Telehealth Updates. Telehealth has been an important flexibility enabling many senior living residents and communities to maintain better access to healthcare as well as reducing transportation and travel costs. Some senior housing residents have seen reduced telehealth access since broad waivers expired on September 30, 2025. This may require rescheduling visits to in-person until a federal budget is reached. It is important to note that telehealth coverage remains for residents who receive care under an Accountable Care Organization (ACO), for those receiving mental health services, for visits under commercial plans (including Medicare Advantage plans), and residents in nursing homes located in eligible rural or underserved areas. For further details, please review the CMS Telehealth website. To learn more about rural or underserved status, please see the Medicare Telehealth Eligibility Analyzer.

Medicare Advantage in 2026. During the Medicare Advantage annual open enrollment, running from October 15^th to December 7^th, senior housing residents can switch plans or adjust existing coverage. Overall, plans are expected to have stable costs even as the total number of plans available has been reduced. As open enrollment occurs, senior housing leaders considering how to support residents in navigating plan options can ensure they access benefits that are changing, like chronic care management, wellness programs, and in-home support, all of which can enhance resident satisfaction and improve health outcomes. Additionally, assessing marketplace updates and resident election changes can inform and better support healthcare referrals and extend resident stays. To explore 2026 Medicare Advantage Plan options, review the Plan Compare website.

Recent VBC Connections and Events. Strategic insights from leading organizations, innovators and teams were featured at both the 2^nd Annual VBC Workshop in Atlanta, Georgia, and the Annual National Association of Accountable Care Organizations (NAACOS) Fall Conference in Washington, DC. Senior housing leaders, innovators, and ACO partners remain at the forefront of some of the most successful collaborations accomplishing the quadruple aim, building the future and bringing care home for seniors. Look out for new case studies and insights coming soon from NIC to advance planning, action and innovation. Also, if you have not yet accessed NIC’s newly updated web page devoted to these important topics, we encourage readers to visit NIC’s Healthcare and Wellness webpage to find podcasts and other important resources aimed at advancing the connections between senior housing and healthcare.

Upcoming Opportunities. Stay tuned for a NIC webinar in November covering action steps and tools for senior housing leaders to gain insight, calculate value, and operationalize strategies to maximize partnerships with ACOs and MA plans. 

The NIC Analytics team presented findings during a webinar with NIC MAP clients on October 9^th, sharing key senior housing data trends during the third quarter of 2025. Additionally, Tom Grape, Founder, Chairman & CEO at Benchmark Senior Living and Andy Kohlberg, President & CEO at Kisco Senior Living joined Lisa McCracken, Head of Research & Analytics at NIC, for a CEO panel discussion on recent trends.

Key takeaways included the following: 

Takeaway #1: Independent Living Occupancy Rate Climbs Above 90%

• The occupancy rate for independent living (IL) communities surpassed 90% in the third quarter, increasing 0.5 percentage points to 90.2%.
• For assisted living (AL) communities, the occupancy rate jumped nearly a full percentage point to 87.2%.
• These strong trends in both property types illustrate the choice-driven demand from the younger or healthier older adults moving into IL, as well as the need-driven demand from those seeking AL services and care.

Takeaway #2: Active Adult Nearly 96% Occupied Upon Stabilization

• The active adult occupancy rate stood at 92.1% in the third quarter, edging down 0.2 percentage points from the prior quarter, but still well above 90% occupied.
• The active adult occupancy rate includes all properties, including those still in lease-up. As a result, the dip may be driven from new units arriving online that are still being absorbed.
• Overall, occupancy rates have ranged from 92% to 94% over the past six quarters since NIC MAP began tracking this data.
• For active adult communities open at least two years, occupancy rates are near 96%.

Takeaway #3: Inventory Growth Setting New Record Lows

• The cost of capital, materials, and labor, among other headwinds, continue to limit inventory growth.
• Fewer than 1,400 new units were opened in the third quarter, and inventory growth remained well below 1% for the second consecutive quarter, with only 0.7% inventory growth from a year earlier.
• This muted new supply is setting new record lows since NIC MAP began tracking this data in 2007.

Takeaway #4: Construction Levels Lowest Since 2012

• For both IL and AL properties, the number of units under construction continued to decline, falling to only 17,000 units combined in the third quarter, levels last seen in early 2012.

Takeaway #5: Negative Inventory Growth in 26% of Primary Markets

• Eight of the 31 Primary Markets have less senior housing units today in their markets than they did three years ago.
• This decline in senior housing inventory is due to property closures, or to units being converted to other uses, without enough new communities or new units being opened to replace them.
• San Antonio has nearly 4% less inventory today compared to three years ago, followed by Pittsburgh at nearly 3% less; Riverside at 2% less; and Tampa and San Diego at 1% less.
• Houston, Baltimore, and Los Angeles round out the eight metro areas with shrinking senior housing inventory.

In conjunction with NIC’s Active Adult Focus Area Committee, NIC recently published two new active adult resources available for existing industry stakeholders and for new entrants into the active adult space.

