How to Boost NOI

Higher wages and the cost of supplies are cutting into senior living NOI and occupancies are still recovering from the fallout of the pandemic.

It’s simple, right? Increase revenue or decrease expenses. Those are the two ways to boost net operating income (NOI). Ideally, senior housing and skilled nursing operators can do both.

But in today’s inflationary economic environment, increasing NOI and profitability can be a challenge. Higher wages and the cost of supplies are cutting into NOI. Occupancies are still recovering from the fallout of the pandemic, though operators do report some pricing power with recent rate hikes.

“We are looking at ways to create operating efficiencies, increase occupancy and drive rates,” said Adam Kaplan, CEO at Solera Senior Living.

2022 NIC Notes Blog NOI Image 1

Kaplan spoke on a panel at the 2022 NIC Spring Conference titled, “How to Increase NOI Today, Tomorrow and into the Future.” He was joined by Lynne Katzmann, president & CEO at Juniper Communities, and Peter Longo, managing partner at Cantex Continuing Care Network. The session was moderated by Joel Mendes, senior director, Seniors Housing Capital Markets at JLL.

Each panelist showcased their proven strategies to boost NOI.

Solera positions itself as the price leader in the market. “We are focused on quality and being the best in every market where we operate,” said Kaplan. Solera provides a premium level of services, high-quality food options, robust engagement programs, and the latest technology.

The strategy has helped to sustain high occupancy levels along with the ability to raise rental rates by as much as 7-10%. Kaplan added that local supply and demand dynamics determine how much rents can be raised. “We take a very granular approach,” he said.

Efficient building designs help drive top line results and generate attractive yields for investors, Kaplan said. For example, new Solera properties have a single community entrance for all levels of care. The design creates a better resident experience and reduces expenses — only one entrance has to be staffed.

Juniper Communities leverages care integration to increase length of stay and augment care charges to boost NOI. Katzmann noted that care coordination is not the same as care integration. The approaches have some commonalities such as developing care plans and monitoring residents around the clock.

Care integration also includes primary care practitioners on site. Juniper’s Connect4Life model integrates onsite primary care, pharmacy, and lab services. “We started our own primary care practice,” said Katzmann. The practitioners can note changes in resident health and take quick action. They also serve as a support for the community team.

Primary care practitioners enter their notes into an electronic system at the community, so coordination is seamless. “We act as a bridge between chronic care management and the medical system,” said Katzmann. “Our resident outcomes are better which impacts NOI.”

Higher NOI, Higher Value

Juniper conducted research on the impact of care integration on NOI. Juniper compared its population to the general population and found that the hospital readmission rate was 80% lower among its residents. The use of the emergency department was 15% lower.

The study showed an increase in NOI of $113,000 a year per property, Katzmann said. Assuming an 8% cap rate, for example, property value would be increased by $1.4 million.

2022 NIC Notes Blog NOI Image 2

Juniper also introduced a Medicare Advantage Plan. This allows Juniper to be paid for care integration from the savings it produces for Medicare.

Panelist Longo at Cantex, which owns and operates a number of skilled nursing facilities, started a Medicare Advantage plan for residents. “It’s had a major impact on how we deliver care and the outcomes,” he said. Residents can sign up for the Medicare Advantage plan. Nurse practitioners deliver care. Cantex is rewarded for better outcomes since healthier residents need less care and fewer expensive interventions.

Practitioners can coordinate home health and hospice care for residents not in the plan. Another benefit: The staff at the building has embraced the approach. “Nurse practitioners proved their worth during the pandemic,” said Longo.

Session moderator Mendes posed a question to the panelists: How much does it cost to set up a Medicare Advantage plan?

“You need capital,” said Longo, adding that it could cost $1 million or more depending on state regulations and other requirements. Scale is also necessary. He said that 60-80 residents are needed for it to make sense to hire a nurse practitioner. About 5-10 facilities should be geographically clustered to share services and circulating nurse practitioners.

Kaplan agreed that a wellness approach is integral to a high-quality operation. At Solera, nurses are available 12 hours a day, every day. But the healthcare operations run in the background. “We focus on lifestyle,” he said. “We are at the intersection of healthcare, real estate and hospitality.”

