The 2026 NIC Spring Conference exceeded expectations, drawing record attendance and generating a palpable sense of enthusiasm about what’s next for senior housing and care. Attendees from across housing, healthcare, and capital markets enjoyed three days of meaningful networking, insightful educational sessions, and dynamic discussions.

Welcoming nearly 2,500 attendees, the conference, held March 30-April 1 in Nashville, was NIC’s largest Spring event to date. The meeting’s theme focused on the intersection of senior housing and healthcare. 

“The big turnout is a testament to the growing interest in the sector and its expansion,” said Ray Braun, president and CEO at NIC. “Participants were able to explore strategies that support smarter investment, stronger operations and improved outcomes for seniors.”

The Conference featured evening receptions, networking lounges, a reception for first-time attendees, and a women’s networking meetup. Participants had numerous opportunities to connect, exchange ideas, build relationships, and make deals with other decision makers.

The educational program was carefully curated to highlight the insights and innovations defining senior housing’s future, from capital markets and investment strategies to the increasing integration of housing, healthcare, and supportive services.

Setting the tone of the event, the conference kicked off with a clear-eyed view of the U.S. economy in a NIC Signature Session. Mark Zandi, chief economist and director of Economic Research at Moody’s Analytics, was interviewed by former NIC Chief Economist Beth Mace to a standing-room-only audience.

“Senior housing has a lot of opportunity,” said Zandi. But he cautioned that worldwide disruptions would likely result in higher inflation and lower growth going forward. 

Mace asked when development might return to senior housing. Zandi said the demographics are positive and baby boomers are a wealthy generation. “The pre-conditions are there for more development,” he said.

Senior housing and healthcare take center stage

Where to start? Make sure residents have primary care and work with physician groups to help residents navigate the system. And engage with value-based care initiatives being launched by the CMS Innovation Center. “It all begins with the needs of the residents,” said Bacher.

A follow-on panel titled “Senior Housing’s Long-Overdue Moment in Healthcare” presented concrete models of care to demonstrate improved health outcomes for residents and cost savings. “Senior housing operators have the opportunity to earn additional revenue through value-based care models,” said Anne Tumlinson, of ATI Advisory. She was joined by Joel Theisen of Lifespark and Jacob Swint of National Church Residences. “Find a partner that knows what they are doing in value-based care,” suggested Swint.

Further insights on healthcare and senior housing

“Insights from Nashville’s Leading Health Innovators” brought together three healthcare executives from Nashville, home to 900 healthcare companies. The NIC Premier Session was led by Leigh Ann Barney, CEO of Trilogy Health Services. “We are trying to align incentives between payers, operators and providers,” noted George Renaudin II, president, Insurance, Humana.

NIC Co-Founder and Strategic Advisor Bob Kramer moderated “Navigating State Regulatory and Medicaid Waiver Models: An Evaluation Framework.” He noted, “The regulatory and waiver environment is critically important.” Leaders from Georgia, Oregon, Minnesota, and California state associations outlined their state’s approach to Medicaid waivers and senior housing. The consensus was that each state differs and the local market is key. Kramer also noted that Medicaid cuts in the recent federal budget adds a layer of complexity to the situation that operators need to be aware of.

“Leading the Transformation: Skilled Nursing Models for Tomorrow,” was led by Mark Parkinson, principal, American Health Care Association, CEO, Park Place. Panelists shared how they are adapting business and care models amid a changing landscape — navigating regulatory complexity, structuring reimbursement and partnership carve-outs, and aligning with hospitals and payers to deliver value.

Forward-thinking programming

The final day of programming ended on a high note with sessions on the active adult market and a deep dive into the state of the capital markets and valuations. 

The active adult panel emphasized that successful projects create a community. “The whole business is built on human capital,” said Michael Levine, senior managing director, Greystar. Programming for residents is essential to maintain high occupancies, but most markets still need to be educated about the product.

Rick Matros, president and CEO, Sabra, said he believes that new development will not be a significant factor in the next five years. “There are good times ahead,” he said.

The conference concluded with a reminder about the upcoming 2026 NIC Growth Conference, May 13-14, 2026, in Indianapolis, Indiana. The event is tailored for small to mid-sized senior housing operators and their partners to provide the tools and strategies needed to scale efficiently and boost performance.

By Susan DiMickele, President & CEO, National Church Residences, and Jacob Swint, VP, Strategic Growth & Operations Support, National Church Residences 

Value-based care (VBC) has moved from an emerging concept to an operating reality, reshaping expectations around outcomes, cost, and resident experience. Yet many senior living operators are still asking a fundamental question: “What does a strategic VBC partnership look like from the operator’s seat?” In an increasingly complex environment, the distinction between a vendor relationship and a strategic partnership with a primary care group determines whether an operator experiences marginal improvement or a meaningful transformation of their value proposition. 

