NIC Notes

Insights in Seniors Housing & Care

By: Lisa McCracken  |  January 10, 2024

Repurposing Distressed Assets as a Solution to Serve the Middle Market

Ideas and Discussion  |  Research  |  Senior Housing

Since the 2019 “Forgotten Middle” study, NIC has recognized the need to move towards actionable solutions for housing and care for the middle-market older adult. In early 2023, NIC joined with CVS Health to sponsor an in-depth study by Milken Institute’s Financial Innovations Lab® and Center for the Future of Aging to identify viable, actionable solutions for financing and scaling middle market senior housing & care. The culmination of this work is captured in a newly released report called, “Innovative Financing and Care Models to Scale Affordable Housing Solutions for Middle-Income Older Adults.” Four potential strategies for both senior housing and housing with care are outlined in this report. 

  1. Repurpose distressed senior living properties to serve the middle market through a pilot refinancing/restructuring program. 
  2. Design a revolving loan fund to provide a sustainable source of capital long-term for middle market development, acquisitions or cap ex. 
  3. Implement a Pay-for-Performance model to provide new revenue streams that offset the ongoing costs of providing supportive care services to chronically ill middle market older adults.  
  4. Launch a regional pilot to generate data to provide evidence-based outcomes to judge performance and determine how best to scale.

With the projected loan maturities in 2024 and 2025 and assessments of the level of distress in the market, NIC sees this is as an opportunity to bring down price points and repurpose distressed assets to bring forth reasonable housing and care options for middle-market older adults. The senior housing and care sector has been working to scale housing & care options for the “Forgotten Middle” and there is a potential that the current headwinds can be turned into a real opportunity to make a meaningful impact for this cohort of older adults. This is one of several potential scenarios. Innovative strategies that encompass select aspects of the four scenarios may yield the most viable alternatives. 

On February 1st, NIC will host a webinar to discuss these findings and implications for our sector. Register to attend. Additionally, the middle market older adult will be another focus of educational content at the NIC Spring Conference. To read the full report from the Milken Financial Innovations Lab, please click here 



About Lisa McCracken

Lisa McCracken, Head of Research & Analytics at the National Investment Center for Seniors Housing & Care (NIC), oversees NIC’s research and analytics team, which develops actionable, data-driven insights on industry challenges and opportunities and showcases practical examples of how organizations nationwide are embracing opportunities to meet the demands of a changing marketplace. Additionally, Lisa oversees a robust research agenda with nationally recognized partners to help the next generation of senior housing and care leaders address evolving and dramatically different consumer preferences and needs. Prior to joining NIC, Lisa served as director of senior living research and development with Ziegler, a leading investment bank for senior housing and care, where she oversaw research staff supporting the senior living, senior housing, and related corporate finance healthcare practices. Lisa began her career as a research analyst at Holleran, a healthcare and aging services research and consulting firm, where she was successively promoted to become vice president of research, managing partner and ultimately president between 2009 and 2013. She is a nationally recognized thought leader and public speaker and has been the lead researcher on a number of national research studies such as the LeadingAge Ziegler 200 and other industry-wide publications.

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