2009 Largest Providers, a Turbulent Economy Slows But Can't Put the Brakes on Assisted Living Growth

With 2009 well underway, many business sectors2006 and 2007 timeframe," Kramer says.
continue to feel the stress of the economicIn another bright spot, revenue growth in the third
downturn, including the mortgage crisis and recentquarter of 2008 still remained in the 4-5 percent
credit crunch. But this year's 70 Largest Providersrange, he adds. If it drops to 3 percent, investors will
list-an annual Assisted Living Executivestill see senior housing as a good defensive
exclusive-suggests that assisted living providers soinvestment compared to other real estate asset
far have not taken as heavy a hit.types.
While growth has slowed from the past few years,Additionally, while many of the major commercial
more than half of providers surveyed by Assistedfinance companies that had been active previously
Living Executive still report increases in licensedare no longer active, some opportunities for financing
assisted living resident capacity, as of January 1, evenremain available to senior housing providers, Kramer
if it's only due to adding one to three new buildingssays. In particular, relationship-based small ($10-$20
to their portfolios.million) deals through local community-based lenders
Modest Gains and Lossesand some regional banks will continue to get made,
During 2008, no assisted living companies merged andand another bright spot is that Fannie Mae and
full-company acquisitions were rare. The onlyFreddie Mac have been very active as sources of
company to grow by acquiring sizable competitorstakeout financing. REIT buyers, who still have good
was Five S tar Senior Living, formerly Five Staraccess to capital, and possibly even some private
Quality Care, which bought New Seasons Assistedequity entities may become active later in the year if
Living Communities (No. 49 on the 2008 list) andprices are low enough and values stabilize.
Somerford Corp. The moves helped raise Five StarBecause of recent steep stock market dives, public
Senior Living from No. 8 to No. 6 and increased itscompanies may find it harder to access capital even
assisted living capacity by more than 45 percent.if their operations are not impacted, Monroe says.
However, despite a year featuring no big deals, theThe turbulent market also makes it unlikely that any
2009 list shows some reshuffling due to smallcompany will go public this year, but if conditions
acquisitions and building. Perhaps not surprisingly, theimprove, Atria remains the company to watch in that
biggest gains remain with the biggest players and arearena, he adds.
in hard numbers rather than major rank changes.Smart Growth and Caution
Sunrise Senior Living continues to top the list with anThe credit crunch and general caution by providers
approximate assisted living resident capacity ofbrought new building starts down 70 percent
32,560 units. (Actual numbers should be somewhatbetween the second and third quarters of 2008, and
higher due to construction last year but were notstarts are expected to stay flat overall for the
available at press time.) Emeritus Senior Living andforeseeable future, Kramer says. Sunrise Senior
Brookdale Senior Living maintained the No. 2 and No. 3Living, the biggest builder in recent years, has frozen
spots, but also continued to grow by 8 percent and54 development projects nationwide, and Capital
20 percent, respectively. Assisted living residentSenior Living Corporation has also suspended new
capacity increased by 20 percent at Atria Seniordevelopment. Still, new construction will raise capacity
Living Group (No. 5).in 2009 and 2010 as new communities that are
In terms of percentage growth, Senior Care Inc.already underway open. For example, Legend Senior
raised its assisted living capacity by nearly 44Living did not make this year's list (currently it ranks
percent, a gain that moved the Louisville,No. 73 with 585 assisted living resident capacity), but
Kentucky-based provider from No. 17 in 2008 to No.will likely enter the list next year due to new
11 this year. Senior Services of America (No. 29)development already underway, which will double its
grew 27 percent and moved up seven places.size.
Affordable assisted living provider BMA ManagementOne sector to watch for new building is affordable
only moved up three spots to No. 24 but also uppedassisted living, which has access to financing sources
its capacity by 28 percent due to new construction.not available to traditional providers such as tax
Mt. West Retirement Corp. changed its name tocredits, nontaxable bond issues, and HUD financing,
Bonaventure Senior Living (No. 25) and raised itssays Blair Minton, chairman and founder of BMA
capacity by 22 percent.Management. He adds that, in 2009, BMA has six
In contrast, the largest rank-changing action was incommunities slated to open and expects to start
the bottom half of the list and did not reflect highanother six to seven properties, keeping pace with a
actual capacity numbers since 60 percent ofyear-over-year capacity growth goal of at least 25
providers on the list have less than 2,000 assistedpercent. The company, which at the start of this
living residents. The biggest mover was Senioryear operated 27 properties in Illinois, also plans to
Management Advisors (formerly Adult Care Group),expand into other Midwestern states.
which jumped from No. 67 to No. 51 by gaining 298"Market rate residents who have more money have
new assisted living residents and a 42 percent gain inmore choices and may not be choosing to move into
capacity. Bell Senior Living jumped 10 places from No.assisted living because they are afraid of what's
46 to No. 36, thanks to 28 percent capacity growthhappening to their assets," Minton says. "Our
or 309 new assisted living units. Erickson Retirementresidents are primarily poor, so it's not affecting
Communities also raised its position by nine to No. 50,them. We've not seen a decrease in occupancy."
adding 196 units or 24 percent. Brightview SeniorThis year could also be a good time to buy up land
Living/The Shelter Group went from No. 70 to No. 62sites at cheap prices, positioning companies with the
with just 149 new units and a 22 percent capacityresources to build well for the next few years when
increase.economic conditions should improve, Monroe says.