What Makes a Value-Based Care Partnership Truly Strategic for Operators 

From an operator perspective, a VBC partnership with a primary care group becomes strategic when it begins with shared accountability. The most effective partnerships align not only around clinical outcomes, but around the metrics operators manage every day: resident length of stay, occupancy, staff turnover, and family satisfaction. If a clinical partner cannot directly influence the operator’s core business drivers, the relationship is unlikely to deliver sustained impact. 

A second hallmark of strategic partnership is the presence of a deeply integrated clinical model tailored specifically for senior housing. Across the National Church Residences portfolio and our primary care medical group, At Your Door – Visiting Healthcare Services, we have seen the effectiveness of onsite primary care teams supported by physicians, advanced practice providers, registered nurses, care managers, and social workers. This interdisciplinary structure reduces unnecessary emergency department use, improves continuity of care, and supports the “Quadruple Aim” of enhanced care quality, lower cost, improved experience, and reduced staff burnout. 

Most critically, strategic partnership requires aligned incentives and shared value creation. For years, external medical groups have operated within senior housing but retained most of the economic upside associated with VBC performance. Yet senior living operators have been creating value for decades through stable housing, early issue identification, and daily resident support. A true partnership recognizes this contribution by offering operators a meaningful seat at the table, including the ability to participate financially in VBC outcomes. 

How to Approach Partnership Strategy in a Still-Evolving VBC Landscape 

The VBC landscape continues to evolve with new payment models, shifting benchmarks, and increasing expectations for risk management. Operators cannot rely on prediction alone; they need partnerships that are flexible, resilient, and prepared for what’s next. 

Operators should look for partners with experience across multiple reimbursement arrangements and the ability to manage risk, matching the operator’s readiness rather than forcing a one-size-fits-all model. They should also prioritize partners who are willing to provide them with access to VBC programs, especially as many operators lack the capital or internal expertise to develop clinical capabilities in-house. 

The right primary care partner lowers the barrier to entry by providing the infrastructure, compliance, reporting, and staffing necessary to support the operator while enabling operators to stay focused on resident experience, staffing, and community operations. When done well, these partnerships can unlock an additional revenue stream for the senior living operator while strengthening key business outcomes including occupancy, length of stay, and staff retention. 

Reflections to Help Leaders Form Partnerships More Intentionally 

Several observations can guide operators as they evaluate potential VBC partners: 

• Start with the “why,” not the reimbursement model. Anchor decisions in resident needs, operator pain points, and long-term goals. 

• Prioritize operational integration. The clinical team must become part of the community’s daily rhythm and not a visiting external entity. 

• Demand radical transparency. Data access, performance review, and shared decision-making are non-negotiable in VBC. 

• Shared financial participation. Operators should insist on direct participation in financial upside. 

• Evaluate cultural alignment. Trust, mission fit, and communication often matter as much as clinical expertise. 

• Consider risk management and risk tolerance. Understanding a partner’s ability to manage, share, and communicate risk exposure is essential for long-term sustainability in VBC. 

The senior living industry is at a pivotal moment. VBC-aligned primary care partnerships are no longer experimental. They are becoming foundational infrastructure for the future of senior living. It is no longer a question of “if” a senior living operator should be participating in VBC programs and a matter of “how”. Organizations like NIC are essential in educating and convening leaders around this shift so operators can finally be recognized and rewarded for the value they have been creating for decades. 

Data from the recently released 4Q 2025 NIC MAP Actual Rate Report showed that:  

In 4Q 2025, discounts between asking and initial rates widened for the independent living (IL) segment and narrowed for the memory care (MC) segment. 

• For the IL segment, discounts between asking and initial rates averaged 12.1% ($581) in December 2025, equivalent to a 1.5-month discount on an annualized basis, up from a 0.9-month discount in September 2025. 

• For the assisted living (AL) segment, average initial rates were 8.0% ($556) below asking rates in December 2025, translating to a 1.0-month discount on an annualized basis, up slightly from a 0.9-month discount in September 2025. 

• Discount between asking rates and initial rates in the MC segment averaged 8.2% ($750) in December 2025, translating to a 1.0-month discount on an annualized basis, down from a 1.3-month discount in September 2025. 

Move-ins outpaced move-outs for the IL and AL segments in the fourth quarter of 2025. 

• The percentage of move-ins for the IL segment averaged 2.0%, while move-outs averaged 1.6% in December 2025. 

• For the AL segment, move-ins averaged 3.0% of inventory in December, while move-outs averaged 2.8%. 

• In the MC segment, both move-ins and move-outs averaged 3.3% of inventory in December 2025.   

Additional key takeaways are available to NIC MAP subscribers in the full report.    