The first new resource, “Investment Thesis for Active Adult Rental Communities,” serves as an educational resource for investors, lenders, developers, operators, and third-party service providers. The presentation provides:

• An active adult industry overview
• Demand drivers, supply metrics, and market penetration rates
• Occupancy rates and rents
• Recent valuations
• And the latest outlook for the active adult industry

The second new resource, “Active Adult Fact Sheet for Municipalities,” serves as an educational resource for municipalities evaluating new active adult rental community development within their cities and towns. The fact sheet provides:

• NIC’s definition of active adult rental communities
• How active adult differs from conventional multifamily and traditional housing
• Typical benefits of active adult communities in cities and towns
• Characteristics of active adult rental communities and their residents

NIC appreciates the time and insights provided by the Active Adult Focus Area Committee to continue to push forward growth, resources, tools, and opportunities for the active adult industry.

This article is the ninth in a series showcasing parent/child dynamics across the senior housing and care industry. My conversation with Joe, Amy, and Nick Jasmon of American Healthcare Management Group (AHMG) explores how our industry has become a family affair.

Tell us about yourself and your work.

Joe Jasmon: In 2004, we were working with a company in Savannah, GA doing a hospital turn around. We created American Healthcare Management Group to carry on that journey and found a niche of helping hospitals get back on their feet. It was all about identifying who needed to be in what box and putting all the pieces together. With that particular hospital, we were able to convert $300 million of revenue from a competing hospital just by making it a better environment for physicians to work in. We were also able to get the company on the Fortune 100 of best places to work.

We took that knowledge on the road to build more consulting opportunities. Along the way, we learned a lot about senior living and started doing more work in the senior space. For the first part of it, I was on the road and Amy was the entire support team—finance, accounting, and HR. When Nick started, he learned how to design, build, and manage a senior living community. We currently have 12 communities in total.

Amy Jasmon: Initially, Joe and I planned for me to have a big presence in our two sons’ lives. As soon as the kids got out the door to college, I was pushed from behind the scenes to the front of the scenes. It’s been a big but rewarding change. I’m good at the people part of it. Whether you’re talking to your executive director or a caretaker, listening is crucial.

Joe: I will brag for her. Nick has labeled Amy the Chief Emotional Officer because there’s no one better at listening. It’s a talent you can’t teach, and we’re blessed to have that within our organization, but also within our family.

Nick Jasmon: I have a degree in family enterprise from Stetson University, which has been helpful as we discuss succession planning. After college, I did internships with Silversphere, and The LaSalle Group, which gave me the opportunity to job-hop around to all different departments and learn the ins and outs of the industry. Ultimately, it was being in the community that I fell in love with.

We help these individuals go through such a difficult stage of life. From a family member’s perspective, you must admit that your parent, who has been your leader, now needs your help. And parents, who are used to being leaders, now need to lean on their kids. Every day, we get to help families navigate this new dynamic and maximize the last bit of time they have left together.

How do you keep separation between church and state?

Amy: It’s difficult. If our phone rings, we know it’s probably work. When one of us has something come up, it becomes a conversation for all of us. Because of our work ethic and commitments to our teams, it’s not the work that takes a backseat, it’s the family and personal side of things. On the flip side, having each other’s back and not having to worry about trust at work is priceless.

Nick: I think we’ve gotten better, but we should really be asking my brother who isn’t in the family business today. When we first started working together, I would frame questions to distinguish whether it was a work question or a mom and dad question.

Joe: We’re only good at keeping work and personal separate during Bears football games because I don’t answer my phone. So, I would say we’re capable, but not very good at it.

Where do you see the industry going?

Joe: The industry has changed significantly over the last 10 years. The industry is afraid to get out of the box it’s been in for the last decade, so the customer base has moved beyond us. Collectively, we have to catch up because our customers don’t want what we’re selling.

Parallel to that is a workforce that has changed drastically over the last decade. In the last two to three years, it’s been difficult to hire good people at every level. There is no accountability. We have to do a better job of getting people to join us from outside of senior living and find a better way to create a caregiver solution for our residents. At some point, I think AI can be harnessed to help us mitigate the struggle we have on a daily basis of getting good people to show up and do a good job.

Amy: I would echo the workforce issues. My biggest frustration is the people even though they’re also the biggest joy for me.

What advice do you have for the next generation or those thinking about joining the industry?

Joe: Our expectation and advice for them is to be the type of people who will get on a plane or a car in a moment’s notice and go to the communities to work side by side with staff. Even if that means mulching or cooking, you have to be ready to jump in. Additionally, utilize the technological skills you have for efficiency’s sake.

Amy: I agree—use your tech knowledge, but don’t forget the personal touch. We want to stay as small as we need to stay so we don’t lose sight of the personal touch. That’s what we’re good at and it makes all the difference.  

What advice do you have for the generation before us?

Nick: The labor part is tough, and I feel like we as an organization often let that bog us down. My advice would be: let’s live in reality and not in a financial document. It’s hard to remember the things going well during times when your impact is not easily seen.

*Interviews edited for length

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.