healthcare worker interviewing for a job

“There’s evidence of improvements in the job market for senior housing,” Beth Burnham Mace, National Investment Center for Seniors Housing and Care chief economist and director of outreach, said Tuesday during the organization’s latest online Leadership Huddle. 

The number of people employed in assisted living is now more than in February 2020, just prior to the pandemic; i.e., the jobs lost during the pandemic are now more than fully recovered.  Skilled nursing is not recovering as quickly, with the number of people employed in skilled nursing about 14% below where it was before the pandemic. Employment in nursing homes has been declining “for quite some time,” she noted.

Market fundamentals

Meanwhile, occupancy in senior living — independent living and assisted living — in NIC’s 31 primary markets has risen to 83.2%, Mace noted.

“We see more net absorption today than what we actually lost during the pandemic period,” she said. 

She noted, however, that the first-quarter occupancy rate is still four percentage points lower than it was before the pandemic, due to new properties that have come onto the market. The secondary markets saw less inventory growth, she said.

“The number of actual occupied units for senior housing is the highest it’s ever been, plus some,” Mace said.

Occupancy is higher in Independent living than in assisted living, but occupancy in assisted living has improved more quickly, she said.


The pace of construction has slowed sharply since the pre-pandemic era. Mace attributed this to the ability to secure debt. 

“Construction is weakened, but it is not zero,” she noted.

The length of construction is longer than it used to be, she said, due to supply chain disruptions and a shortage of skilled labor.

“There’s still inventory growth coming, but it’s not at the paces and the levels that we saw in the past,” Mace said.

Lending environment

The cost of debt has risen since the Federal Reserve began inching up interest rates in March 2022, and banks are under regulatory pressure to hold reserves against loans, she said. Additionally, Mace noted, terms and conditions for borrowers have become difficult.

“Many borrowers are increasingly challenged to make debt service payments, especially if they’re with interest rate caps added to obligations, which is often the case now,” she said.

Adjustable rate mortgages account for a significant portion of loans issued in the past several years, Mace said.

Banking challenges

Regional banks are facing significant disruptions, the chief economist said. She noted issues faced by Silvergate, SVB and Signature Bank in March. Monday, First Republic Bank was sold to JP Morgan Chase.

Mace called what is happening these days a “bank walk,” as opposed to the “bank runs” seen during the Great Depression. 

“What we’re seeing is, the deposit base in the US in the banks, especially the regional banks, is starting to shift. That’s really a result of the shift of interest rates,” Mace said. “Once interest rates became 4%-ish, we saw a lot of consumers that were taking their money out of savings accounts in small banks and walking to other opportunities.”

The outflow of deposits is significant, the chief economist noted, because without deposits, loans become problematic for banks, with the potential for further credit contraction.

Approximately $10 billion of senior housing debt is due to mature this year and in 2024, Mace said.