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Assisted Living & Memory Care · Asset Class

Assisted Living & Memory Care Feasibility & Market Studies

Independent, lender-grade analysis for assisted living, memory care, and the seniors housing continuum across HUD-FHA Section 232, SBA, Fannie Mae and Freddie Mac Seniors Housing, USDA, and bank and bridge capital. This page is our standing read on where senior housing is supply-constrained and where legacy oversupply lingers, how going-concern lease-up forecasts fail review, and the difference between the market study a lender requires and the feasibility study that surrounds it.

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89.5%
Q1 2026 senior housing occupancy, 19th straight quarterly gain1
17K
Units under construction in Q3 2025, fewest since 20122
806K
Additional units needed by 2030 to hold penetration3
~55%
Of assisted-living operating expense that is labor, the largest line6
The Senior Housing Thesis

One national occupancy number hides two markets.

Assisted living is the asset class where the collateral is an operating business, not a building. Assisted living, memory care, and skilled nursing are going concerns: staffing, licensing, and care delivery drive value, and the appraisal must allocate that value among real estate, FF&E, and business or intangible value. Active adult and independent living sit closer to conventional multifamily. That distinction is the first of the two markets a single headline number conceals, and it decides which loan program and appraisal basis apply. We prepare the market study and the feasibility study aligned to the standard that will judge the file.

The sector is riding a structural tailwind while supply has collapsed. NIC MAP Primary Market occupancy reached 89.5 percent in the first quarter of 2026, the nineteenth consecutive quarterly gain, up from a pandemic trough of 77.8 percent in June 2021.1 Units under construction fell to roughly 17,000 by the third quarter of 2025, the fewest since 2012, and the first baby boomers turned 80 in 2026.23 Yet the blended 89.5 percent hides the second market split: independent living sits above 91 percent while assisted living is at 87.9 percent, and Boston runs 93.6 percent while several Sun Belt metros still work through legacy oversupply near 85 percent.1 A national occupancy figure, or a national rate assumption, is analytically useless for underwriting a specific community.

What follows is organized as a working desk: a national and metro supply-and-demand monitor, the going-concern lease-up forensics that sink senior-housing studies, the program routing that decides which deliverable a project needs, and the study-type distinctions competitors state loosely. Every figure is dated and attributed in the sources below.

The Supply & Demand Monitor

Where senior housing stands, market by market.

A supply-pressure read for the major US senior housing markets, drawn from NIC MAP Vision Primary Market data and refreshed each quarter from named sources. Sorted from tightest to most oversupplied. Occupancy is the Q1 2026 all-property reading; metro-level segment detail is a subscription product and is flagged where thin.

The national picture frames every metro. From a pandemic all-occupancy trough of 77.8 percent in June 2021, senior housing occupancy climbed in a straight line to 89.5 percent in the first quarter of 2026, the nineteenth consecutive quarter of gains, with occupied units reaching a record 637,000.1 The supply side is the mirror image: quarterly construction starts fell to roughly 1,076 units in the Primary Markets in the first quarter of 2025, the lowest since 2009, units under construction fell to about 17,000 by the third quarter of 2025, the fewest since 2012, and year-over-year inventory growth hit a record-low 0.4 percent.2 The defining structural fact is that absorption has outrun inventory growth for more than seventeen consecutive quarters, with roughly 31 units absorbed for every 10 opened, pushing average operating margins above 25 percent in mid-2025, the highest since 2018.14 The result is a market that is broadly supply-constrained, with a shrinking set of Sun Belt exceptions.

