 

Overall, the inventory composition for the Secondary Markets is quite similar to that of the Primary Markets except for the slightly larger share of non-stabilized inventory in the Primary Markets, and this is largely due to construction pipelines and development activity.

Seniors Housing Property Age in Years by Number of Units | 3Q22

Source: NIC MAP® Data, powered by NIC MAP Vision

Seniors Housing Property Type by Percent of Units | 3Q22

Source: NIC MAP® Data, powered by NIC MAP Vision

Seniors Housing Payment Types by Percent of Units | 3Q22

Source: NIC MAP® Data, powered by NIC MAP Vision

Conclusion

The 68 Secondary Markets tracked by NIC MAP Vision somewhat mirror the Primary Markets in terms of inventory composition in aggregate. Additionally, the Secondary Markets have benefited from recovering strength in demand with limited new supply and have better closed the gap to pre-pandemic occupancy than the 31 Primary Markets on average. 

^{______________________
1}Stabilized occupancy inventory are properties that are (a) at least two years old, or (b) if less than two years old, properties that have achieved occupancy of at least 95.0% since their opening.

How to understand consumer behavior to innovate senior living. 

About 19 million people belong to the silent generation (born 1928-1945). They are the senior living customers of today. Compare that to the 70 million baby boomers (born 1946-1964) just starting to enter the pool of potential residents.  

The groups are quite different, and not only in size. The silent generation (age 77-94) is often characterized as thrifty, respectful, unassuming, and loyal. Baby boomers (age 58-76) are portrayed as demanding, self-assured, independent, and competitive.  

A well-attended educational session at the 2022 NIC Fall Conference addressed the challenge to understand the differences between the silent and baby boomer generations and how that impacts the senior living industry.  

“Do we really understand our consumer?” asked Joe Daniels, panel moderator, and vice president at Direct Supply. “We have the opportunity to do things differently.” 

Daniels was joined on the panel by several experts. They agreed that the industry must adopt a more customer-centric approach, especially to attract boomers. Marketing campaigns should micro target the local population, which can vary widely from place to place.  

“It’s crucial to dive into the details,” said Arick Morton, CEO at NIC MAP Vision. “Who is really your customer?” He suggested using county-level psychographic, age and income data to understand the local customer base.

Operators need to curate an experience, tailored by market, showcasing a vibrant lifestyle to entice baby boomers to move sooner rather than later, according to panelist Traci Bild. The experience starts with the marketing process. “Be empathetic, listen, slow down,” advised Bild, chief visionary officer at Bild & Co. “Change the customer experience and how you make people feel.”  

Think about your own buyer experiences, said panelist William Swearingen, senior vice president, Spectrum Retirement Communities. The buyer experience needs to meet their expectations. “It doesn’t take a budget. It’s about attitude, culture, and service,” he said.  

Surveys can be useful to get feedback from customers and referral sources on the buyer experience. Ask customers, including the adult children, how the buying process makes them feel.  

“Life sells on a tour,” said Morton. Potential residents and their families aren’t sold by beautiful empty spaces, he explained. They want to see residents actively engaged.   

From Bingo to Madonna 

Do prospective customers see residents playing bingo because it’s the best activity being provided? “Think about what that means,” said Swearingen. He cited a 2010 study that showed most people are well defined by the age of 40. Today’s resident who is age 85 was 40 years old in 1977. Activities should reflect events and interests of the late 1970s and early 1980s. These consumers don’t care about celebrity throwbacks to the 1940s. “We need to wake up,” said Swearingen. When he’s living in a retirement community at age 80, he expects the piped in music to feature Madonna’s greatest hits. “Take a chance,” he said. 

A few tweaks to the dining experience can have a big impact for a relatively small investment. “Dining is the highlight of the day,” said Bild. “How can you improve the overall experience?” The use of outdoor patios as dining venues increased during the pandemic which has been a plus.  

Technology is another area where senior living providers can improve their offerings. Major advances are being made in the areas of life safety and convenience. For example, artificial intelligence applications can help manage falls. Voice assistants, such as Amazon’s Alexa can carry out everyday demands. “We have a clear opportunity,” said Morton.  