About the Report: The NIC MAP Seniors Housing Actual Rates Report provides aggregate national data from approximately 300,000 units within more than 2,500 properties across the U.S., operated by over 50 senior housing providers. The operators included in the current sample tend to be larger, professionally managed, and investment-grade operators as a requirement for participation is restricted to operators who manage five  or more properties. Visit the NIC MAP website for more information. 

2025 represented a year of accelerating transaction activity in the senior housing market as participants looked to capitalize on the unprecedented supply/demand fundamentals within the industry. Momentum gathered throughout the year, with activity notably picking up in the second half of the year. The activity represented both smaller, as well as large transactions. 

The robust M&A market has been driven by a demographic megatrend that is set to further accelerate with the leading edge of the Baby Boomer generation turning 80 this year. The 80+ age group – the key cohort for senior housing – is projected to grow by 28 percent over the next five years. At the same time, new development remains at historically low levels, and even the most attractive development projects are still a ways away from penciling. In this environment, participants are looking to acquire now and reap the benefits of the attractive fundamentals. 

In addition, senior housing is a large, highly fragmented market. Private investors, owner-operators and non-profits continue to own about 86% of this approximately $450 billion to $600 billion market, with long-term, REIT ownership still only in the mid-teens. This provides ample room for continued transaction growth. 

Throughout the year, REITs with experience in senior housing represented the largest and most active buyer group. Senior housing is a unique asset class that requires deep expertise for success. REITs with a track record for completing transactions, scalable operational platforms and strong industry relationships, including effective collaboration with outstanding senior housing operators, have competitive advantages in generating deal flow and long-term success.  

The largest REITs have led the way. Ventas (VTR) alone closed $4.8 billion of senior housing investments from 4Q24 through February 2, 2026. Healthpeak (DOC) also announced the formation and planned initial public offering of Janus Living, a new REIT dedicated to senior housing. 

Smaller-to-mid-sized REITs have also increased activity. American Healthcare REIT (AHR) closed $575 million in 2025 through November, National Health Investors (NHI) closed $392 million in 2025 as of December, Sabra (SBRA) closed more than $280 million through 3Q25 and CareTrust REIT (CTRE) entered into the SHOP business with its first acquisition for $40 million. 

In November, there was also a notable industry merger with Sonida Senior Living (SNDA) announcing a merger with CNL Healthcare Properties. The $1.8 billion deal, set to close in the first half of 2026, sets up the newly combined company to further compete in the acquisition market. 

Just as notably, private buyers – including numerous newer private equity funds led by industry veterans and groups that are new entrants into senior housing altogether – have started competing for deals. Transactions in the $30 million to $100 million range, which are more accessible for a wider range of buyers compared to larger transactions, are where competition is the heaviest.  

Heading into 2026, expect competition for deals to continue heating up as investors try to position themselves ahead of the most attractive parts of the supply/demand curve. Those with a successful transaction track record and proven platform remain positioned to win in an increasingly competitive environment. And despite the increase in overall competition, there remain significant opportunities to acquire assets at a discount to replacement cost and that deliver attractive risk-adjusted returns across a range of investment profiles. 

Overall, the senior housing industry has unprecedented momentum, and the transaction market is no different. The investment market will play an integral role in determining who are the biggest and best participants as the industry’s demand continues to accelerate. 

NIC partnered with Gibbins Advisors to prepare the first ever industry-specific bankruptcy report to examine not only recent filings, but also data going back prior to the pandemic for a historical perspective of trends. While bankruptcy data is a trailing measure of distress, it is an important measure for industry participants to track when monitoring the overall health of the senior housing and care sector.  

There are several key findings, which are profiled in detail in the full report. A summary of those key takeaways is below.  

• Senior Care tends to comprise approximately one quarter of all Healthcare sector Chapter 11 bankruptcy filings. Senior Care and Pharmaceuticals are the two highest subsectors within healthcare for bankruptcy filings, with the two representing nearly half of all filings between 2019-2025.  

• In 2019 and from 2021 to 2025, Senior Care Chapter 11 bankruptcy filings ranged from 10 to 15 per year. In 2025, the sector recorded 12 bankruptcy filings, representing a modest increase from 10 filings in 2024 and broadly consistent with the average observed over the prior four-year period. 

• The number of Senior Care bankruptcy filings since 2019 is relatively evenly distributed between CCRCs, SNFs, and Senior Living segments. 

• Almost 98% of Senior Care Chapter 11 bankruptcy filings in the past seven years have been companies with less than $500M in liabilities. Just two cases in the period from 2019 to 2025 had liabilities in excess of $500M.  

We encourage readers to view the full report.

In or around August 2026, Gibbins Advisors will produce another industry-specific report, reflecting updated information for the first half of 2026.