By Roger Mali
According to a recent report by Lument, 45 percent of qualified respondents to a survey conducted by the company plan to acquire seniors housing assets this year. Meanwhile, only 14 percent plan to sell. That imbalance tells you exactly where pricing power sits.
There is a particular kind of confidence that settles over a seller’s market though, and it tends to make people sloppy. When every headline confirms that buyers are circling, when capital is abundant and occupancy is climbing, there is an assumption that you need only list a portfolio for sale and let the market do the rest.
That assumption has never been true. It is especially dangerous right now because this market is rewarding even unprepared sellers with premiums they may never see again.
A Record Year
LevinPro LTC recorded 871 publicly announced seniors housing and care transactions in 2025, a total that demolished the prior annual record of 721 deals, beating it by more than 20 percent. Total disclosed spending reached $30.5 billion, the highest annual transaction volume in over a decade and a 177 percent increase from 2024.
The fourth quarter of 2025 alone produced 285 deals and nearly $15.2 billion in capital deployed — more than many annual totals for the industry prior to 2020.
Feeding the Appetite
Occupancy across the 31 primary markets tracked by the National Investment Center for Seniors Housing & Care (NIC) reached 89.1 percent at the end of 2025, marking the 18th consecutive quarter of occupancy gains and putting the industry within reach of crossing 90 percent occupancy this year.
On the supply side, new construction starts have fallen to the lowest level since 2009, and 60 percent of the 140 markets NIC tracks have no seniors housing development underway at all.
The pipeline to replenish inventory has been frozen by elevated construction costs, restricted capital and tighter financing, creating a multi-year runway where demand will continue to outpace supply.
The youngest baby boomers have turned 60, and the oldest are turning 80. The average age of admission for long-term care residents sits at 84. This decade, the core of the baby boomer generation is aging in volumes this sector has never before had to absorb.
Separating the Good from the Great
For all these tailwinds, the harder question remains whether an operator contemplating a sale has done the work to position its portfolio for the kind of valuation this market is capable of producing.
I like to start my assessment with an honest accounting of what is (and is not) performing within the portfolio. Buyers right now are absorbing entire portfolios and swallowing underperforming or distressed assets to a degree that would have been unthinkable five years ago.
In one transaction I am advising on, an institutional investor is deploying over $200 million into a portfolio where nearly half the assets are non-performing. The deal still closes because the performing assets justify the valuation. Last decade, those same non-performing facilities would have killed the conversation.
That shift creates a strategic choice: Should operators bundle weaker assets or divest them separately? In some cases, bundling works because the discount is negligible and allows the operator to shed liabilities that it might otherwise carry for years. In other cases, a cleaner portfolio commands a higher multiple. The key is running that analysis before going to market because it shapes how the deal is underwritten.
The willingness of lenders and investors to overlook weak assets should not replace disciplined fundamentals.
Timing the Reimbursement Cycle
Sellers consistently leave money on the table through poor timing. In states that reset Medicaid rates annually, the difference between selling at the top of the cycle versus mid-cycle can represent millions of dollars in valuation on a single facility.
Operators who can show rates at or near peak will have the ability to negotiate from a position of strength. Those selling mid-cycle are asking buyers to underwrite projections that have yet to materialize.
It is also unrealistic and naive to assume reimbursement and rent growth will continue at post-COVID levels. Over time, increases are likely to flatten or fall below inflation as demand spreads available funding across a larger population.
Simply put, per diem pressure is coming.
Clinical Identity
Today’s buying environment is broad and aggressive, often overlooking specialization. However, that does not mean specialization has lost value; it has simply been temporarily discounted. Facilities with a defined clinical niche, be it short-term rehabilitation or long-term skilled nursing, create stronger value over time.
If you are in the middle of shifting your clinical model or payer mix, finish that work before going to market. Buyers and lenders do not want to underwrite a transition; they want to underwrite proven performance.
And ultimately, nothing matters without leadership depth. A portfolio with strong facility-level leadership across operations, billing, compliance, and census development is inherently more valuable.
Buyers price continuity at a premium, and instability at a discount.
The Window
The conditions driving this market are real and will persist as the demographic wave builds. But this exact moment will not. Construction will restart. Capital will find other opportunities. Reimbursement rates will level off. Inexperienced operators will encounter clinical and compliance obstacles that even deep pockets cannot fix. The operators who capture the full value of what they have built will be those who prepared their portfolios before the market asked them to do so.
Roger Mali is founder and managing director of Elevate North Group, an advisory and operating firm specializing in turnaround management, financial restructuring and strategic advisory for distressed and underperforming healthcare organizations.
This article originally appeared in the May-June issue of Seniors Housing Business magazine.