The following analysis examines broader occupancy trends, year-over-year changes in inventory, and same-store asking rent growth – by care segment – within 1,049 entrance fee and rental CCRCs in the 99 NIC MAP Primary and Secondary Markets.

3Q 2025 Market Fundamentals by Care Segment – Entrance Fee vs. Rental CCRCs

The exhibit below compares the market performance of entrance fee CCRCs and rental CCRCs by care segment for the third quarter of 2025, highlighting year-over-year (YOY) changes in occupancy, inventory, and asking rent growth.

Occupancy. Entrance fee CCRCs continued to report higher occupancy rates than rental CCRCs across all care segments. Among entrance fee CCRCs, the independent living segment achieved the highest occupancy at 93.6%. Similarly, within rental CCRCs, independent living reported the strongest performance with a 91.8% occupancy rate.

The difference in occupancy rates between entrance fee CCRCs and rental CCRCs was largest in the independent living segment (1.8pps), followed by nursing care (1.7pps) and assisted living (0.9pps), with the smallest gap seen in the memory care segment (0.1pps).

Rental CCRCs recorded the higher YOY occupancy growth in independent living (2.4pps), assisted living (2.1pps), and memory care (2.1pps) segments. While entrance fee CCRCs showed higher YOY occupancy growth in the nursing care (2.4pps) segment.

Asking Rent. The average monthly asking rent for entrance fee CCRCs remained higher than that of rental CCRCs across all care segments. Rental CCRCs showed higher YOY rent growth in assisted living (4.4% to $6,459) and memory care (4.3% to $8,238) segments. Entrance fee CCRCs experienced stronger YOY rent growth in independent living (4.5% to $4,325) and nursing care (4.9% to $479*) segments.

Note, these figures represent asking rates and do not reflect any discounts that may be applied. The nursing care average daily rent is the average private pay per diem rate.

Inventory. Compared to the level a year ago, rental CCRCs experienced inventory decline across all care segments except for memory care, which showed a modest gain (0.9%). The largest decline was observed in the assisted living segment (-2.0%), followed by nursing care (-1.5%) and independent living (-0.7%) segments.

In contrast, entrance fee CCRCs displayed a mixed trend: assisted living recorded the largest YOY inventory increase (0.7%), the nursing care segment experienced the largest decline (-0.9%), while independent living segment inventory remained unchanged from the prior year.

Negative inventory growth can occur when units or beds are temporarily or permanently taken offline or converted to another care segment, offsetting any newly added supply.

Steady Increases in CCRC Entrance Fees

The exhibit below explores the average entrance fees and YOY entrance fee growth across 99 NIC MAP primary and secondary markets from 2020 through 2025. The bar chart illustrates the average entrance fee in dollar amounts, while the line graph depicts the YOY entrance fee growth rate.

The average entrance fees in CCRCs have risen steadily over the past five years. In 2020, the average entrance fee was approximately $400,000, increasing to about $430,000 by 2022 and surpassing $480,000 by 2025. Overall, the average entrance fee in CCRCs has increased by $88,386 during this five-year period, representing a cumulative growth of 22.3%. As background, over the same five-year period, the median sales price of houses sold in the United States has risen cumulatively by 29.5%, according to data from FRED. This reflects continued demand for entrance fee-based CCRCs, as the cost to enter these communities gradually climbed year after year.

The YOY entrance fee growth rate in CCRCs fluctuated during the period. The orange line in the exhibit above highlights annual percentage growth rates, with the growth rate peaking at 6.3% in 2022, indicating a notable jump in costs that year. This was followed by a moderation in growth, with rates easing to 3.5% in 2023, rising slightly to 4.3% in 2024, and maintaining the growth at 4.3% in 2025. These changes suggest that the pace of growth has varied, potentially influenced by market dynamics, consumer demand, and broader economic conditions.

Look for future articles from NIC to delve into the performance of CCRCs.

Senior housing posted a positive total return of 2.88% in the third quarter of 2025, bringing year-to-date returns to 7.00%, the highest NCREIF property type return for both the third quarter and year-to-date performance. Senior housing in the third quarter outperformed the broader Expanded NCREIF Property Index (NPI) by 166 basis points, with the index posting a total return of 1.22%. Senior housing capital appreciation in the third quarter was positive with valuations increasing 1.50%. The capital appreciation return is the change in value net of any capital expenditures incurred during the quarter. Senior housing income return in the third quarter was also positive, yielding 1.38%. For the broader NPI in the third quarter, both capital appreciation (+0.06%) and income yield (+1.16%) were lower than senior housing but still positive.

By senior housing property subtype, independent living (+3.11%) outperformed assisted living (+2.66%) in the third quarter. In recent years, independent living has also outperformed assisted living over the one-, three-, and five-year periods. This outperformance may be driven by higher margins typically generated in lower acuity settings such as independent living, which require less staffing and labor expenses than higher acuity settings such as assisted living. Additionally, independent living has had higher occupancy rates over the five-year period, which surpassed 90% in the third quarter. Over the longer run, since NCREIF began tracking returns data for these subtypes roughly a decade ago, both assisted living and independent living posted similar average returns of more than 5.7% annually.

Annualized Total Returns by NCREIF Property Subtype
As of 9/30/2025; Unlevered

Note: Since Inception is 2014 for Assisted Living and 2016 for Independent Living
Source: NCREIF, 3Q 2025, Unlevered Annualized Total Returns

Compared to other NCREIF property types over the one-year period, senior housing was also the strongest performer, returning 9.21% and outperforming the NPI by nearly 450 basis points. Over the 10-, 15-, and 20-year periods, senior housing was the third strongest property type behind industrial and self-storage, outperforming the NPI on an annualized basis by 66, 68, and 262 basis points, respectively. Since the 2003 inception of NCREIF’s senior housing historical series, income yield drove roughly 60% of senior housing total returns, while price appreciation contributed roughly 40%. These performance measures reflect the returns of 213 senior housing properties valued at $12.68 billion in the third quarter. Overall, the number of senior housing properties tracked within the NPI has grown significantly from the 56 properties initially tracked in 2003.

Annualized Total Returns by NCREIF Property Type

As of 9/30/2025; Unlevered

Source: NCREIF, 3Q 2025, Unlevered Annualized Total Returns

Senior Housing Total Returns by Income Yield versus Price Appreciation

As of 9/30/2025; Unlevered

Source: NCREIF, 3Q 2025, Unlevered Annualized Total Returns

Senior housing occupancy rates in the third quarter continued climbing, with independent living surpassing 90% occupancy and assisted living jumping nearly one full percentage point to more than 87% occupied. Occupied senior housing units reached another record high, while year-over-year inventory growth fell to new record lows since NIC MAP began tracking this data in 2006. New supply is expected to remain moderate in the near term as the number of units under construction has fallen to levels last seen in 2012. Looking ahead, as a result of these robust market fundamentals, occupancy rates are on track to reach new record highs in 2026.

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. Register now for an upcoming NIC webinar, Partnering with ACOs: Understanding the Business Case for Value-Based Care in Senior Housing. Speakers from Presbyterian Homes, LCS, and NIC will cover 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.