Supply pressure: Supply-constrained Balanced Oversupply risk Data thin. Occupancy is NIC MAP all-property senior housing occupancy (independent living plus assisted living plus memory care), Q1 2026 release.
Metro / Region Occupancy (Q1 2026) Pipeline & supply Demand read Supply read
Boston93.6%Minimal pipelineStrongSupply-constrained
Baltimore91.8%Minimal pipelineStrongSupply-constrained
San Francisco91.6%Minimal pipelineRecovering stronglySupply-constrained
Philadelphia~91%+Minimal pipelineStrongSupply-constrained
New York metro~91%+metro detail thin — subscriptionMinimal pipelineStrongSupply-constrained
Minneapolis>90%LowStrongSupply-constrained
Tertiary markets~90.4%Very lowStrongTightest
Secondary markets~90.0%LowStrongTighter than primary
Tampa>90%Low–moderateStrongBalanced / tightening
Las Vegas87.0%Moderate legacy supplyRecoveringWorking through oversupply
San Jose~86.1% (Q4 2025)LowVolatile recoveryRecovering
Los AngelesNear cyclical highsdata thin — subscriptionLowRecoveringData thin, flagged
Miami / S. Florida86.2%data thin — subscriptionModerateImprovingOversupply risk
Atlanta86.0%Elevated legacy supplyImprovingOversupply risk
Houston~84.7% (Q1 2025)Elevated legacy supplyImprovingOversupply risk
Sun Belt growth metrosMixed; submarkets <87%Highest, most heterogeneousFastest absorptionOversupply pockets

Metro figures compiled from NIC MAP Vision Primary Market occupancy (Q1 2026 release, April 23, 2026) with supply and demographic context; see sources 1–3 and 14. Occupancy is all-property (IL + AL + MC combined). Metro-level segment, rate, and absorption detail below the top-line occupancy is a NIC MAP subscription product; cells marked “thin” lack publicly verifiable operating data. Sun Belt growth metros span Phoenix, Austin, Dallas, the Carolinas, and Nashville, where metro averages hide oversupplied submarkets.

The occupancy number depends entirely on the basis

No figure on this page is more misused than occupancy. NIC MAP reports both an all-occupancy rate, which includes properties still in lease-up, and a stabilized rate for properties at least two years old or already at 95 percent, and it classifies communities as majority independent living or majority assisted living. These bases are not interchangeable: a lender comparing a subject's projected occupancy to a market figure must confirm which basis applies. Providers also diverge by sample, with JLL reporting 89.9 percent for the fourth quarter of 2025 against NIC MAP's 89.1 percent, and Genworth/CareScout reporting assisted living occupancy rising from 77 to 84 percent on a different survey basis.1134 Any feasibility or market study that cites a single occupancy number without stating its basis is not defensible.

Rate is normalized, and it is acuity-driven

Revenue in assisted living and memory care is not a flat rent. NIC MAP reported same-store asking-rent growth of about 4.3 percent in the third quarter of 2025, with assisted living at 4.4 percent, normalized into a 4.0-to-4.5 percent band from a 6.2 percent peak in the second quarter of 2023, and average asking rent exceeded $5,650 per month.1 On top of that base room rate sit care and level-of-care fees that scale with acuity, which is why revenue is acuity-driven rather than a posted rent. The Genworth/CareScout survey put the national median assisted living cost at $5,900 per month in 2024, up 10 percent, rising to $6,200 per month in the 2025 survey.4 A model that treats the care-fee layer as a flat rent, or overstates the achievable acuity mix, overstates revenue.

Cap rates, capital, and replacement cost

Investment has re-engaged. CBRE's 17th U.S. Senior Housing & Care Investor Survey, conducted in late October 2025, reported cap rates falling 17 basis points over six months, with assisted living down 19 and independent living down 20.12 JLL's 2026 survey put the average fourth-quarter 2025 cap rate at 6.2 percent and rolling four-quarter transaction volume just above $24 billion, the highest since 2015.13 Development cost has risen sharply to roughly $317,400 per unit ($333 per square foot), with assisted living construction running $280 to $452 per square foot by tier.17 High replacement cost plus record-low new supply is what puts a floor under existing-asset values and rate power, and it is why assisted living is the most-targeted institutional segment heading into 2026.

Common Review Failures

How senior-housing feasibility and lease-up forecasts fail review.

Lease-up, labor, and the going-concern operating model are the variables a credit committee, HUD, SBA, and USDA underwriters scrutinize most, and the places senior-housing studies most often break. Each failure below is tied to a real mechanism or number.

