By Steve Moran

There is tension in the air. Is senior living health care or a lifestyle choice?

Most of the recent NIC conference in San Diego (spring 2023) revolved around the intersection of health care and senior living. There are some compelling reasons for senior living operators to have deep integration with the health care system, because it means a better quality of life for residents (the most important thing), participation in cost savings, longer lengths of stay.

What Is True

There are a number of factors that make this an emerging phenomenon:

  • Senior living operators know better than any sector of the health care system how to provide for the needs of older people.
  • More importantly, senior living operators know how to create great life experiences for older people.
  • Senior living has become much more of a health care model, meaning there are a bunch of services that can be provided in a more homelike setting.
  • Hospital stays are stupidly expensive.
  • Hospital stays are remarkably unpleasant, with everything that happens in the hospital being done to meet the needs of the hospital and not the patient.
  • Hospitals are at or near capacity in many areas, and it is only going to get worse.


There are big challenges, which is why only a few operators are doing this.

  • It’s complicated. Lots of moving parts; there are costs involved.
  • It means a new level of sophistication on the part of corporate leadership and at the community level.
  • It means keeping residents who are much less medically stable in the community rather than sending them out.
  • It creates more of an emotional burden on staff.

The biggest challenge is that it means that assisted living and memory care are moving into an arena that was once considered to be skilled nursing. In doing so, if we screw it up, there will be more scrutiny and the potential for more regulation.

Overall though, this is a tremendous opportunity for differentiation and higher cash flow.