As the session concluded, panelists agreed that technology, while expensive, is a must-have to boost NOI. The right technology allows the company and the staff to operate efficiently. The ability to capture and communicate real time data is also critical to demonstrate value to partners.

The 2022 NIC Fall Conference is coming up next month. See upcoming sessions and register today.

1Q22 NIC Lending Trends Report: Uptick in New Nursing Care Construction Loans Closed

There was quarter-over-quarter increase in new senior housing construction loans closed in 1Q22, new nursing care construction loans closed increased.

NIC Analytics released the 1Q2022 NIC Lending Trends Report today. The quarterly report, available for free to NIC’s constituents, currently tracks $86.5 billion in senior housing and nursing care loans. The report includes data for over five years of construction loans, mini-perm/bridge loans, and permanent loans from 3Q2016 through 1Q2022.

While there was a 39.4% quarter-over-quarter increase in new senior housing construction loans closed in first quarter 2022, new nursing care construction loans closed increased quite notably (over 600% on a same-store quarter-over-quarter basis). Though this increase is partially explained by a very small number of new nursing care construction loans closed in the prior quarter, it is still the largest same-store quarter-over-quarter increase for nursing care new construction loans in the recorded time series to date. This blog discusses the key takeaways from the first quarter report.

Takeaways from the 1Q22 NIC Lending Trends Report.

    • Nursing care new construction loan closings were very strong in first quarter 2022 following a weak fourth quarter 2021. Partially due to the low fourth quarter, the quarter-over-quarter same-store growth for nursing care new construction loan closings was 645.8% in first quarter 2022. Senior housing new construction loan closings also picked up in first quarter 2022 from fourth quarter 2021 at a growth of 39.4% on a same-store quarter-over-quarter basis. However, the senior housing new construction loan volume closed was below its recent peak in third quarter 2021.
    • Delinquencies were quite flat in first quarter 2022. Nursing care delinquencies remained unchanged from fourth quarter 2021, and senior housing delinquencies had a modest increase of 5.0% on a same-store quarter-over-quarter basis. This increase for senior housing was less than half of its increase in fourth quarter 2021 (13.6%). Delinquencies for both senior housing and nursing care were below 1.5% of total loans (1.1% for senior housing, 1.4% for nursing care). There were no foreclosures for the sample in first quarter 2022.
    • New mini-perm/bridge loans closed for senior housing were down in first quarter 2022 from their recorded high in fourth quarter 2021, but were still well above the levels from second quarter 2020 through third quarter 2021. On a same-store basis, the quarter-over-quarter decline was 50.7% for senior housing. Nursing care mini-perm/bridge loan closings remained at a high level, but also had a decline in first quarter 2022 from the fourth quarter 2021. However, the decline for nursing care mini-perm/bridge loan closings was more modest at 7.2%. Last quarter we posited that the heightened mini-perm/bridge loans in combination with the lowered permanent loans may reflect that some lenders may currently be more comfortable issuing a mini-perm over permanent loan for some deals.

2022 NIC Notes Blog 1Q22 Lending Trends Graph1

These data are not to be interpreted as a census of all senior housing and skilled nursing lending activity in the U.S., but rather reflect lending activity from participants included in the survey sample only.

The 2Q2022 NIC Lending Trends Report is scheduled be released in mid-November 2022.

Interested in participating? The NIC Lending Trends Report helps NIC Analytics to deliver on NIC’s mission to enable access and choice by further enhancing transparency of capital market trends in the senior housing and care sectors. We very much appreciate our data contributors. This report would not be possible without them.

If you would like to participate and contribute your data, please contact us at analytics@nic.org. As a courtesy for providing data, data contributors receive this report early before publication on the website. The information provided as part of the survey will be kept strictly confidential. Individual answers will be combined with the answers of all other respondents. Data acquired from this survey will only be reported in the aggregate, and therefore, the resulting aggregated data will not be attributed to you or your company upon distribution.

Six Key Drivers Shaping the Future of Senior Living: Key Driver #2

While senior living providers struggled with labor shortages prior to the pandemic, the crisis exacerbated the problem.