  1. Penetration and capture error against the qualified population

    The most common demand error is applying a national or metro penetration rate to a primary market area without qualifying the elderly population by both age (75+ or 80+) and income (households that can afford $5,000 to $7,500 per month private pay). Penetration averaged roughly 10.2 percent of the 80+ population across the top 140 markets in 2023; a study that captures an outsized share without a defensible age band, income screen, and competitive capture overstates absorption.15

  2. Importing multifamily expense ratios and margins

    Stabilized assisted living and memory care operating-expense ratios run 55 to 70 percent of revenue versus 35 to 45 percent for stabilized multifamily. Memory care margins run below assisted living because tighter staffing ratios (roughly one caregiver per five or six residents versus one per eight in AL) compress margin even at 20-to-30-percent-higher rates. A memory-care-heavy community modeled to assisted living margins is a reject-and-rework.6

  3. Underestimating the labor model and agency re-escalation

    The single biggest operating risk and the most common underwriting error. Labor runs roughly 55 percent of operating expense, with a direct-care median wage of $17.36 per hour in 2024 and turnover routinely cited at 40 to 80 percent. A defensible study builds the staffing model position by position at documented local wages, carries labor above pre-pandemic norms, and stress-tests an agency-labor re-escalation priced at 1.5x to 3x permanent cost.5

  4. Overstating the acuity and care-fee revenue mix

    Revenue in assisted living and memory care is acuity-tiered, a base room fee plus care levels plus second-occupant and community fees, not a flat rent. Overstating the acuity mix or the achievable care-fee capture inflates revenue, and memory care must be underwritten to memory-care economics rather than a blended assisted-living assumption.4

  5. Ignoring length of stay and the re-lease burden

    Short length of stay is a structural churn problem. NCAL data put average assisted living length of stay near 22 months, operators report 18 to 28 months in AL and 18 months to three years in memory care, and nearly 40 percent of residents leave within the first year. A static-occupancy pro forma that ignores move-out replacement understates marketing cost and overstates net absorption.7

  6. Unbenchmarked lease-up pace

    Assisted living and memory care lease-up is slower and more needs-driven than multifamily; industry practice models 18 to 30 months to stabilization, and NIC MAP data show a rising share of new communities that never reach 80 percent campus occupancy. A pro forma that fills a 60-to-90-unit community in 12 months without a comparable-property basis is a red flag.14

  7. A breakeven occupancy with no cushion

    The loan is sized to the lower of the LTV or LTC test and the DSCR test. A pro forma with breakeven occupancy near stabilized occupancy has no margin of safety: lenders generally want breakeven at or below roughly 85 percent, and with stabilized assisted living near 88 percent that cushion is thin. Operator quality is the other half of the underwriting, and a first-time operator on a memory care deal is a structural problem for HUD 232 and agency lenders.8

Capital-Source Routing

Which channel funds the project, and what it requires.

Senior housing routes through federal, agency, bank, and bridge capital, and each channel requires a different deliverable, appraisal basis, and coverage standard. The study is built to the union of requirements across the channels actually in play, and to the segment, since program eligibility turns on whether the asset is a licensed care facility or passive real estate.

The senior housing lender matrix
Deliverable, appraisal basis, and coverage convention by capital source. Coverage figures are program conventions and lender-marketing summaries; verify against the current handbook or SOP at underwriting.8
Capital sourceDeliverableCoverage convention
HUD-FHA Section 232 (LEAN)Market study, going-concern appraisal, PCNA, Phase I ESA1.45x DSCR, ~80% LTV, 35-year
SBA 7(a) / 504Feasibility plus special-purpose going-concern appraisalOwner-occupancy 51% / 60%; max 7(a) $5.0M
Fannie Mae Seniors HousingMarket or feasibility study on stabilized collateral1.30x IL / 1.40x AL / 1.45x MC
Freddie Mac Optigo SeniorsMarket study on stabilized, licensed collateral≥1.30x, up to ~75% LTV
CMBS, life-company & bankLender-aligned market or feasibility study1.40x–1.50x, 60%–70% LTV
Bridge / debt-fund (to HUD or agency)Lease-up and absorption analysis65%–75% LTC, 24–36 months, floating
USDA B&I / Community FacilitiesIndependent five-component feasibility studyUp to $25M (B&I); rural areas only

Sources: HUD Handbook 4232.1 and Section 232 program materials; SBA SOP 50 10 8; Fannie Mae and Freddie Mac Seniors Housing guides; USDA OneRD (7 CFR Part 5001). See sources 8–11.

