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 15,000 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 32 workers and generates about $2.5 million annually.

    • The assisted living industry consists of about 15,000 firms that employ 474,400 workers and generate over $37.3 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

                            Jul 8, 2024 - Moderate Sales Growth Expected
                            • Assisted living facilities sales are forecast to increase at a 4.74% compounded annual rate from 2024 to 2028, faster than the growth of the overall economy, according to Inforum and the Interindustry Economic Research Fund, Inc. Assisted living industry employment increased slightly during the first quarter of 2024 while average wages for nonsupervisory employees decreased slightly, according to the US Bureau of Labor Statistics.
                            • Nearly three million older Americans who need long-term help are not receiving it, according to KFF Health News and The New York Times. The shortage of help is largely driven by the high costs of assisted living facilities, nursing homes, and aides at home. Paid care, either at home or in a facility, is often so expensive that only the wealthy can afford it, and many of the for-profit companies providing care raised their prices sharply during the coronavirus pandemic. The US spends less on long-term care than do most wealthy countries, according to KFF Health News and The New York Times.
                            • Assisted living facilities are at risk of losing staff members following the first-ever federal staffing mandate for nursing homes, according to LaShuan Bethea, Executive Director of the National Center for Assisted Living. The final rule will require nursing homes to provide a minimum of 3.48 hours of nursing care per resident day, including 0.55 hours of care from a registered nurse per resident day, at least 2.45 hours of care from a nurse aide per resident day, and 24/7 onsite RN services. Competition for workers, especially nurses and other caregivers, may increase at a time when all providers already face recruiting and retention challenges.
                            • 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.
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