Assisted Living Facilities

Industry Profile Report

Dive Deep into the industry with a 25+ page industry report (pdf format) including the following chapters

Industry Overview Current Conditions, Industry Structure, How Firms Operate, Industry Trends, Credit Underwriting & Risks, and Industry Forecast.

Call Preparation Call Prep Questions, Industry Terms, and Weblinks.

Financial Insights Working Capital, Capital Financing, Business Valuation, and Financial Benchmarks.

Industry Profile Excerpts

Industry Overview

The 14,700 assisted living centers in the US serve adults who need help with everyday tasks, but don’t require full-time care. Continuing care retirement communities (CCRC) provide independent living, assisted living, and nursing home facilities, allowing residents to stay on the same campus as their needs change.

Resident Turnover

Because the average stay at an assisted living facility is less than two years, firms may struggle to maintain occupancy while managing constant turnover.

Employee Turnover

Employee turnover in the senior living industry is high but remained stable in 2022 at 42.

Industry size & Structure

The average assisted living facility employs about 31 workers and generates about $2.3 million annually.

    • The assisted living industry consists of about 14,700 firms that employ 452,000 workers and generate over $34 billion annually.
    • The industry is concentrated at the top and fragmented at the bottom; the top 50 companies account for about 40% of industry revenue.
    • The assisted living industry includes chains, independent operators, and non-profit organizations. More than 55% of establishments are chain-affiliated; more than 40% are independently owned, according to the American Health Care Association/National Center for Assisted Living (AHCA/NCAL).
    • About 90% of firms are for-profit entities, while about 10% are non-profit tax-exempt organizations.
    • Large companies include Brookdale Senior Living (726 communities), Life Care Services (LCS – 135 communities, 95 campuses), and Holiday Retirement.
    • There are approximately 28,900 assisted living communities with almost 1 million beds in the US.
    • More than 800,000 Americans reside in assisted living; 71% are women and 29% are men. More than half of residents are aged 85+.
                            Industry Forecast
                            Assisted Living Facilities Industry Growth
                            Source: Vertical IQ and Inforum

                            Recent Developments

                            Apr 3, 2024 - Moderate Sales Growth Expected
                            • Assisted living facilities sales are forecast to increase at a 5.5% compounded annual rate from 2022 to 2027, faster than the growth of the overall economy, according to Inforum and the Interindustry Economic Research Fund, Inc. Firms increased their prices slightly during the first nine months of 2023, according to the US Bureau of Labor Statistics (BLS). Labor costs have increased, as employment at assisted living facilities increased moderately and average wages for nonsupervisory employees increased significantly during 2023, according to the BLS.
                            • Occupancy rates at private-pay senior-housing communities are nearing pre-pandemic levels, according to the National Investment Center for Seniors Housing & Care (NIC). The average occupancy rate was 85.1% in the 31 largest US markets in the fourth quarter of 2023, just 2 percentage points below the first quarter of 2020 but up significantly from the pandemic low point of 77.8% in the first half of 2021. Rent increases have outpaced inflation, according to the NIC, with independent living costing an average initial rate of $4,126 a month in December and the more intensive assisted-living units costing $6,422.
                            • Many assisted living communities and nursing homes that call local fire departments for lift assist services are now being billed, according to McKnight's Senior Living. Decatur City Council in Illinois is among the latest local governments to adopt an ordinance charging communities for fire department responses to lift assist calls. Facilities will be billed $500 per assist call for at least the next year. The ordinance addresses what city officials say is a growing problem: an increase in lift assist calls that take fire department staff members away from their core responsibilities. The number of lift assist calls received increased from 430 in 2014 to more than 1,000 in 2023, according to the Decatur Fire Department.
                            • Many facilities have reported that acuity among residents is rising, with people moving into communities with more chronic health conditions than in past years, according to Senior Housing News. The average assisted living resident manages more than 14 chronic conditions. Residents of both senior living and nursing home communities have an average annual health care expenditure of about $20,000 to $30,000, with residents spending $3,000 to $4,000 out-of-pocket. There is a big opportunity to offer more health care services in these communities, according to Caroline Pearson, vice president of the National Opinion Research Center at University of Chicago.
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