One eligibility question is worth stating plainly, because it is widely misunderstood. Contrary to the common characterization that SBA cannot finance skilled or medical nursing care, SBA SOP 50 10 8, effective June 1, 2025, makes licensed nursing homes and assisted living facilities that provide healthcare or medical services expressly eligible; the SOP defines qualifying services broadly to include wellness checks, medication monitoring, and onsite medical staff even part-time.9 The disqualifier is a pure landlord residential facility with no license and no services, the same category as an apartment building. Operating a licensed care facility satisfies the 51 percent (existing) or 60 percent (new construction) owner-occupancy test by nature, and because SBA treats care facilities as special-purpose property, the lender must obtain an independent going-concern appraisal that allocates value among land, building, equipment, and intangible assets, prepared by an appraiser with at least four comparable going-concern appraisals in the prior 36 months.9

The going-concern point is the analytical crux across every channel. Because a sale transfers real estate plus FF&E plus the operating business, going-concern value can far exceed the underlying real estate, and if a facility goes dark that intangible value evaporates and the collateral may be worth far less.18 That is why HUD 232, agency, and SBA lenders treat operator quality, survey history, staffing ratios, and trailing comparable-property performance as credit inputs, and why standalone independent living or active adult, which carries lighter intangible value, routes to conventional or agency multifamily execution instead.

  • Stabilized, licensed AL or MC seeking lowest-cost permanent debtHUD 232/223(f) at 1.45x DSCR and ~80% LTV, or agency Seniors Housing at 1.30x–1.45x by segment.
  • Ground-up construction or substantial rehabilitationHUD 232 new construction (Davis-Bacon applies) or bank construction, with a takeout to HUD or agency at stabilization.
  • Lease-up or operational turnaroundBridge-to-HUD or bridge-to-agency debt fund, 24–36 months, sized on an absorption and lease-up analysis.
  • Small owner-operated assisted living or residential careSBA 7(a) or 504, with owner-occupancy satisfied by the license and a special-purpose going-concern appraisal.
  • Rural assisted living or nursing facilityUSDA Business & Industry (to $25M) or Community Facilities, with an independent five-component feasibility study.
  • Standalone independent living or active adult (no care)Conventional or agency multifamily execution; not HUD 232 or SBA, which require licensed care.
Study Types

Market study, feasibility study, appraisal: three questions.

These three documents answer different questions and are not substitutes. Lenders and borrowers conflate them constantly; HUD, SBA, USDA, and agency reviewers do not.

What each document answers, and the standard that governs it.
DocumentQuestion answeredGoverning standard
AppraisalWhat is it worth? A going-concern opinion of value allocated among real estate, FF&E, and business or intangible value.USPAP; Appraisal Institute going-concern method
Market studyWill it fill? Demand, supply, penetration and capture, and rate in the primary market area, without the site-specific model.NIC MAP-anchored; program market-study requirements
Feasibility studyWill it fill and cover its debt? The market study plus base, upside, and stressed pro formas with breakeven occupancy and coverage.Lender, HUD, SBA, or USDA underwriting

Going-concern, or business-enterprise, value is the analytical crux for needs-based care. Assisted living, memory care, and skilled nursing are going concerns: a sale transfers the real estate plus FF&E plus the operating business, including a valid operating license, an assembled workforce, and other intangible value. Appraisers therefore value the total assets of the business and allocate among land and improvements, tangible personal property, and intangible or business-enterprise value, a method well established in the appraisal literature.18 The caution for lenders is that going-concern value can far exceed the underlying real estate; if a facility goes dark, the intangible value evaporates and the real estate and FF&E collateral may be worth far less. The practical implication is to match the collateral to the appraisal basis and the loan program to the segment.

