Paying Up For Square Footage In Skilled Nursing
The size of a skilled nursing facility can have important ramifications for the services they provide, especially as many facilities are engaging in higher acuity services and more frail patients. Four-bed wards and even triples became a thing of the past (mostly) more than 10 to 15 years ago. You need a lot more room to provide quality therapy programs, and with increasing demand for private rooms, or at a minimum large semi-private rooms, small facilities on a square foot per bed basis have become less desirable in the market, both for buyers as well as consumers. Most nursing facilities built today have at least 400 square feet per bed, and often much more. But in the past, many had 250... Read More »The Price of Age in Seniors Housing
Largely, the relationship between the age of a seniors housing property (including assisted and independent living) and the average price per unit is a near-perfect correlation, as the newest communities tend to sell at higher prices than the older ones. That was not the case in 2016, which saw its oldest properties jump in price and its newer ones fall, compared with 2015. Communities built earlier than 2001 (the tail-end of the assisted living building boom) sold for $179,900 per unit, up from $153,800 per unit in 2015, according to The Senior Care Acquisition Report. The anomaly of the year occurred in the group of properties built between 11 and 15 years ago, which sold on average for... Read More »
The Consistency of Skilled Nursing Facility Expense Ratios
Just like the average cap rate, the average expense ratio in the skilled nursing market for facilities sold has been very consistent. For the past five years, it has had a low of 88.2% and a high of 88.7%, for a very small 50 basis point spread, according to the 2017 Senior Care Acquisition Report. It was 88.5% in 2015 and 88.6% in 2016, just to show the consistency. Obviously, this excludes expenses such as interest, depreciation, amortization, taxes and rent. When these are all included, it is clear to see why the skilled nursing industry complains to their elected representatives as well as CMS that it is difficult to make money. And future cuts to Medicaid (as promised by both the... Read More »Cash Flow Drives Record Skilled Nursing Prices
We have written several times in recent years that reports of the “death of the skilled nursing facility” have been greatly exaggerated. That is clearly evident in the record-high prices we have recorded in the sector, soaring to an average of $99,200 per bed in 2016 (up from the previous record of $85,900 per bed in 2015) and to a median of $94,660 per unit (from $66,500 per bed in 2015), according to the Senior Care Acquisition Report. But this pricing peak contradicts a normally reliable indicator of the market’s health. As we have always stated, it is the absolute level of net operating income (NOI, and interchangeable with EBITDA) that drives value in the market. From 2011 through... Read More »Gross Income Multiple Falls For Seniors Housing Deals
A popular multiple that investors use to measure the value of a seniors housing and care property is the Gross Income Multiple (GIM). So, as prices have stayed consistently near record-highs for seniors housing (independent living and assisted living) properties, how much were buyers paying with respect to the properties’ revenues? In 2016, according to the 22nd Edition of The Senior Care Acquisition Report, the average GIM fell 15 basis points to 3.75x from the 3.9x recorded in both 2014 and 2015, widely considered the height of the seniors housing bull market. The median fell by a larger degree (30 basis points) and to a level not seen since 2011, when it was also 3.2x. Understandably,... Read More »Schedule a demo
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