The Endemic Staffing Crisis

NIC Co-Founder and Strategic Advisor Robert Kramer has identified “Six Key
Drivers
” that will shape the senior living industry over the next 10 years. Kramer
is also Founder & Fellow at Nexus Insights, a think tank to advance the well-being of older adults through innovative models of housing, community, and healthcare. What follows is an analysis of the second key driver: the workforce.

bob headshot-1While senior living providers struggled with labor shortages prior to the pandemic, the crisis not only exacerbated the problem but brought into bold relief the enormous staffing challenge the senior living industry will continue to face over the next 10 years. Just as the pandemic has become endemic—a situation we must adjust to and live with—so too the staffing crisis will be an ongoing issue that requires radical new approaches.

Our industry has historically struggled with workforce issues that were often viewed as correlated with the economy. Low unemployment rates have always been a challenge for the industry.

The crisis today, however, is clearly not just a question of a tight labor market. It is rather a recognition that senior care providers are not just competing to be the employer of choice among other senior care and aging services providers but also with the broad scope of employers in retail, hospitality and healthcare.

It is critical that we compete for the best workers. Staff shortages are a detriment to our residents and our business. The quality of care suffers when too few workers are trying their best to take care of residents. Overworked employees can get stressed, leading to absenteeism and turnover. Providers that face a staffing shortage often have to limit new admissions.

The old approaches alone won’t work. New, innovative ideas are essential to meet this ongoing endemic labor challenge. Here are five short- and long-term strategies to consider:

  1. Recast our relationships with frontline and other hourly employees.

    We need to rethink how we view and interact with our hourly employees. Prior to the COVID-19 outbreak, many operators and providers were focused on their hourly staff only from the time they clocked in for a shift to the time they clocked out. What happened outside that shift was not really relevant to us. That approach became totally inadequate during the pandemic. Workers with young children at home needed to care for them when the schools were closed. Workers were worried about feeding their kids who received free, nutritious meals at school which were no longer available. Our hourly workers weren’t just worried about providing dinner but having to provide three meals a day. Added to that, family members, and the workers themselves, got sick and needed help. Scheduling disruptions were common.


    I believe that a significant shift in our approach is needed for our providers to be successful employers of choice in the future. We need to move from a transactional relationship with hourly employees to one of empathy and understanding.


    We can’t solve their problems, but we can help to address the issues these hourly workers bring with them to work. What does that mean? This is often a population in poverty or struggling to stay out of poverty. They are often juggling multiple jobs as well as multiple assistance programs that they hope to qualify for or continue to qualify for. They are overwhelmingly female, and a significant number are people of color. About a quarter are immigrants. Many are single mothers with children. Understanding these issues means addressing everything from daycare and housing to that last mile of transportation to get to work and even domestic and spousal abuse.


    In her book, Workforce Stability, author Ruth K. Weirich, shows that increased worker stability boosts productivity, retention, and morale, leading to greater profitability. The question is how to create an environment that supports workforce stability.


    Weirich points to the huge gap that exists between management and employees. Management is often so far removed from the world of the hourly worker that it’s hard to have any understanding, let alone empathy for the daily world of survival that these employees and their families face. We have to start there. Without understanding and empathy we cannot do what’s necessary to boost morale and retain good workers.


    Let me emphasize that we are not going to solve all their problems. But we can demonstrate our empathy and be willing to partner with them to be part of the solution.


    For example, maybe that means providing day care on site, or partnering with a childcare program. Maybe it means aligning with a domestic abuse center so employees can get free access to confidential services. Perhaps the human resources team needs to be trained on how to navigate various housing and government assistance programs. That’s not what you normally think of as a duty for your HR/benefits team. But if your employees are struggling to get support from these programs, you either need to contract with someone to provide that assistance or you have to offer that expertise in house.


    The more employees realize that they’re getting help with these tangible issues that they struggle with outside of work, the more you will become the employer of choice. In turn, they are going to pass that word along to their family and friends.


  2. Highlight our purpose-driven work.


    As the acuity level among residents continues to rise, the industry already has a reputation of paying low wages for demanding work. But we also have a good story to tell. Senior living provides the satisfaction of a job with purpose. Not every employer can say that. We can promote personal connections and how we make a difference in people’s lives which can be enormously attractive to potential workers.


