Middle market senior housing is one of the toughest niche offerings to get right. Residents want quality care and lifestyle at a price they can afford, and operators need sustainable margins to make the model work. At Cardinal Senior Living, we have been able to create a middle market offering that leverages a highly efficient operating model with other strategic positioning to serve this growing cohort of older adults.
Below are what we see as key elements of our success.
1. Maximize 3rd shift.
Overnight staff should not just monitor hallways. We train them to handle housekeeping and laundry while the residents sleep. It keeps day shifts free for direct care and cuts the need for dedicated housekeeping hours.
2. Leverage EBT (Electronic Benefits Transfer) cards.
Many residents qualify for food assistance but do not use it. We help them apply and integrate those benefits into our dining program. It supplements our food budget, adds menu variety, and keeps costs in check without sacrificing quality.
3. Fight property taxes.
Real estate taxes can crush middle market margins. We fight assessments aggressively. Every appeal, every exemption, every piece of data that supports our case. Lower taxes go straight to the bottom line.
4. Know your Medicaid waiver inside and out.
Rules, rates, and eligibility vary by state—and they change often. We stay on top of every update, build strong relationships with caseworkers, and advocate for fair rates. Medicaid can be the difference between keeping a building full or letting rooms sit empty.
5. Use roommates strategically.
For residents who cannot afford a private suite, we offer shared rooms at a lower rate. It keeps our census up, lowers cost per resident, and often gives residents the social connection they need to thrive.
Middle market success comes from doing the hard, unglamorous work, knowing every program, every regulation, and every lever to pull on expenses. It is not about cutting corners. It is about running smarter.