Top performing senior housing communities significantly lower emergency department utilization, hospitalizations and skilled nursing admissions
Senior housing residents’ total cost of care decreases for several years after moving in
Annapolis, Md. (September 9, 2025) – New research shows that senior housing’s preventative approach to care contributes to increased quality of life for residents and reduced healthcare costs over time. Senior housing includes a broad range of housing options, including independent living, assisted living, and memory care communities.
The analysis was conducted by NORC at the University of Chicago (NORC) and supported by the National Investment Center for Seniors Housing & Care (NIC). Researchers assessed the sustained impact senior housing has on residents’ health and medical costs and found that older adults who remain in senior housing utilize less acute care services and see their health stabilize for several years after moving in.
Researchers also found that senior housing can promote health and wellness of residents with neurodegenerative diseases(NDD) by reducing the number of hospitalizations and readmissions, providing relief for family caregivers, and enabling timely access to care in a supportive environment, ultimately leading to greater longevity.
“As the government and private sector look for solutions that improve older adults’ health and curb healthcare costs, senior housing is a valuable part of the healthcare continuum,” said Tim Jackson, senior principal of healthcare strategy at NIC. “Better outcomes and lower costs are possible because of the effective management and coordination of care that many senior housing communities provide.”
Researchers looked at the year before an older adult transitions into senior housing, typically a period of increasing healthcare challenges culminating in an event or incident that necessitates a move. They found that, while residents experience higher volumes of primary and supportive care visits to stabilize their conditions in their first year of residency, older adults see measured improvement by the third year after moving in. For example:
- Approximately one in four residents had a hospital admission in year three, compared to one in three in the first year.
- The proportion of residents with an emergency department visit declined by 14% from year one to year three.
- Average total Medicare costs per patient were $7.2K lower in year three than in year one.
The findings suggest that senior housing continues to improve residents’ health and well-being for several years post move-in. By year six, residents have more healthy days at home, fewer hospitalizations, fewer emergency department visits, fewer skilled nursing facility stays, and lower costs of care.
The analysts noted older adults with chronic illnesses like NDD are typically high utilizers of healthcare services and require specialized care. For example, more than 70% of older adults with dementia—a common type of NDD—have at least one other medical disease or condition. But when NORC researchers assessed the top-performing senior housing communities, researchers found they create greater stability and safety for residents with NDD by reducing hospital visits, stays and readmissions—as well as lowering Medicare and out-of-pocket costs.
High levels of access to primary and supportive care services contribute to reductions in acute care services and costs for residents with NDD. For example:
- 98% had one or more primary care visits.
- More than 20% had one or more neurologist visits.
- More than 20% had one or more physical therapy visits.
- More than 45% received home health services.
“The number of older adults who require special care is growing, and senior housing operators are looking to provide effective and efficient solutions that help address their unique healthcare challenges,” said Lisa McCracken, head of research and analytics at NIC. “These findings suggest that senior housing communities can reduce the burden on caregivers and the healthcare system, ultimately promoting the health and wellness of older adults.”
The research is part of an ongoing initiative led by NIC, in collaboration with NORC, to assess how senior housing supports the health and well-being of older adults.
Methodology
The research was conducted in two parts. First, NORC analyzed Traditional Medicare Fee-for-Service (FFS) claims data to explore how health outcomes and costs change for residents over time, from move-in (Year 1) through several years post move-in (Years 3 and 6). Using FFS data from 2016-2023, NORC constructed cohorts of residents based on their move-in date and tracked outcomes and costs over time, by calendar year, among residents who remained in senior housing. NORC concatenated stays across settings (Independent Living, Assisted Living, Memory Care) to construct an overall “senior housing stay.” If a resident moved in during Q1-Q3 of any year 2016-2023, that year is considered their Year 1; if they moved in during Q4, they were included in the following year’s cohort. Key measures included primary and supportive care utilization, acute care utilization, costs, and health outcomes.
Researchers then assessed how senior housing manages the health of residents with NDD—including Alzheimer’s and other dementias—by measuring their use of primary and supportive care services, acute care services, health outcomes, and costs of care. NORC analyzed Medicare claims and encounter data to compare outcomes and costs among assisted living and memory care residents with NDD compared to two separate, risk-adjusted comparison groups: individuals with NDD living in non-congregate settings, and individuals with NDD living in nursing homes.
For full methodology and findings, click here.
** FFS refers to Medicare fee-for-service claims data; see Methodology above.
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About the National Investment Center for Seniors Housing & Care
The National Investment Center for Seniors Housing & Care (NIC), a 501(c)(3) organization, works to enable access and choice by providing data, analytics, and connections that bring together investors and providers. The organization delivers the most trusted, objective, and timely insights and implications derived from its analytics, which benefit from NIC’s affiliation with NIC MAP, the leading provider of comprehensive market data for senior housing and skilled nursing properties. NIC events, which include the industry’s premiere conferences, provide sector stakeholders with opportunities to convene, network, and drive thought-leadership through high-quality educational programming. For more information, visit NIC’s website and follow NIC on LinkedIn, Facebook, and Instagram.
About NORC at the University of Chicago
NORC at the University of Chicago conducts research and analysis that decision-makers trust. As a nonpartisan research organization and a pioneer in measuring and understanding the world, NORC has studied almost every aspect of the human experience and every major news event for more than eight decades. Today, NORC partners with government, corporate, and nonprofit clients around the world to provide the objectivity and expertise necessary to inform the critical decisions facing society. www.norc.org