Senior Living Proof 5 by hspearman6

RESEARCH REPORT U.S. Senior Living Market | Food & Hospitality | 2022

The Senior Living market is booming, but what are the points of entry, who are the major players, what are the fundamentals needed for market penetration? This 4xi Research Report has been created for food and hospitality operators and provides the answers as you consider your future strategy in this important market opportunity.

www.4xiconsulting.com

Welcome to the 4xi Research Report: U.S. Senior Living Market, 2022.

INTRODUCTION

We have compiled this report focused for foodservice and hospitality operators seeking to learn more about the market: size, major players, different sectors, and what’s most important when considering the market. With a healthier, aging population set to almost double in the next 40 years, and less than 20% market penetration, the Senior Living sector is appealing but what are the key learnings to take on board as you consider your future strategy for the sector – this report aims to answer many of those questions.

KEY TAKEAWAYS: $

430B+ 16K 2M 2X <20% $

8B+

estimated total market size, 2021 including real estate assets senior living facilities in the top 100 metro markets total number of beds top 100 metro markets citizens aged 65+ is set to double over the next 40 years from 50 million to almost 100 million estimated current foodservice contracted penetration rate, <30% in the top 100 metro markets foodservice sector opportunity

In this report we break down the sub-sectors: Community Living, Independent Living, Aging in Place, Assisted Living, Skilled Nursing Care, and Memory Care – what they are, characteristics, and key components. We break each sector down in terms of numbers of properties and residents, and growth trajectories. The report identifies the major players – investors and property owners, operating companies by sector, and predominant foodservice and hospitality operators. Finally, we address the trends in the sector and areas of focus for those serious about growing their Senior Living market focus and growth. We trust that you find value in this report, and should you wish to explore further then 4xi can provide a range of strategic advisory services including Amenities Design, Customer, Employee, and Resident Experience strategies, training, and workshops, Strategic Partnership & Growth support, and a range of innovation, technology, services, and solutions. We look forward to learning more and how we may be of assistance to you on your journey. Inspiring the future, together.

Simon J. Elliot

Managing Partner 4xi Global Consulting & Solutions

Scope: Senior Living – Foodservice....................................................................... 2 Background............................................................................................................ 5 An Aging Population, 6 History, 7

Industry & Sub-Sectors.......................................................................................... 8 Independent, Active Living, Or CCRC’s, 9 Senior Living, Aging In Place, 10 Assisted Living, 11 Skilled Nursing Care, 12 Memory Care, 13

Market Size........................................................................................................... 14 Sub-Sectors As Opportunity Groups................................................................... 15 Market Growth...................................................................................................... 16 Major Players........................................................................................................ 17 Investors, 17 Highlights: Investors, 18

Management Companies (By Sub-Sector).......................................................... 19 Independent Living, 20 Highlights: Independent Living Management Companies, 21 Assisted Living, 22 Highlights: Assisted Living Management Companies, 23 Memory Care, 24 Highlights: Memory Care Management Companies, 25 Continuing Care Retirement Communities, 26 Highlights: CCRC Management Companies, 27

Market Penetration: Foodservice......................................................................... 28 Why Such Low Market Penetration?, 28

Fundamentals, The Foundations Of Success...................................................... 29 Foodservice Providers In Senior Living................................................................ 30 Highlights: Foodservice Management Companies, 32 Watchlist: Foodservice Management Companies, 33

Trends................................................................................................................... 34 Opportunities........................................................................................................ 36 Definitions............................................................................................................. 39 Sources And Further Reading.............................................................................. 40

Table of Charts Figure 1. U.S. Citizens 65+..................................................................................... 5 Figure 2. Change In The 65+ Population................................................................ 6 Figure 3. Community Locations: Top 100 Metro Markets.................................... 14 Figure 4. Community Residents: Top 100 Metro Markets.................................... 14 Figure 5. Total Market Size: By Sub Sector.......................................................... 15 Figure 6. Total Market Growth: Senior Living....................................................... 16 Figure 7. Total Market Growth: Foodservice.................................................. 16, 28 Figure 8. Investor Market Share........................................................................... 17 Figure 9. Property Owners: Top 10...................................................................... 17 Figure 10. Independent Living: Top 30................................................................. 20 Figure 11. Assisted Living – Top 30...................................................................... 22 Figure 12. Memory Care – Top 30........................................................................ 24 Figure 13. CCRC’s – Top 15................................................................................. 26 Figure 14. Market Penetration: Foodservice........................................................ 28 Figure 15. Top Foodservice Companies In Senior Living: Market Share...................31