Current residents already have smart phones. “They’re more tech savvy than we think,” said Swearingen. The pandemic only accelerated the trend.  

Amid rising resident acuity, more technology will be devoted to the management of chronic health conditions. Morton thinks that the silent generation has been less motivated to move into senior living because of their health status. But baby boomers are likely to delay move-ins until their health is compromised. “We need to understand how to build healthcare programming to meet their needs,” said Morton. 

Providers should also be aware that a demographic shift is under way among adult children. A growing number of them belong to Gen X, a group worried about financial security.  

The panelists discussed how to expand the consumer base. Private pay senior living mostly serves a well-off, white population, overlooking diverse groups. “We need an intentional effort to reach out to these populations,” said Swearingen. He added that marketing approaches tailored to different groups can result in two to three extra move-ins. 

Websites should feature persons of color as residents. Spanish language marketing campaigns can result in occupancy growth. Providers shouldn’t assume that members of diverse groups can’t afford senior living. At the same time, certain groups that have a tradition of providing elders with care at home should be educated about what the industry offers. 

Daniels concluded the session by asking the panelists the single biggest difference between boomers and the silent generation.  

Swearingen said boomers are an opinionated population. “Be prepared to answer their questions,” he said. “Don’t be afraid.” 

Bild noted that how the provider makes people feel has more impact than anything else. “Boomers like attention,” she said. “Master the human connection,” adding,  “Time is on our side.” 

Morton reminded the audience that the silent generation and boomers have very different life experiences. The world adapted to the boomers. The silent generation adapted to the world. “Understand who is your customer. Get the data.”

Loneliness and isolation were health concerns for older adults before the pandemic and have become more so in the aftermath of the worst of the pandemic period partly due to restrictions and protocols that were put in place within seniors housing communities and health care facilities. A search for publications that mentioned “loneliness” or “isolation” and “older adult(s)” or “older people” produced a result of roughly 19,000 publications in 2013. This number climbed to more than 25,000 in 2019 and spiked to more than 40,000 and 45,000 publications in 2020 and 2021, respectively. While down to roughly 32,000 thus far in 2022 (as of December 15), the level of interest and concern remains elevated.  

One reason for concern is that neuroscience research has shown that loneliness can speed cognitive decline. For example, one study found that individuals who were age 75 or older and lonely – defined as feeling unseen or unheard within a group – had a 210% increased chance of developing dementia. At the same time, there was a 60% increase in lifespan for individuals of the same age group who had rich social networks¹.  

Isolation, meanwhile, can result in both physical and mental health issues escalating into major emergencies if they remain unchecked by health care providers, family, friends, or the surrounding community. Developers, operators, and health care providers can take steps to reduce isolation and loneliness among older adults. 

Senior Housing Developers

Senior housing developers can reduce loneliness and isolation by site selection, location, and design. For example, new development, conversions, or retrofits with a tilt toward urban in-fill locations allow residents to be closer to city centers and population clusters. Indeed, some residents report that even the sound of nearby public transportation helps them feel less isolated from the community. However, from a cost-basis, in-fill locations can be expensive sites in which to build, and as a result, developers could also look to smaller secondary and tertiary cities for urban development where costs may be less prohibitive. 

Developing properties near or within multigenerational communities may also help reduce the potential for resident isolation and loneliness. For example, providing senior housing within walking distance of single-family housing helps residents be closer to younger generations or younger families. While age-eligible housing is an attractive lifestyle for many older adults, offering intergenerational developments with a mix of housing, retail, health, and wellness provides another option for those at risk of isolation. Locating senior housing on or near college campuses is another opportunity that allows proximity to walkable and alma mater experiences such as auditing courses or attending sporting events, which has been a popular draw to older adults for many years. Recently, some universities and colleges have begun incorporating non-students into classrooms, housing, and daily life as part of their diversity, equity, and inclusion initiatives and to address loneliness among both older adults and college students. 

Regarding design, spaces that encourage positive interactions and socialization between residents, visitors, and the surrounding community help to reduce loneliness and isolation. Rather than fences or walls, use of wide side yards with benches, shade trees, and sidewalks that are wide enough for both wheelchairs and pedestrians help to enhance community integration. Additionally, enlarged thresholds help to draw visitors in and to encourage residents to go out while providing opportunity for those less mobile to observe activities in the immediate surroundings. Inside, bedrooms that face communal space encourage residents to go out and socialize. In the dining area, small and intimate tables provide ease of conversation with other residents, while reconfigurable tables allow for larger gatherings with visitors.  