The demand analysis underneath the market study is anchored to NIC MAP Vision, the authoritative source for senior housing occupancy, inventory, construction, absorption, and rate, cross-referenced against provider divergence and calibrated to a defensible primary market area, age band, and income screen.1 For a HUD-insured Section 232 transaction the underwriting package additionally requires a going-concern appraisal, a Project Capital Needs Assessment, and a Phase I environmental site assessment, and the facility must be licensed with continuous protective oversight.8 A market study prepared to narrative standards alone does not satisfy program review without the full third-party set.

The care continuum, each with a distinct study scope

Senior Housing Questions

Assisted living feasibility and market-study questions.

What is the difference between a senior housing market study, feasibility study, and appraisal?

The three deliverables answer different questions and are not substitutes. A market study assesses demand, supply, penetration and capture, and rate in the primary market area. A feasibility study goes further, testing whether the specific project pencils under base, upside, and stressed cases and computing breakeven occupancy and debt-service coverage in each. An appraisal is a USPAP-compliant opinion of value, and for needs-based care it is a going-concern appraisal that allocates value among real estate, FF&E, and business or intangible value. Lenders require different combinations by program, and agency and HUD reviewers do not treat them as interchangeable.

Why is assisted living a going concern and not just real estate?

Assisted living, memory care, and skilled nursing are operating businesses in which staffing, licensing, and care delivery drive value. A sale transfers the real estate plus FF&E plus the operating business, including a valid operating license, an assembled workforce, and other intangible value, so the appraisal values the total assets of the business and allocates among land and improvements, tangible personal property, and business-enterprise value. Going-concern value can far exceed the underlying real estate; if a facility goes dark, the intangible value evaporates and the collateral may be worth far less. Independent living and active adult sit closer to conventional multifamily with lighter intangible value.

What DSCR and program terms does HUD Section 232 require?

HUD-FHA Section 232, administered by HUD's Office of Residential Care Facilities and processed through the LEAN methodology, is the dominant federal program for licensed residential care: assisted living, board-and-care, and nursing homes. It requires a minimum 1.45x debt-service coverage ratio for market-rate skilled and assisted living, state licensure with continuous protective oversight, and an FHA and MAP-approved lender with a MAP-approved healthcare underwriter. Section 232/223(f) refinance or acquisition of stabilized facilities runs 35-year fully amortizing, non-recourse, up to roughly 80 percent LTV. Independent living generally cannot exceed 25 percent of units, and standalone IL is not eligible.

Can assisted living be financed with an SBA loan?

Yes, when the facility is licensed and provides healthcare or medical services. SBA SOP 50 10 8, effective June 1, 2025, makes licensed nursing homes and assisted living facilities that provide healthcare or medical services eligible, defining qualifying services broadly to include wellness checks, medication monitoring, and onsite medical staff even part-time. A pure landlord residential facility with no license and no services is ineligible. The operating company must occupy 51 percent of an existing building or 60 percent of new construction, care facilities are treated as special-purpose property requiring a going-concern appraisal, and the maximum 7(a) loan is 5 million dollars. Standalone independent living is generally not SBA-eligible.

What is senior housing occupancy right now, and is there oversupply?

NIC MAP Vision reported Primary Market senior housing occupancy of 89.5 percent in the first quarter of 2026, the 19th consecutive quarterly gain, up from the pandemic all-occupancy trough of 77.8 percent in June 2021, with independent living above 91 percent and assisted living at 87.9 percent. Construction has collapsed to multi-decade lows, roughly 17,000 units under construction by the third quarter of 2025 and record-low 0.4 percent inventory growth, so the asset class is broadly supply-constrained. The exceptions are Sun Belt metros such as Houston, Atlanta, Miami, and Las Vegas still absorbing legacy oversupply, all improving quarter over quarter, which is why metro averages must be checked at the submarket level.