    Millennials and members of Gen-Z, in particular, are looking for purpose driven work. These young people want to feel they are making a difference in what they do, not just “holding a job.” Older workers are often looking for purpose in a second career. We offer what these groups are seeking. The added benefit is that we will expand our pool of potential workers to groups that the industry has largely ignored (see point #3 below).


    Sometimes residents and employees can even find purpose together.


    For example, at two Goodwin House properties in Virginia, the staff included a large number of immigrants, many of whom for years had been seeking U.S. citizenship. So, the communities started a program to help. Residents raised money to pay the fees for filing for citizenship and tutored employees on civics. A front-page story about the program appeared in the Washington Post and the community’s recruitment efforts soared.


    At another community during COVID, a resident asked a frontline caregiver how she kept going because it was so tough. The frontline caregiver said she was concerned about her three children—ages four, six and eight—who were not learning at home. The resident was an educator and knew many of the other residents had college and graduate degrees. So, they started an online tutoring program for the staff’s children.


    Bottom line: If we want our employees to treat residents like family, we have to treat our employees like family too. We must demonstrate that we care about the details of their lives and their daily challenges, just as we want them to care for the details and daily challenges in the lives of our residents.

  3. Expand our pool of workers.


    With low birth rates, competition for workers will become more intense. Though the senior living industry has typically targeted workers in the 35-55 age group, we need to expand our workforce to recruit those who are younger and those who are older.


    In the wake of the pandemic, Millennials and Gen Z now understand the effects of social isolation and loneliness and have increased empathy for older people. As I mentioned in the previous point, these younger generations don’t want just a job. They want to know their work has meaning and purpose. We need to highlight that our jobs make a real difference in people’s lives. This is enormously attractive to younger people.


    Older workers can help fill the gaps too. In Japan, for example, people aged 60-80 provide care and companionship for those age 80-110.


    Retirees here are exploring “encore careers.” These second careers combine continued income, personal meaning and social impact. The key is that these older workers, like their younger counterparts, want to help others. Take, for example, someone who has retired from decades of government service or clerical work. An “encore career” in senior living offers the spirit of service and a paycheck.


    Another interesting idea is to engage residents as volunteers. This model could be especially useful for middle market properties. The nonprofit 2Life Communities, in their new Opus middle market community, will require residents to volunteer 10 hours of their time every month to help out. Residents can help at the front desk, work in the library, coordinate activities, or perform other duties. An unexpected benefit is that new residents are attracted to the community because of its focus on volunteerism.


    Immigration initiatives are going to be key to address workforce shortage now and in the future. Immigration is critical to attract workers who both value service and esteem older adults. We must pursue opportunities to advance immigration at the state, federal and company level.

  4. Emphasize training and career paths.

    Workers often leave their jobs because of an issue with their direct manager. The manager may be unaware of the worker’s situation or may not be providing the necessary support for the worker to be successful. Are our managers trained to develop a relationship with the worker? Do the managers listen? Are they engaged with the worker during those critical first 90 days on the job? The same holds true for frontline workers. Are they being properly trained? Do they understand their job and the company’s values? How are you investing in them to make them feel supported?


    Establish a career path for workers. Show them how they can advance and help them do it. A structured program can help caregivers become certified as CNAs and CNAs become LPNs. Line cooks can be trained to become chefs. Housekeepers can become supervisors. Consider a scholarship program for those seeking the credentials needed to advance. Or offer scholarships in return for a set number of years of service. Another idea is to develop relationships with community colleges and nursing schools to provide internship opportunities and a recruitment pipeline.

  5. Leverage technology.

    Senior living providers are adopting innovative strategies to screen potential employees. Machine learning is being used to find applicants who want to serve others. Finding the right employees by asking the right questions can boost retention efforts.


    Technology will also free workers from some rote tasks. The goal of technology is not efficiency, which is simply the byproduct, but to enable the staff to have more real interactions with residents. The employee has the time to chat with residents and ask how they’re feeling that day, instead of rushing to quickly perform a task and move on or being bogged down with paperwork.


