4.7.3.1Vertical

Assisted Living Chains & REITs

Publicly traded and PE-backed multi-site assisted living operators.

Market snapshot

These figures describe Assisted Living Facilities (4.7.3), the segment that Assisted Living Chains & REITs sits within. They are not figures for Assisted Living Chains & REITs on its own.

Market size
~$48B
Growth
~4.8%CAGR (2017–22, nominal)
Companies
~18,567 firms
Firms by employee count

70.8% of firms have fewer than 20 employees: 13,147 micro-businesses, below most mandates.

The investable universe5,420 firms with 20+ employees
20–99
3,98373%
100–499
90017%
500+
53710%

Predominantly private-pay senior housing (~18,600 firms, mostly small, with 71% under 20 staff) that recovered faster than skilled nursing because it isn't tied to Medicaid rates. Occupancy is climbing back toward the demographic surge (~4.8%/yr growth); operations and REIT-owned real estate are often split, and PE/REIT capital keeps consolidating the space. The count leans partly on a broad 'other residential care' bucket.

NAICS 623312, 623990. U.S. Census Bureau, 2022 Statistics of U.S. Businesses; U.S. Census Bureau, 2022 Economic Census.

Business model & economics

Revenue model

Primarily private-pay monthly resident fees

Key economics

Revenue per firm
$2,586,481
Revenue per employee
$80,516
Employees per firm
33.4
Recurring revenue
High

recurring monthly occupancy

EBITDA margin
Occupancy- and labor-sensitive; better than SNF
Capex intensity
High

Characteristics

  • Balanced cost base: payroll is 41% of revenue, leaving room to scale margin without cutting staff
  • Deep strategic-buyer pool: 537 firms exceed 500 employees, so a scaled asset has trade buyers
  • Predominantly private-pay: better positioned than SNF.
  • Occupancy recovering toward the demographic surge.
  • Operations and REIT-owned real estate often split.

NAICS 623312, 623990. U.S. Census Bureau, 2022 Statistics of U.S. Businesses; U.S. Census Bureau, 2022 Economic Census.

Geographic concentration

AlabamaArizonaColoradoFloridaGeorgiaIndianaKansasMaineMassachusettsMinnesotaNew JerseyNorth CarolinaNorth DakotaOklahomaPennsylvaniaSouth DakotaTexasWyomingConnecticutMissouriWest VirginiaIllinoisNew MexicoArkansasCaliforniaDelawareDistrict of ColumbiaHawaiiIowaKentuckyMarylandMichiganMississippiMontanaNew HampshireNew YorkOhioTennesseeUtahVirginiaNebraskaSouth CarolinaIdahoNevadaVermontLouisianaRhode IslandAlaskaOregonWashingtonWisconsin

Assisted living concentrates in the Pacific Northwest and Upper Midwest (Oregon, Washington, Alaska, and Wisconsin), where the assisted-living model is most established relative to nursing homes.

OregonWashingtonAlaskaWisconsin

U.S. Census Bureau, 2022 Statistics of U.S. Businesses (firms by state), NAICS 623312/623990. Concentration shown by location quotient.

M&A deal context

Deal activityHigh

Who’s acquiring

  • Senior-living operators
  • Healthcare REITs & real-estate investors
  • PE-backed platforms

What’s driving deals

  • Occupancy recovery and demographic tailwind.
  • Operations/real-estate transactions and REIT activity.
  • Consolidation of regional operators.

Find Assisted Living Chains & REITs acquisition targets

Search Acquisera’s index for companies classified under Assisted Living Chains & REITs (4.7.3.1) and build a targeted deal pipeline.

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