Table of contents

4xi Research Report: U.S. Senior Living Market, 2022

Simon Elliot, Lead Author Managing Partner

Contributors

4xi Global Consulting & Solutions

Katrina Miner, Producer

Strategic Marketing Consultant 4xi Global Consulting & Solutions

Barbara boden

Ed Snowden

4xi Global Consulting & Solutions

tony johnson

Melanie corey ferrini

Managing Partner

Chief Customer Experience Officer 4xi Global Consulting & Solutions

Healthcare and Senior Living

Design Strategy & Innovation 4xi Global Consulting & Solutions

And thanks to all the 4xi connections and friends that have helped, supported, and contributed to the creation of this report. 4xi Global Consulting & Solutions is a boutique firm specializing in the human experience away from home – at work, in education, at rest, in care, and at leisure. We help corporations, service providers, business owners, innovators, and investors navigate the world of food, facilities, amenities through the lens of a hospitality focus – an end-to-end experience with the human experience (HX) at the heart. As part of our work, we commission research reports to give greater data and insights into topics our constituents believe are important, or of interest to understand more or explore. For more information on our Market Research Reports or our services, please visit our website at www.4xiconsulting .com or email us at hello@4xiconsulting.com. © 2022. 4xi Global Consulting. All Rights Reserved. 4xi has curated publicly available data and information to produce this report. The sources of this data have been provided. 4xi Consulting accepts no responsibility for the accuracy of the data subsets. This report is designed to provide a general overview and market guidance. This report is restricted to a single download per purchase. Sharing, distributing, copying this document in full or in part may be in breach of copyright and therefore we gratefully request that subscribers respect and preserve the commercial integrity of the report. Should you wish to explore multiple licenses for broader sharing in your organization, then please contact us at: hello@4xiconsulting.com

The fact of the matter is that we are getting healthier. Healthier lifestyles, better access to healthcare, quality of medicine, technological advancement, treatments, and care has resulted in people living longer, happier, and healthier lives.

By percentage, the age group of 65 years and above in the United States is expected to increase from 16% in 2018 to 23% by 2060. According to data published by Aging.com, two million housing facilities will be needed for senior residents for adequate living space by 2040. Source: Grand View Research.

95M 90M 85M 80M 72M 68M 60M 55M

2020 2025 2030 2035 2040 2045 2050 2055 2060

52M

BACKGROUND

The rise in the 65+ population is due to increased life expectancy and is expected to grow rapidly in the decades to come. According to National Institute on Aging (NIA), globally, around 8.5% of the population is aged sixty-five and above. According to data published by Population Reference Bureau, the number of Americans aged 65 years & above is projected to rise from around 52 million today to 95 million by 2060, almost doubling the 65+ age group.

Number of U.S. Citizens 65yrs+ in Millions FIGURE 1.

AN AGING POPULATION Change in the 65+ Population

High Growth (>30%) Moderate Growth (20-30%) Medium Growth (10-20%) Low Growth (<0%)

According to the 2020 U.S. Census, the aging population is increasing most notably in the West, Southwest and in the South with Florida leading the way. Other growth areas include the Carolinas, Pennsylvania, New Jersey, and New York. The population of the 65+ population is set to almost double in the next 40 years, representing a significant market opportunity including for providers such as foodservice operators.

FIGURE 2.

