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/ Home / Editorial / Thought Leaders / Politics & Policy /
Thought Leaders: Real Estate
Silver Linings
Kevin McMeen
01/01/2007

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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