    For example, the Japanese market has pioneered the use of “smart” diapers. Equipped with sensors, these diapers not only alert the staff when a resident is wet or soiled but also perform an instant urinalysis. This tells the staff whether the resident is dehydrated and at risk for developing a urinary tract infection. The technology eliminates the need for the staff to perform the routine and invasive checks that can lead to confusion and sometimes anger on the part of the resident. The worker in that situation doesn’t feel good either. The technology frees up staff time so they can engage with residents in ways that improve their quality of life.

The pandemic made a difficult staffing situation much worse and just as the pandemic looks to be endemic so too the staffing challenge is going to be endemic and require new, creative solutions. If we are only competing on wages, we are going to keep losing and will continue to have high turnover. Paying fair and competitive wages is essential, but the challenge is much deeper. We must engage workers beyond the hours of their shift and demonstrate empathy and willingness to come alongside them in their challenges. We must rethink our role and deploy a range of short- and long-term strategies to win the competition for talent.

Next Up—Key Driver #3: A New Customer Arrives with a Different Take on Longevity. Our new customers want their lifespan to match their healthspan or wellspan. We need an engagement view of aging and retirement shaped by growth and opportunity, not by deficits and decline.

 

Skilled Nursing Occupancy Increased Slightly in May 2022

NIC MAP Vision released its Skilled Nursing Monthly Report on August 4, 2022, including key monthly data points from January 2012 through May 2022.

“Skilled nursing occupancy held steady in May, as operators still confront a challenging operating landscape amidst high inflation and staffing challenges.”

– Bill Kauffman

NIC MAP Vision released its latest Skilled Nursing Monthly Report on August 4, 2022. The report includes key monthly data points from January 2012 through May 2022.

Here are some key takeaways from the report:

Skilled nursing property occupancy increased in May, albeit slightly. It increased 9 basis points from April, ending the month of May at 77.3%. In the last three months, skilled nursing occupancy has hovered in the range of 77% which is the highest occupancy level since April 2020, at which time occupancy began to fall rapidly due to the onset of the pandemic. Occupancy continues to recover since the pandemic low of 72.1% set in January 2021 but has encountered challenges such as new COVID-19 variants, e.g. Delta and Omicron. In addition, staffing shortages continue to create difficulties within skilled nursing properties limiting the ability to admit new residents. However, the current occupancy trend does suggest that demand for skilled nursing properties is recovering, given the 149-basis point increase from January to May. Occupancy has increased 307 basis points from one year ago and 518 basis points from its pandemic low.

2022 NIC Notes Blog SNF May Graph 1

Skilled mix increased 10 basis points from April to end May at 25.8%. This increase seemingly was driven by Medicare as its patient day mix increased from the prior month and managed Medicare patient day mix decreased in the same period. Managed Medicare patient day mix decreased 7 basis points to end the month of May at 7.6% and Medicare increased 13 basis points ending the month at 11.7%. Skilled mix has increased 11 basis points compared to one year ago. In addition, in a similar trend to patient day mix, Medicare revenue mix increased from the prior month. It increased 49 basis points from 20.8% to end the month of May at 21.3%. This suggests that skilled nursing operators increased the use of the 3-Day Rule waiver as COVID-19 cases increased in the month of May.

Managed Medicare revenue mix decreased 18 basis points in the month of May, ending the month at 10.6%. After increasing 13 basis points from March to April this year, it is now down 82 basis points from 11.4% in February. Historically, there has been declines in the managed Medicare revenue mix from the winter to spring months, which suggests lower volumes in the springtime whereas the winter months typically have an increase due to slips and falls, more illnesses, and elective surgeries. In addition, Managed Medicare revenue mix has increased 251 basis points from the 8.1% pandemic low set in May 2020. Meanwhile, managed Medicare revenue per patient day (RPPD) continued its decline, decreasing from $456 in April to $454 in May. It has decreased 1.84% from the prior year in May 2021.
2022 NIC Notes Blog SNF May Graph 2
Medicaid patient day mix increased for the third consecutive month, although only increasing slightly from April to May. It increased 3 basis points from the prior month to end May at 65.9%. Its patient day mix has increased 293 basis points from February, while Medicare patient day mix decreased 255 basis points in the same period. Some of the explanation of this increase in Medicaid patient days is due to the decline in COVID-19 cases relative to February as operators moved residents back to Medicaid days from Medicare days, after requiring isolation and higher skilled care.