Senior Housing Operators

Senior housing operators can reduce loneliness and isolation by leveraging campus resources, affinity groups, pet therapy, and technology. Regarding resources, operators can offer popular campus services such as maintenance, landscaping, meal prep, and housekeeping off-site to engage the surrounding community. Wellness centers with fitness and nutrition amenities that are open to staff, residents, and the surrounding community increase multigenerational integration, particularly if set in a quiet environment that encourages conversation. Providing on-site childcare for staff could also help to increase multigenerational interaction, as well as help with employee hiring and retention. This is not always easy to implement effectively, however. Pet therapy has become popular in both schools and older adult communities for pets’ ability to reduce anxiety and feelings of loneliness, and operators can enlist regular visits from such pets to increase interactions between residents, staff, and visitors.  

Affinity groups can reduce loneliness and isolation by increasing opportunities to socialize and connect in a specialized setting. Communities catering to LGBTQ+ older adults and allies have gained interest², as well as veterans-focused age-eligible communities. Some adult day care operators have had success in target marketing for ethnic backgrounds with newspapers, television programs, and conversation in a particular language. Operators of culturally focused communities can also consider dietary customs, opportunities for meal sharing, and spaces for cultural events in their designs. As a commercial real estate property type, active adult rental properties are a response to the preferences of the baby boomer generation and appeal to a cohort of the older population seeking an option for living in a secure, maintenance-free setting with amenities and opportunities that foster socialization and shared activities with like-minded older adults.  

Regarding technology, today’s older adults are more tech savvy than prior generations and are increasingly expanding the use and number of devices employed³. Ensuring regular, private communication between staff, family, and residents and sharing real-time data via apps or wearable devices reduces isolation and the likelihood of physical or mental health issues going unchecked. Wearables can track changes in socialization by reporting “where two or more are together.” Access to traditional social media allows connectedness to friends, family, and daily life.  

Health Care Providers

Skilled nursing properties and hospitals can reduce loneliness and isolation by design and by leveraging technology and campus resources. Inviting use of skilled nursing and hospital campuses for community events, such as farmers markets, or charity events, including cornhole tournaments, could increase community integration with residents, patients, visitors, and staff. Corridors designed as walking paths encourage patients to step out and visitors to come in. Within skilled nursing and hospital rooms, large consultation areas can include both the patient and family bedside with designated space to display family photographs either digitally or physically. Additionally, skilled nursing properties and hospitals can downplay the clinical environment by adding art, appealing lighting, and communal touches such as: 

• A piano that residents, patients, visitors, or staff can play
• Meditation rooms
• Rotating art exhibits
• Public events and demonstrations
• Inviting landscapes
• Rooftop or botanical gardens
• Healing gardens or labyrinths
• Indoor playgrounds
• Restaurants  

Regarding technology, skilled nursing and hospital rooms can incorporate devices and wearables to communicate with family, friends, and staff. Additionally, the use of robots has increasingly been used to provide socialization in addition to providing entertainment and helping with staffing shortages. For example, some interactive therapeutic robots provide animal therapy in environments where live animals are unable to visit and can stimulate interaction between patients and caregivers⁴.

Final Thoughts

While the pandemic brought new restrictions and protocols, strained labor availability, and increased concerns about loneliness and isolation, senior housing developers and operators and health care providers can incorporate social needs into daily life and care. In general, older adults must not feel like a burden to those around them and should not be isolated from family, friends, staff, or the surrounding community. All available resources should be leveraged to encourage socialization, communication, connectedness, and inclusion. 

 ¹ “Lifestyle, Social Factors, and Survival After Age 75: Population Based Study”, BMJ, The Advisory Board Company.

 ² “Retirement Communities Cater to LGBT Population”, WSJ, November 16, 2022.

 ³ “Baby Boomers & Tech – How the Pandemic Changed the Relationship”, GWI, July 6, 2021.