HISTORY

Let’s take a quick look at the history of Senior Living and aged care. As far back as 44 BC, Cicero wrote the first known text on aging, and in 1025, an Arabic text known as the Canon of Medicine addressed the health issues and necessary medical care centered around aging. Throughout the ages, different programs and political measures were enacted to support aging population. In the United States, one of the earliest documented care facilities was developed in Philadelphia by the Quakers, The Friends’ Almshouse of Philadelphia. By the mid-1800s other religious groups founded similar facilities for aging widows in reaction to the conditions in the nation’s poorhouses and by the end of the civil war, pensions were established for retired soldiers and their families.

By 1909 aging was recognized as a social issue, separate from illness and with a focus on poverty. In 1935 the Social Security Act was passed in response to the Great Depression that saw half of all seniors living in extreme poverty. In 1950, what we think of today as the private Nursing Home industry was born and doubled in size by 1965 when Medicaid and Medicare were signed into law. Through the Moss Amendments in 1968, which brought federal regulation to the industry, the development of nursing home chains increased, making way for the first hospice care facility in 1974 and the first nationally recognized Assisted Living facility in 1981. By 2011 the first of the Baby Boomer generation began to retire and it is estimated that by 2030, 10,000 people per day will be turning sixty-five.

Taking care of our seniors is a more important task than ever before. The demographic is growing, they are more financially independent, and more discerning. 4xi GLOBAL CONSULTING & SOLUTIONS. © 2022 ALL RIGHTS RESERVED | 7

INDUSTRY & SUB-SECTORS

For those contemplating the Senior Living market for the first time, there are a vast range of sub-sectors to understand – from Active Living and Retirement Communities that are quite different in terms of style of delivery, execution and experience when compared with Skilled Nursing Care or Memory Care. It is important to understand each of these subsectors as the requirements and commercial arrangements are distinctly different.

Independent living

Independent Living, Active Living, or Continual Care Retirement Communities (CCRC’s) are gaining traction among seniors with high disposable income. Such retirement communities are known to cater to people aged from as young as 55. The idea behind these communities is to prevent seniors from relocating when additional care is needed. Thus, they provide care from Independent Living through Skilled Nursing if and when it becomes necessary for the resident. These communities resemble that of a resort experience and are often the size of a small town. Residents can purchase a home on the property and have access to medical and support services, while enjoying a resort or country club type experience.

Foodservice CHARACTERIZATION: Tendency to be more commercial style operations Residents have total freedom of spend, therefore, there is a lack of secured revenue for operators Pricing is more aligned to retail venues Some meal plan options, but optional Tends to be fully commercial, risk contracts Opportunity for up-selling services

55+ resort style experiences are more and more common, including some operators converting hotels and resorts into Senior Living communities – the expectation of support, services, and experiences are no different.

SENIOR LIVING AND AGING IN PLACE

The U.S. Centers for Disease Control and Prevention defines aging in place as “the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level”. The act of aging in place happens over a period in an elderly person’s life where they can have the things that they need in their daily life, while maintaining their quality of life. With aging in place, In-Home care has become a popular choice with the advent of multiple agencies that have expanded these services for seniors. In-Home care agencies offer delivery service for meals, healthcare visits and transportation services and should be considered a competitor in the market.

Foodservice CHARACTERIZATION: Meal delivery is a growing service Communal dining areas can be available in some communities In-residence dining can be available in some communities Sometimes partly subsidized by insurance Residents are likely to be more price sensitive

Traditional Senior Living communities offer multi-unit housing with self-contained living units for older adults who can care for themselves. These properties provide some access to medical and support services, but it’s considered that the residents are self-sufficient. In some cases, additional services are available as optional.

Aging in place or living in a Senior Living apartment-style community, allows seniors to keep their current social network and expand upon it. It not only allows seniors to stay near current friends, but it gives them the opportunity to expand their networks and meet new, like-minded people, and friends.

Assisted living

Assisted Living facilities focus on those who need some help with daily tasks. These properties may have individual apartments for residents along with communal spaces for meals and social activities. Staff may help with a variety of tasks related to housekeeping, personal hygiene, and medication reminders. Assisted Living care often serves as a bridge between Independent Living and Skilled Nursing Care. It is intended for those who can manage many activities on their own and do not require intensive 24-hour assistance.