To get more trends from the latest data you can download the Skilled Nursing Monthly Report. There is no charge for this report.

The report provides aggregate data at the national level from a sampling of skilled nursing operators with multiple properties in the United States. NIC continues to grow its database of participating operators to provide data at localized levels in the future. Operators who are interested in participating can complete a participation form. NIC and NIC MAP Vision maintain strict confidentiality of all data received.

NIC MAP Data Release Webinar 2Q22 Key Takeaways: Senior Housing Occupancy Continued to Recover

NIC MAP Vision clients, with access to NIC MAP® data, attended a webinar in mid-July on key seniors housing data trends during the second quarter of 2022.

NIC MAP Vision clients, with access to NIC MAP® data, attended a webinar in mid-July on key seniors housing data trends during the second quarter of 2022. Findings were presented by the NIC Analytics research team. Here are key takeaways from the data release.

2Q 2022 Key Themes

Key trends during the second quarter of 2022 for the seniors housing market include:

  • Senior housing occupancy increased 0.9 percentage point to 81.4%.
  • The number of senior housing units under construction across the 31 NIC MAP Primary Markets was the fewest since 2015.
  • Assisted living’s occupancy is recovering faster than that of independent living, but both property types still require significant occupancy gains to fully recover to their respective pre-pandemic levels.
  • Reflective of its faster recovery, the average asking rent for assisted living grew by 4.6% from year-earlier levels. This represents its largest annual increase since NIC MAP began reporting the data in 2005.
  • The preliminary data shows the dollar volume of seniors housing and care property sales transactions during the second quarter totaled $2.0 billion.

Takeaway #1: Senior Housing Occupancy Improved Further in 2Q 2022

  • The occupancy rate for seniors housing—where seniors housing is defined as the combination of the majority independent living and assisted living property types—rose 0.9 percentage point during the second quarter of 2022 to 81.4% for the 31 NIC MAP Primary Markets. This marked the fifth consecutive quarter where occupancy did not decline. At 81.4% in the second quarter, occupancy was 3.4 percentage point above its pandemic-related low of 78.0% recorded in the second quarter of 2021 but was still 5.8 percentage points below its pre-pandemic level of 87.2% in the first quarter of 2020.
  • Demand as measured by the change in occupied inventory or net absorption was strong in the second quarter, increasing by more than 8,609 units in the Primary Markets. This was the strongest demand ever recorded by NIC MAP except for the post-pandemic boost in demand we saw during the last half of 2021.
  • Since the recovery began in second quarter 2021, 35,544 units of the 45,525 units placed back on the market have been re-occupied, or 78% of those units.
  • These improved supply and demand dynamics at midyear offer a positive outlook for 2022.

2022 NIC Notes Blog 2Q2022 NIC MAP Data Graph 1

Takeaway #2: Units Under Construction Fewest Since 2015

  • In the second quarter of 2022, the number of seniors housing units under construction in the 31 NIC MAP Primary Markets was the least since 2015.
  • For assisted living, there were 19,162 units under construction, down about 1,000 units from the first quarter. Notably, this was the fewest units under construction since early 2015. As a share of inventory, this amounted to 5.7% but below its peak of 10.1% in late 2017.
  • For independent living, there were 15,882 units under construction in the second quarter, equal to 4.5% of the stock of independent living, as compared to 6.7% in 1Q 2020.

Takeaway #3: Construction Activity Still Slow in Most Markets

  • This heat map shows which metropolitan markets are experiencing the most construction activity. First, notice the generally blue tones on the right side of the chart indicating that construction activity is relatively “cool” in many markets.
  • Looking at the right-hand part of the grid, those markets that are shaded brighter red are seeing the most construction as a share of inventory. This includes Miami where construction as a share of inventory amounted to 11.2% in the second quarter (2,885 units in 18 properties). This was the market’s second most ever (first was 2Q 2021 at 11.3%). And, at 9.8% of inventory, Portland, Oregon’s construction was at an all-time high at 2,093 units in 15 properties. Washington, D.C. (10%) was also high as seen by the red shadings.
  • Atlanta stands out on this heat map, with its red shades, but construction as a share of inventory in Atlanta was relatively low for Atlanta in the second quarter at 7.3% (16 building and 1,876 units). This is well below the 17.4% share seen in Atlanta in mid-2017, when there were 31 buildings under construction (over 3,333 units). Since that time, the inventory of senior housing in Atlanta has increased by 33% (more than 6,300 units).
  • On the other extreme is Pittsburgh where construction as a share of inventory was virtually zero in 2Q 2022. This is a dramatic shift from a share of 10% in 2019.
  • For perspective, for senior housing, the 2Q 2022 construction level equals 5.1% of inventory for the Primary Markets, and it peaked at 7.7% in late 2017 and more recently at 7.7% in the pre-pandemic 1Q 2020.