 ⁴ “How a Robotic Baby Seal Is Revolutionizing Memory Care”, The Front Porch Center for Innovation and Wellbeing, October 20, 2016.

Sharing a commitment to advancing diversity, equity, inclusion, and belonging (DEIB) in the senior living industry, Argentum, the American Seniors Housing Association (ASHA), and NIC earlier this year formed the Senior Living DEIB Coalition to empower businesses operating in and around senior living.  

The DEIB Coalition believes that not only are DEIB efforts the right thing to do, but data from several studies show that organizations that engage in DEIB initiatives perform better, are more innovative, and manage risk more effectively. That in turn helps to provide the best outcomes for the residents and staff of senior living communities, as well as staff in our respective corporate offices. 

*(WEF) World Economic Forum

Senior Living DEIB Survey 

One of the first efforts the DEIB Coalition undertook was to identify the current state of DEIB efforts in the industry. The resulting survey, conducted by Ferguson Partners, collected information to understand both the degree to which DEIB programs are deployed and the diversity of the participating companies’ respective staffs. The survey marks the first industry-wide effort to collect data on diversity, equity, inclusion, and belonging in the senior living industry. 

Results of the survey can be found in the 2022 Senior Living DEIB Survey Executive Summary. 

Senior Living DEIB Toolkit 

Survey results indicate opportunities for senior living companies to give more focus to DEIB efforts. To aid industry operators and other organizations in advancing their respective DEIB practices, the DEIB Coalition commissioned development of a toolkit to help interested companies customize programs that work for their organizations. 

Developed by The Axela Group, the Senior Living DEIB Action Toolkit for Operators offers resources to assist in your DEIB efforts. 

The DEIB Coalition’s goal is to co-create a plan of action and strategy around DEIB, including the development of resources to inform, equip, and catalyze positive impact and thinking around DEIB. The 2022 Senior Living DEIB Survey and Action Toolkit for Operators are the first of many deliverables. Refer to NIC’s Senior Living DEIB Coalition page to learn more.  

“Organizations reporting an increase in the pace of move-ins has held steady now for several consecutive waves. When the BA.4 and BA.5 variant surge occurred in summer of 2022, the rate dropped from more than 50% of operators reporting an increase in the pace of move-ins to the current ~40%. Operators may now be combatting what is being referred to as the ‘tripledemic’ – a collision of RSV, influenza, and COVID-19 that is sickening millions – which may be tempering move-ins.

Lead volumes being reported are higher now than in most previous waves, but as noted above with the pace of move-ins holding steady, the reported increase in lead volumes is not yet materializing with move-ins.”

–Ryan Brooks, Senior Principal, NIC

This Wave 48 survey includes responses from November 14 to December 11, 2022, from owners and executives of 40 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. 

New questions in the Wave 48 survey asked about the impact of the current operational environment (occupancy rates, operating expenses, inflation, etc.) on the ability to service debt as well as the impact of increased interest rates on the ability to service debt. 

With regard to the impact of the current operational environment on the ability to service debt, almost half (44%) of nursing care operators reported there was no impact, followed by one-third of assisted living, independent living, and memory care operators. Comparatively, one quarter of assisted living and nursing care operators reported the current environment had a significant impact on their ability to service debt, while one-fifth of independent living and memory care operators reported a significant impact.

When specifically asked what impact the increase in interest rates has had on their ability to service debt, nine in ten (89%) nursing care operators report no impact on their ability to service their debt as a result of increased interest rates. This is followed by two-thirds of assisted living (64%) and memory care (63%) operators, and finally independent living, of which 58% reported no impact to their ability to service debt. As for operators reporting a significant impact on their ability to service their debt, 15% of assisted living and memory care operators report significant impact, as did 13% of independent living operators. No nursing care operators reported the increase in interest rates has had a significant impact on their ability to service their debt.

Organizations reporting an increase in the pace of move-ins has held steady now for several consecutive waves. When the BA.4 and BA.5 variant surge occurred in summer of 2022, the rate dropped from more than 50% of operators reporting an increase in the pace of move-ins to the current ~40%. Operators may now be combatting what is being referred to as the ‘tripledemic’ – a collision of RSV, influenza, and COVID-19 that is sickening millions – which may be tempering move-ins.