Foodservice CHARACTERIZATION: A more structured approach to dining Dining is an important part of the Assisted Living community Meals are often included in resident fees Options to extend meal plans Therefore, more dependable but often limited revenue streams Nutrition and special dietary considerations are essential

The focus on clean living and organic products affects everyone, including seniors. Many older people grew up eating healthy fare and prefer natural food and organic preparation with nutritious ingredients to prepackaged food options.

Skilled Nursing care

Skilled Nursing Care (formerly Nursing Homes) are residential care facilities that offer aroundthe-clock, skilled medical care. Skilled nursing facilities are designed for those needing consistent, high-level care and those recovering from an illness or injury, such as a stroke or respiratory virus. Skilled Nursing Care is often the next step after someone has been treated in the hospital for injury or illness, making them a good place for those who do not require hospitalization but do need regular care and assistance. They can also be beneficial for those living with a terminal illness who need readily available medical assistance. Rehabilitation in other sub-sectors, such as CCRCs often act as a feeder to this sub-sector. The focus is on resident health more than the overall lifestyle. Thus, Skilled Nursing Care tends to have fewer lifestyle services and amenities than the other communities. These types of facilities may still offer some basic activities or amenities for the use of rehabilitation patients, such as a swimming pool, classes, community events.

Foodservice CHARACTERIZATION: A highly structured approach to dining Dining is an important part of community and care All meals included in the resident fees Reliable but limited revenue streams Nutrition and special dietary considerations are essential

Memory care

Memory Care is a special type of senior housing designed to meet the unique needs of adults who have Alzheimer’s disease or a similar form of dementia. The focus of Memory Care programs is on improving the quality of life for people with dementia while also keeping them safe and secure. Some Memory Care communities are standalone facilities, while other Memory Care programs are attached to an Assisted Living community or a Skilled Nursing property. In both cases, these dedicated Memory Care communities offer residents a secure, thoughtfully designed environment that helps reduce the risk that an adult with Alzheimer’s will wander off property or otherwise get themselves into a dangerous situation. In addition to the safety aspect, Memory Care communities offer many other health, physical, and emotional benefits.

Foodservice CHARACTERIZATION: A highly structured approach to dining Dining is an important part of care All meals included in the resident fees Reliable but limited revenue streams Nutrition and special dietary considerations are essential

The total Senior Living market size in 2021 was estimated at over $430 Billion with almost 16,000 facilities and nearly 2 million residents in the Top 100 Metro Markets alone. Across the entire U.S. this is closer to 24,000 facilities and over three million residents. The following charts highlight the Top 100 Metro Markets by region: Northeast, Southeast, North Central, South Central, and West.

Market size

Community Locations: Top 100 Metro Markets

3,413

3,272

3,318 West

2,235

3,685

North Central South Central North East South East

Total: 15,923 FIGURE 3.

Community Residents: Top 100 Metro Markets

402,906

385,031 261,052

480,078 460,781

West North Central South Central North East

Total: 1,989,848

South East

FIGURE 4.

3% 4%

7% 8%

Active Living & CCRCs Independent Living

30%

Senior Living Assisted Living

20%

Skilled Nursing Care Memory Care Aging in Place

28% FIGURE 5.

The chart above breaks the total Senior Living market down into percentage share by sub-sector. Skilled Nursing facilities are primarily attached to hospitals or part of a national or local health network and can rely on food production from a central location. Memory Care and Assisted Living facilities tend to be freestanding facilities owned by senior housing investment groups. Owner groups vary in size and can be national or regional. There is a small portion of Skilled Nursing and Memory Care facilities that are accredited private housing with 12-50 residents and are in residential neighborhoods. Meals are provided for all residents. Next is Senior Living and Aging in Place, similar in style, they can also be part of a senior housing owner group or completely private. The housing is freestanding apartment style living facilities or their private home.

