Many Americans between the ages of
40 and 65 have an aging relative in need of senior care services. Today,
facilities differ markedly from the scary places we saw as children when we
visited a grandparent. Many senior facilities look, feel and smell like a
home—not something from One Flew Over
the Cuckoo’s Nest.
Such improvements, coupled with the tremendous future need for
the services these facilities provide and regulatory limits on supply, are
transforming the senior care housing segment into a real estate asset class that
will offer unprecedented and lasting investment opportunities. For those who
doubt this prediction, I have two words: baby boomers. Members in this
demographic bubble want to place their parents in high-quality facilities, the
same types they will occupy in droves themselves in a few years.
As an added bonus, many states restrict the ability to build
certain kinds of senior facilities: New bed licenses are not issued unless
demand can be clearly demonstrated. What’s more, demand generally remains
constant—seniors rely on fixed retirement incomes, not jobs and salaries. No
other real estate sector enjoys these types of barriers to entry or insulation
from the economic cycle.
Senior housing offering skilled nursing care (high acuity) or
assisted and independent living (low acuity) exist in a variety of settings,
with myriad hospitality and care services. Each of these care options offers
numerous investment opportunities.
REITS, such as Healthcare Property Investors, Ventas, Health
Care REIT and others, vary in size and strategy, but they all own
properties—from senior housing to hospitals—and triple-net lease those to
operators. This is generally the safest play, as operators cannot operate
without facilities. REIT returns have been strong, averaging well over 15
percent per year for the past five years and between 5 and 9 percent (with
dividends) over a 10-year period.
Individuals can invest directly in the senior care segment via
IRS 1031 exchanges. There are operators that specialize in raising equity
capital in this fashion. Though returns can vary substantially, they generally
range from 8 to 11 percent. Alternatively, investors can make direct cash
investments in property development or acquisitions with an operator. This
option combines direct investment in both the real estate and the senior care
operation, which carries both high risk and returns and is certainly not
intended for unsophisticated investors. Stable acquisitions of this type can
generate five-year levered cash yields of 13 to 15 percent, ignoring asset
appreciation.
Finally, there are stock market plays in such companies as HCR
Manor Care, Genesis HealthCare and Kindred Healthcare in skilled nursing, and
Sunrise Senior Living, Emeritus Assisted Living and Brookdale Senior Living in
the senior housing segment. HCR Manor Care is arguably the benchmark for the
skilled nursing industry, with steady returns and strong management. Sunrise has
long been viewed as the public benchmark for senior housing, with high-end
facilities and generally strong, consistent growth.
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