2022 NIC Notes Blog 2Q2022 NIC MAP Data Graph 2

Takeaway #4: Senior Housing Occupancy Up from Pandemic Low in All Markets

  • The chart below provides more detail on market recovery patterns from the pandemic low by metropolitan market. The dash line shows the occupancy rate in 2Q 2022, and the top of the grey bar shows the 1Q 2020 occupancy rate and the bottom of the grey bar shows the pandemic-related low point which was 1Q 2021 for many markets, but some did not reach that point until later in 2021.
  • Of note on the chart, all markets are above their pandemic-related low points. The market with the highest first quarter senior housing occupancy rate was Boston at 86.3%, followed by Minneapolis (85.1%), Portland, and Baltimore. San Jose fell from its second-rate position in the first quarter and its first-place position prior to that. The lowest were Houston (76.1%), Atlanta, and Cleveland.
  • There is a 10.2 percentage point wide gap between the best and worst performing markets.
  • Based on the length of the grey bar in the chart, you can see that San Jose, St. Louis, Los Angeles, Miami, and Sacramento saw the deepest drops in occupancy, all more than 12 percentage points. In contrast, Orlando, Portland, San Antonio, Detroit, Seattle, and D.C. all saw peak-to-trough losses of less than 8 percentage points.
  • Regarding improvements from their respective low points, Riverside saw a jump of 7.1 percentage points from its low point to 81.6%, but its low point was very low at 74.5%. Miami saw a gain of 6.4 percentage points, an improvement from a low of 73.8% up to 80.2%. The smallest improvements occurred in Cincinnati, Seattle, and Chicago.
  • For perspective, the aggregate Primary Markets’ occupancy rate was 81.4%, and it saw a 3.4 percentage point improvement from its low point.

2022 NIC Notes Blog 2Q2022 NIC MAP Data Graph 3

Key Takeaway #5: Preliminary Closed Seniors Housing & Care Dollar Volume: $2.0 Billion for 2Q 2022

  • According to the preliminary data, the number of closed deals and the dollar volume closed in the second quarter increased from the first quarter. The second quarter ended with $2.0 billion in closed transaction volume. If that figure were to hold, volume would be up 22% from the relatively weak first quarter as volume closed registered only $1.7 billion in 1Q2022.
  • The number of transactions closed, a different measure in activity than dollar amount, increased from 68 deals closed in the first quarter to 80 deals in the second quarter, according to the preliminary figures.
  • Of the $2.0 billion closed, the private buyers represented $1.5 million of that, or in other words, represented 73% of the closed volume in the second quarter. The private buyer category is comprised of companies that are not publicly traded—for example, a private REIT, single owner or partnership, family offices, etc. Private partnerships and family regional owner/operators have been a steady source of liquidity. However, we are now coming into a different paradigm in terms of the real estate investment markets as interest rates and inflation continue to pressure overall liquidity.
  • Note that the transactions data discussed in this key takeaway include only the closed property sales transactions throughout the United States. It does not include deals that have been announced in the quarter and not yet closed. It is also important to remember that this data is preliminary for the second quarter of 2022, as data points could be updated with other deals being captured as we learn about their closings. These updates typically occur as public records become available and given slower recordings within public records it is possible this data is updated more so than usual, especially when it comes to single property transactions that are often under the radar from public announcement and reporting.

Interested in learning more?

To learn more about NIC MAP data, powered by NIC MAP Vision, an affiliate of NIC, and accessing the data featured in this article, schedule a meeting with a product expert today.