How long does assisted living and memory care lease-up take?

Assisted living and memory care lease-up is slower and more needs-driven than multifamily. Industry practice models 18 to 30 months to stabilization, built as a fill velocity in units per month against documented trailing local absorption rather than an aspirational curve. Short length of stay compounds the challenge: NCAL data put average assisted living length of stay near 22 months, operators report roughly 18 to 28 months in AL and 18 months to three years in memory care, and research indicates nearly 40 percent of assisted living residents leave within the first year, so a community must re-lease a large share of its units every year just to hold occupancy. A pro forma that fills a 60-to-90-unit community in 12 months without comparable support is a red flag.

Why does labor dominate assisted living underwriting?

Labor is the single biggest operating risk and the most common underwriting error. Wages, benefits, and contract staffing run roughly 55 percent of operating expense in assisted living and memory care, the largest single line by a wide margin, and total operating expense ratios run 55 to 70 percent of revenue versus 35 to 45 percent for stabilized multifamily. PHI's Key Facts 2025 put the direct care workforce median wage at $17.36 per hour in 2024 with turnover routinely cited at 40 to 80 percent. A defensible study builds the staffing model position by position at documented local wages, carries labor above pre-pandemic norms, and stress-tests agency re-escalation; underwriting a memory-care-heavy community to assisted living labor ratios is a classic failure.

By Market

Assisted living feasibility studies by state.

Senior housing demand, supply, and licensing are local. Explore the state markets where penetration, the qualified-income population, and the state licensure and Medicaid-waiver layer determine whether a community pencils.

Underwriting an assisted living or memory care project? Start with the going-concern read.

Feasibility Study Company prepares independent Assisted Living & Memory Care feasibility and market studies, built to the review standard your capital source applies. A methodology briefing walks through the analytical framework, the deliverable and appraisal basis your capital source requires, and the current occupancy, penetration, and labor data for your metro and submarket.

Request a methodology briefing
Sources

Data sources and dates.

Every figure on this page traces to a named authority. Senior housing readings are point-in-time and provider-dependent; NIC MAP metro-level segment detail is a subscription product, and occupancy figures differ by basis (stabilized versus all-occupancy, majority-IL versus majority-AL) as noted.