As mentioned above, senior housing owner groups vary in size and can be national or separated geographically. Meals can be provided on-site or via delivery, and seniors have the choice of cooking their own meal. Seniors in the Active Living, Independent Living and CCRCs have a wide variety of living choices. From their own apartment or private home in a community, to luxury private home communities known as CCRCs (Continuing Care Retirement Communities). All Senior Living options in this category offer seniors a combination of cooking their own meals, having meals provided or dining on-site. These communities also offer restaurant style locations and are open to outside delivery. See the Market Growth Chart in the next section to track each sub-sector’s potential.

No matter the type of care a senior chooses, according to the most recent census data, less than two percent of people retire to a state other than the one they already live in.

SUB-SECTORS AS OPPORTUNITY GROUPS

Total Senior living Market Size: by Sub Sector

Market growth

The global Senior Living market size in 2021 was estimated at over $430 Billion and set to rise to over $850 Billion in the next 40 years. Unsurprisingly, this growth tracks the same growth in the 65+ population growth. North America dominated the global market with a share of over 45.0% in 2020 due to the high number of seniors in the population, greater government funding, and the implementation of a streamlined regulatory framework. Around 60% of the funding for long term care in the U.S. comes from Medicaid. Under the Affordable Care Act, a separate system called Medicare Prospective Payment System (MPPS) was started to support long term services. For the foodservice sector this means a growth from an estimated $8 Billion today to over $16 Billion in the same period. There are not any markets in the foodservice world with such dramatic growth projections.

Total Market Growth: Senior Living $1T $900B $800B $700B $600B $500B $400B $300B $200B $100B $2020

2025

2030

Active Living & CCRCs

2035

2040

2045

2050

2055

2060

Independent Living

Assisted Living

Memory Care

Senior Living

Skilled Nursing Care

Aging in Place

FIGURE 6.

Total Market Growth: Foodservice $18B $16B $14B $12B $10B $8B $6B $4B $2B $-

2020 2025 2030 2035 2040 2045 2050 2055 2060 FIGURE 7.

For the foodservice sector this means a growth from an estimated $8 Billion today to over $16 Billion in the same period. There are not any markets in the foodservice world with such dramatic growth projections.

Given the size and potential growth of the Senior Living market there is a growing interest. There are major players already established today including REIT (Real Estate Investment Trusts), Management Companies, and Foodservice providers. The following breaks that down.

INVESTORS - TOP 10 5%

22%

6% 9% 19%

10% 10%

10%

FIGURE 8.

Welltower

Diversified Healthcare

Ventas, Inc.

Colony Capital

Brookdale

Harrison Street RE Trust

Healthpeak Properties

National Health Investors

Boston Capital

Senior Lifestyle

PROPERTY OWNERS - TOP 10 Rank Company

Residents

Properties

Welltower

Toledo, OH

68,689

701

Ventas, Inc.

Chicago, IL

58,425

665

Brookdale

Brentwood, TN

31,130

348

Healthpeak Properties

Denver, CO

30,401

218

Boston Capital

Boston, MA

29,193

404

Diversified Healthcare

Newton, MA

27,253

247

Colony Capital

Boca Raton, FL

18,764

208

Harrison Street RE Trust

Chicago, IL

16,419

114

National Health Investors

Murfreesboro, TN

12,852

148

Senior Lifestyle

Chicago, IL

12,475

133

TOTAL

305,601

3,186

Major Players

4% 4%

FIGURE 9.

Welltower Founded in 1970, by Bruce Thompson and Frederic D. Wolfe as the first healthcare focused real estate investment trust (REIT). Through multiple acquisitions and partnerships, Welltower is now the largest provider of Senior Living in California. In 2016, they began investing in Manhattan as part of the company’s strategy to invest in markets with high barriers to entry. They have recently partnered with Promedica and Atria to further expand all levels of Senior Living in the NYC metro area. www.welltower.com | CEO: Shankh Mitra

HIGHLIGHTS: INVESTORS

Ventas, Inc. Ventas’s portfolio of approximately 1,300 properties is buoyed by the demographic tailwind of a large and growing aging population. They use the power of capital to unlock the value of Senior Living communities, life science, research & innovation properties, medical office & outpatient facilities, and other healthcare real estate, working with leading care providers, developers, research, educational and medical institutions, innovators, and healthcare organizations. www.ventasreit.com | CEO: Debra Cafaro

