The occupancy rate for entrance fee continuing care retirement / life plan communities was greater than 90% in the fourth quarter of 2023, according to Omar Zahraoui, principal at the National Investment Center for Seniors Housing & Care.

By comparison, the rate was 86.1% for rental CCRCs, Zahraoui wrote in a blog, posted to NIC’s website, that originally appeared in Ziegler’s Senior Living Finance Z-News newsletter. 

The difference in occupancy rates between entrance fee CCRCs and rental CCRCs was 3.8 percentage points in independent living, 3.4 percentage points in assisted living and one percentage point in skilled nursing.

Regardless of model type, assisted living and memory care units saw the greatest year-over-year occupancy growth in CCRCs, followed by independent living, Zahraoui said. Occupancy decreased year over year in the skilled nursing sections of CCRCs.

Monthly rent

The monthly year-over-year average asking rent for entrance fee CCRCs across all service/care segments was higher than in rental CCRCs. According to Zahraoui, the highest year-over-year asking rent growth for entrance fee CCRCs occurred in the assisted living and memory care sections. For rental CCRCs, the largest year-over-year asking rent growth was seen in independent living, with the smallest growth in memory care.

“Interestingly, the memory care segment experienced the largest annual occupancy gain (3.7 percentage points) across all care segments and payment types,” Zahraoui said. 

He noted that the numbers for asking rates do not include any incentives that may have been offered to residents and prospective residents.


Skilled nursing inventory has declined from last year in both entrance fee and rental CCRCs, whereas entrance fee CCRCs experienced positive year-over-year inventory growth in assisted living and memory care.

“Negative inventory growth can occur when units/beds are temporarily or permanently taken offline or converted to another care segment, outweighing added inventory,” Zahraoui said. “Anecdotally, there is a trend of CCRCs converting skilled nursing beds to assisted living or memory care units.”

Sector outlook

In January, Fitch Ratings assigned a “deteriorating” outlook to the CCRC sector for the second consecutive year.

CCRCs “still face a number of considerable headwinds heading into 2024,” Fitch Senior Director Margaret Johnson told investors at a January webinar sponsored by the ratings firm. “Cost inflation in terms of supplies and labor, higher interest rates and volatility in the housing sector all contributed to the ‘deteriorating’ or ‘negative’ outlook. But by far, the biggest driver of the ‘deteriorating’ outlook is continued wage pressure.”