  1. NIC and NIC MAP Vision press release (April 23, 2026): Q1 2026 Primary Market senior housing occupancy 89.5 percent, 19th consecutive quarterly gain; independent living above 91 percent, assisted living 87.9 percent; occupied units a record 637,000; same-store asking-rent growth ~4.3 percent (AL 4.4 percent) in Q3 2025 and average asking rent above $5,650 per month.
  2. NIC MAP Vision construction and inventory data (2025–2026): quarterly starts ~1,076 units in Q1 2025 (lowest since Q2 2009); units under construction ~17,000 by Q3 2025 (lowest since 2012); year-over-year inventory growth a record-low 0.4 percent in Q1 2026.
  3. NIC MAP Vision Senior Housing Outlook (June 26, 2024): a 550,000-unit shortfall and $275 billion investment shortage by 2030; roughly 549,000 additional units needed by 2028 and 806,000 by 2030 to hold current penetration; CEO Arick Morton, development "must accelerate to more than 3.5 times the current pace."
  4. Genworth and CareScout Cost of Care Survey: 2024 survey (released March 2025) national median assisted living cost $5,900 per month ($70,800 per year), up 10 percent; 2025 survey national median $6,200 per month ($74,400 per year), per CEO Samir Shah, from 25,000+ rates collected July–November 2025; assisted living occupancy reported rising 77 to 84 percent on the survey basis.
  5. PHI, Direct Care Workers in the United States: Key Facts 2025 (June 2025; BLS OEWS analysis): direct-care median wage $17.36 per hour in 2024, median annual earnings under $26,000, 36 percent in or near poverty, 49 percent on public assistance; workforce ~5.4 million in 2024.
  6. Janover Pro and MMCG (2025): labor roughly 55 percent of AL and memory-care operating expense; stabilized AL/MC operating-expense ratios 55–70 percent of revenue versus 35–45 percent for stabilized multifamily; memory-care staffing ratios and margin compression.
  7. NCAL and Senior Housing News operator survey (March 2025): average assisted living length of stay near 22 months; roughly 18–28 months in AL and 18 months to three years in memory care; nearly 40 percent of AL residents leave within the first year.
  8. U.S. Department of Housing and Urban Development, Handbook 4232.1 and Section 232 program materials (Office of Residential Care Facilities, LEAN): 1.45x minimum DSCR, licensure and continuous protective oversight, LTV/LTC and term parameters, and third-party report set (market study, appraisal, PCNA, Phase I ESA).
  9. U.S. Small Business Administration, SOP 50 10 8 (effective June 1, 2025): eligibility of licensed nursing homes and assisted living providing healthcare/medical services; owner-occupancy 51 percent (existing) / 60 percent (new construction); special-purpose going-concern appraisal; maximum 7(a) loan $5,000,000 (13 CFR §120.151).
  10. USDA Rural Development: Business & Industry guaranteed loans under OneRD (7 CFR Part 5001), up to $25 million, requiring an independent feasibility study; Community Facilities direct and guaranteed loans for essential community facilities including assisted living and nursing homes.
  11. Fannie Mae and Freddie Mac Seniors Housing program guides: Fannie Mae segment DSCR minimums 1.30x (IL), 1.40x (AL), 1.45x (Alzheimer's/MC), existing stabilized only, experienced-operator requirement, SNF capped near 20 percent; Freddie Mac Optigo up to ~75 percent LTV, DSCR as low as 1.30x.
  12. CBRE, 17th U.S. Senior Housing & Care Investor Survey (conducted late October 2025): senior housing cap rates fell 17 basis points over six months, assisted living down 19 and independent living down 20.
  13. JLL, 2026 Seniors Housing & Care Investor Survey (March 12, 2026): average Q4 2025 cap rate 6.2 percent; rolling four-quarter transaction volume just over $24 billion by year-end 2025, the highest since Q2 2015; JLL Q4 2025 occupancy 89.9 percent versus NIC MAP 89.1 percent (sample-weighting difference).
  14. NIC and Senior Housing News (2025): net absorption outpaced new openings for 17-plus consecutive quarters, roughly 31 units absorbed per 10 opened; average operating margins above 25 percent in mid-2025, highest since 2018; rising share of new communities that never reach 80 percent occupancy.
  15. Plante Moran (2024), citing Census projections: penetration rate averaged roughly 10.2 percent of the 80+ population across the top 140 markets in 2023; the U.S. 80+ population projected to roughly double from about 13 million (2020) to about 27 million (2040).
  16. KFF and NCOA: 41 of 47 responding states cover services in assisted living through at least one Medicaid home-care program (32 via 1915(c) waivers); roughly 18 percent of assisted living residents nationally rely on Medicaid for care services; Medicaid does not cover room and board.
  17. ASHA / State of Seniors Housing (via McKnight's) and The Weitz Company ASHA construction-cost briefs (early 2026): total development cost ~$317,400 per unit ($333 per square foot), up 17.8 percent since 2020; assisted living construction $280–$452 per square foot by tier; CNA wage growth decelerating from 9.8 percent (2022) to 2.8 percent (2025).
  18. Appraisal Institute, The Appraisal of Real Estate: going-concern and business-enterprise-value method allocating total assets of the business among real property, tangible personal property (FF&E), and intangible/business value.
  19. Multi-Housing News (2025): units under construction context, down from just under 50,000 units under construction in late 2019 before the pandemic; construction 2.4 percent of inventory in Q3 2025.
  20. Activated Insights 2025 Benchmarking Report (via HHAeXchange): home care median caregiver turnover 75 percent in 2024; contract/agency labor priced at 1.5x–3x permanent cost during the 2021–2023 spike.