Brookdale Senior Living Brookdale was established in 1978 and is based in Brentwood, Tennessee with their second biggest corporate office now located in Wisconsin. Brookdale Senior Living owns and operates Senior Living communities and retirement communities across the United States. They are the only national full spectrum Senior Living company with over 1,100 properties in forty-six states. www.brookdale.com | CEO: Lucinda Baier

Healthpeak Properties Founded in 1985, this real estate investment trust invests in real estate related to the healthcare industry including senior housing, life science, and medical offices. It is organized in Maryland and headquartered in Denver, Colorado with offices in Nashville, and San Francisco. The company owns interests in 485 properties which are a mixture of Medical Offices, Life Sciences properties, CCRCs and nineteen properties because of a joint merger with Brookdale. www.healthpeak.com | CEO: Thomas Herzog

Boston Capital Founded in 1974, Boston Capital dealings are mainly in mixed use housing, but they have ventured into Senior Living, currently owning 404 properties. They own properties across the United States. www.bostoncapital.com | CEO: John P. Manning

management companies By Sub-Sector

Independent living, as seen by its advocates, is a philosophy, a way of looking at society and disability, and a worldwide movement of disabled people working for equal opportunities, self-determination, and self-respect. In the context of eldercare, independent living is seen as a step in the continuum of care, with Assisted Living being the next step.

Independent living - TOP 30

independent living

Rank Company

Geography

Residents

ATRIA, formerly Holiday Retirement

Winter Park, FL

West, Mid-West, Mid-Atlantic, Northeast, South, FL, HI

28,695

LCS

Des Moines, IA

West, Mid-West, Northeast and South

26,457

Erickson Senior Living

Baltimore, MD

Northeast, Mid-Atlantic, TX, CO, MI, FL

20,594

Brookdale Senior Living

Brentwood, TN

National

16,626

Five Star Senior Living

Newton, MA

Mid-West, Mid-Atlantic, Mid-South, FL

10,901

Senior Lifestyle

Chicago, IL

National, excluding upper Mid-West

6,784

Watermark Retirement Communities

Tucson, AZ

Northeast, Mid-Atlantic, the Carolinas, FL and West

5,410

Bonita Springs, FL

The Carolinas, FL, TX

5,295

Seattle, WA

Northeast, West and FL

4,768

Carlsbad, CA

Northeast, Mid-West, West and South

4,726

Discovery Senior Living

Leisure Care, LLC

Integral/Solstice Senior Living

Merril Gardens

Seattle, WA

West, South, NH, PA

4,101

Sonida, formerly Capital Senior Living

Dallas, TX

Mid-West, Mid-South and the Carolinas

3,709

Grace Management, Inc,

Maple Grove, MN

Northeast, South, Mid-West and West

3,561

Sunrise Senior Living

McClean, VA

USA, Canda and UK

3,251

Chicago, IL

West, South and Mid-West

3,150

Spectrum Retirement Communities

Denver, CO

West and Mid-West

2,898

American House Senior Living Communities

Southfield, MI

Northeast, Upper Mid-West and FL

2,770

Kisco Senior Living Communities

Carlsbad, CA

CA, HI, UT, NC, FL

2,737

Sagora Senior Living

Ft. Worth, TX

TX, OK, FL, AL, CA

2,626

Senior Resource Group

Sunshine Retirement Living

Century Park Associates, LLC

Solana Beach, CA

West, South, Northwest and TX

2,565

Bend, OR

West, South, Mid-West and Northeast

2,545

Cleveland, TN

Northeast, Mid-Atlantic, Upper Mid-West and West

2,388

Atlanta, GA

Northeast, South, Mid-West and TX

2,227

The Arbor Company

Brightview Senior Living

Baltimore, MD

Northeast and Mid-Atlantic

2,178

Pacifica Senior Living

San Diego, CA

West, the Carlolinas, FL, RI

1,826

ALG Senior

Hickory, NC

1,767

Harmony Senior Service

Charleston, SC

South, Mid-South, Mid-Atlantic, and Mid-West

1,708

Senior Living Communities

Charlotte, NC

The Carolinas, CT, FL, GA

1,708

Bridge Senior Living

Orlando, FL

Northeast, Mid-West and South

1,595

Capri Communities

Waukesha, WI

West

1,530

TOTAL

173,492 FIGURE 10.