The Top 70 had only three new entrants. Grace"Unless we have 25 percent unemployment rates, I'd
Management leaped to No. 37 after growing almostlove to be able to open properties in 2010-13," he
57 percent to 1,399 residents, thanks to 10 newadds. "You're not going to have competition, the
management contracts in 2008. CCRC provider MBKdemand will be growing, and the double kicker is that
Senior Living joined the list at No. 60 after more thanthere will be a greater demand for assisted living
doubling its assisted living resident capacity in 2008 tofrom people who deferred a move. People who are
842. And Milestone Management Services (formerlynow considering CCRCs will be moving to assisted
Our House Senior Living) entered at No. 69 with 709living."
residents, a 23 percent increase from 576 reportedThe new year may also bring some good pricing
last year.opportunities for assisted living providers who wish to
Only six providers reported capacity losses, butgrow their portfolios through acquisition and have
actual numbers were low, indicating again the sale ofaccess to capital, Monroe says. Indeed, January 2009
only one or two communities. The largest decreasealready saw a notable big deal as Sunwest
was 259 residents by Kisco Senior Living, reducing itsManagement sold off 45 senior living communities to
rank by 13 spots from No. 41 in 2008 to No. 54 ina large undisclosed private equity buyer, which has
2009. However, because Kisco has new projectscontracted with Senior Resource Group to manage
under development, the company is likely to charge41 of the properties under the name LaVida
back up the list in 2010. Only one company thatCommunities. The company maintained its long-term
made last year's list, Harmony Living Centers,No. 4 spot in 2009 but had a troubled year with
dropped off-not due to a capacity loss, but simplyabout 30 limited liability companies affiliated with it
maintaining its 2008 resident capacity of 705. Infiling for Chapter 11 bankruptcy, and President Jon
addition to the three already-mentionedHarder also resigned in January.
name-changers, Oakdale Heights ManagementWell-financed small companies, with five to 10
Company renamed itself Northstar Senior Living (No.properties, in particular, have a great chance to
28).double in size due to their ability to find the small
Obstacles and Opportunityamount of capital needed for one-off acquisitions,
When the banking crisis came to a head lastMonroe says. But one big player to watch for
September, virtually all growth activity grinded to aacquisition activity in 2009 is Emeritus. The company
halt due to lack of capital and uncertainty aboutmet all its 2008 goals last year to buy up leased
whether cap rates reflected true property values,assets formerly operated by Summerville Senior
says Steve Monroe, managing editor of the Senior-Living, with which it finalized a merger in 2008, as well
Care Investor newsletter. The only noteworthyas picked up leases to 11 properties formerly
action at year end was that a major expected dealoperated by Sunrise and owned by HCP Inc. in a rare
did not happen. In December, Health Care REITDecember deal, according to Justin Hutchens, former
withdrew its offer to buy Arcapita Inc.'s 90 percentEmeritus COO and senior vice president. While the
interest in 29 Sunrise-managed properties at whatcompany will scrutinize its spending closely due to the
normally would have been seen as a very aggressiveshaky economy and has slowed new development, it
$643.5 million price.is well-positioned to grow next year in markets
Still, despite the rocky economy, assisted livingwhere demand exceeds supply, Hutchens says.
entered this slowdown in much better shape than itProviders tempted to press the panic button would
did the last big recession, which coincided withdo well to remember that demographic trends
excessive overbuilding around the year 2000,ultimately favor senior living and assisted living in the
according to senior housing experts. Despite concernslong term, says Karen Shayne, CEO of
that inability to sell homes, shrinking assets, andNashville-based Maristone Senior Living and a veteran
laid-off family members who can give care at homeof more than a decade of experience in long-term
will spur seniors to delay moves into assisted living,care. The new company has two properties under
occupancies trended down but not precipitously inconstruction and slated to open this summer and fall,
the third quarter of 2008, says Robert G . Kramer,but while Shayne foresees the year as "bumpy," she
president of the National Investment Center for theis not worried about filling units. In the metro Nashville
Seniors Housing & Care Industry (NIC). Whilemarket, she says she is "getting calls like crazy" from
fourth-quarter occupancy data was not yet availableinterested residents and is confident that within 18
at press time, other data indicated that the mostmonths, senior housing "will explode again. There's an
troubled markets, such as Florida, California, andebb and flow to every industry, but I think by far
some specific metro markets-Phoenix, Las Vegas,now with the baby boomers incoming and seniors
Chicago, and Riverside, California-have started tobecoming more sophisticated, if you have the right
bottom out, he adds. "Also, keep in mind thatprograms to present, they will come.
occupancy is coming down from historic highs in the