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 14,600 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 at about 50%.

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 14,600 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

                            Mar 7, 2023 - Study Finds That Facilities Provided A Safe Environment During Pandemic
                            • Residents of assisted living facilities were as safe or almost as safe as those living in the greater community once COVID-19 vaccines became available, according to a study conducted by researchers at the University of Chicago. The study found that the difference in death rates during the COVID-19 pandemic, relative to deaths before the pandemic, was strongly reduced in all senior housing settings after COVID-19 vaccines were introduced. The researchers found that living in any type of senior housing was safer than living in a long-stay skilled nursing facility during COVID-19, both before and after the vaccines became available.
                            • Senior living community and nursing home facilities saw the largest drop in employment in the aftermath of the coronavirus pandemic, but they also have seen the highest average wage increases, according to the Peterson Center on Healthcare and Kaiser Family Foundation. An analysis of data from the Bureau of Labor Statistics showed that the number of workers employed in senior living communities and nursing homes remains significantly below pre-pandemic levels while hospitals and physician offices have nearly returned to pre-pandemic employment levels. Wages for community elder care facility workers increased 20.5% between February 2020 and November 2022, and nursing home employee average earnings increased by 21.8%.
                            • Assisted living developers are still dealing with supply chain issues and labor shortages, according to Forbes Magazine. Facilities aren’t being constructed fast enough to meet demand — there are about a million units on the market right now for about 70 million Baby Boomers. The number of people in that demographic who require two or more daily care tasks (medication management, cleaning, etc.) and qualify for assisted living is constantly growing. Builders and managers of assisted living facilities face rising costs for everything from borrowing money to buying supplies due to inflation that remains near record highs.
                            • Shifting demographics are forcing the assisted living industry to diversify more rapidly across rates and services, yielding increasingly lavish residences for upper-income Americans and a growing number of affordable housing models, according to industry experts. Developers are also experimenting with nontraditional models. Kallimos Communities in Colorado, for example, is planning a multigenerational development featuring 100 subsidized rental homes clustered around shared green spaces and offering dining, arts and wellness opportunities. Other changes are reshaping housing, from pandemic-fueled safety concerns and labor shortages to trends favoring more personalized and community-based solutions. Housing for older Americans offers three general options: independent living, for active lifestyles; assisted living, which includes some medical care; and memory care. Nursing homes provide nursing care and typically do not fall under the category of senior housing.
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