Lead volumes being reported are higher now than in most previous waves, but as noted above with the pace of move-ins holding steady, the reported increase in lead volumes is not yet materializing with move-ins. 

Regarding the current share of all full-time open positions across respondent organizations, in the Wave 48 survey, approximately two out of five respondents have between 10% and 20% of full-time positions unfilled, whereas roughly one in five respondents have 20% or more positions currently unfilled. This is an improvement from the Wave 42 findings from June 2022, where one-half of respondents had between 10% and 20% of full-time positions unfilled and another one in five had 20% or more full-time positions unfilled.

When asked about backfilling staff shortages, nearly all respondents (93%) reported paying overtime in Wave 48, and two out of three respondents are currently tapping agency or temp staff (68%). Other identified strategies for finding needed staff include the creation of a dedicated corporate recruiter, shift incentives, and partnering with organizations outside of the senior housing and care industry. Of those organizations currently utilizing agency or temp staff, one-half expect their reliance on agency staff to decrease in the next six months. Slightly under one-half (44%) expect their utilization to stay the same, and only 5% expect their agency utilization to increase. 

There is evidence provided in the Executive Survey Wave 48 that there may be a sign of relief coming with regards to the industry’s staffing challenges. One-third of respondents (31%) anticipate staffing challenges will improve in the first six months of 2023 while another one-third (36%) anticipate improvements in the second half of 2023. About one in six respondents (17%) anticipate it will take until 2024 before staffing challenges improve and finally, one in six (17%) predict the staffing challenges will remain until at least 2025.  

While there may be indications of improvement on the staffing front, staffing and labor challenges certainly persist. When asked whether they were currently experiencing a staffing shortage, 90% of respondents indicated that they were. Of these organizations reporting a staffing shortage, one-third are experiencing the shortage in the entirety of their property portfolio, while another one-third are experiencing the shortage at more than 50% of their properties. 

When asked about providing rent concessions, approximately one-third of respondents indicate they are offering rent concessions to attract new residents. Over the last four waves in which this question was asked, there has been a consistent decline in the rate of organizations offering rent concessions. At the beginning of 2022, Wave 37 findings show almost half (47%) of respondents were offering rent concessions. In November and December of 2022, Wave 48 findings show just over one-third (38%) of respondents are offering rent concessions. 

In the Wave 48 survey, there were no organizations offering rent concessions in all their properties, down from 7% in Wave 46 and 20% in Wave 41. Conversely, almost one-half (45%) of organizations are currently offering rent concessions in just 0-25% of their properties, while one-third (36%) are currently offering rent concessions in 26-50% of their properties. Of organizations who are currently offering rent concessions, the most common forms being offered are rent discounts (39%), followed by free rent for a specific period of time (26%), upgrades to units (13%), and rent freezes (13%).

Wave 48 Survey Demographics

• Responses were collected between November 14 and December 11, 2022, from owners and executives of 40 senior housing and skilled nursing operators across the nation.
• Owners/operators with 1 to 10 properties comprise roughly two-thirds (63%) of the sample. Operators with 11 to 25 properties account for 25%, and operators with 26 properties or more make up the rest of the sample with 13%.
• Half of respondents are exclusively not-for-profit providers (50%), just under one-half operate for-profit seniors housing and care properties (48%), and 3% operate both.
• Many respondents in the sample report operating combinations of property types. Across their entire portfolios of properties, 63% of the organizations operate seniors housing properties (IL, AL, MC), two-thirds (38%) operate CCRCs – also known as life plan communities, and 13% operate nursing care properties,

This is your survey! Owners and C-suite executives of seniors housing and care properties, please help us tell an accurate story about our industry’s performance. While some standard questions will remain for tracking purposes, in each new survey wave, new questions can be added based on respondents’ suggestions. Please let us know what you think.

Wave 49 of the ESI is now live. The current survey is available and takes ten minutes to complete. If you are an owner or C-suite executive of seniors housing and care and have not received an email invitation to take the survey, please contact Ryan Brooks at rbrooks@nic.org to be added to the list of recipients.

NIC wishes to thank survey respondents for their valuable input and continuing support for this effort to provide the broader market with a sense of the evolving landscape as we recover from the pandemic.