ATRIA, formerly Holiday Retirement Founded in 2003, Atria Senior Living is a privately held, for-profit senior housing company based in Louisville, Kentucky. The company operates more than 200+ communities in 28 states and seven Canadian provinces. The communities are pet friendly and offer seniors a range of independent activities including volunteering and travel.

HIGHLIGHTS

INDEPENDENT LIVING MANAGEMENT COMPANIES

www.atriaseniorliving.com | CEO: John Moore

LCS As a pioneer in the Senior Living industry since 1971, the dedicated LCS family of companies is designed to help fulfill a community’s mission. This structure allows for development and shared expertise across six senior-focused companies working together as one. www.lcsnet.com | CEO: Joel Nelson

Erickson Senior Living Erickson Senior Living is one of the most respected developers and managers of continuing care retirement communities and a recognized leader in innovative senior housing and healthcare design. Located in eleven states and focused on positive community impact, the future and sustainability. www.eriksonseniorliving.com | CEO: R. Alan Butler

Watermark Retirement Communities Founded in 1985 and headquartered in Tucson, Arizona, Watermark currently manages more than sixty assets in 21 states, including CCRC’s, standalone Independent Living, Assisted Living, and Memory Care communities. They also have Medicare-certified rehabilitation and skilled nursing neighborhoods. Watermark has ownership interests in many of these assets, both on its own and through its development arm, The Freshwater Group. www.watermarkcommunities.com | CEO: David Barnes

Discovery Senior Living Discovery Senior Living ranks prominently among the nine largest senior housing providers in the US, and is nationally renowned for designing, developing, marketing, and operating a multi-brand portfolio of upscale, luxury senior-living communities. With a 30-year reputation and almost 14,000 existing homes or homes under development, the company is a recognized industry leader with a penchant for excellence and innovation. www.discoveryseniorliving.com | CEO: Richard Hutchinson

An Assisted Living residence or Assisted Living facility (ALF) is a housing facility for people with disabilities or for adults who cannot or who choose not to live independently. The term is popular in the United States, but the setting is like a retirement home, in the sense that facilities provide a group living environment and typically cater to an older adult population.

assisted living - TOP 30 Rank Company

Geography

Residents

Brentwood, TN

National

34,489

Brookdale Senior Living

Sunrise Senior Living

McClean, VA

USA, Canda and UK

14,505

Five Star Senior Living

Newton, MA

Mid-West, Mid-Atlantic, Mid-South and FL

11,308

Enlivant

Chicago, IL

Mid-West, the Carolinas and Northwest

9,274

Trilogy Health Services

Louisville, KY

IN, KT, MI, OH

8,550

ALG Senior

Hickory, NC

7,819

Senior Lifestyle

Chicago, IL

National, excluding upper Mid-West

7,670

LCS

*Eclipse Senior Living (no longer in business, units aquired by 5-Star)

Gardant Management Solutions, Inc.

Sonida, formerly Capital Senior Living

ASSISTED living

12 13

Meridian Senior Living Frontier Management, LLC

Des Moines, IA

West, Mid-West, Northeast and South

6,348

Lake Oswego, OR

Northeast, Mid-West, Mid-Atlantic, South and West

5,942

Bourbonnais, IL

Mid-Atlantic and Mid-West

5,547

Dallas, YX

Mid-West, Mid-South and the Carolinas

4,972

Bethesda, MD

Northeast, Mid-Atlantic, Upper Mid-West, CA, TX, FL

4,787

Portland, OR

West, Upper Mid-West, South, the Carolinas and Northeast

4,217

Pacifica Senior Living

San Diego, CA

West, the Carolinas, FL, RI

3,915

Watermark Retirement Communities

Tucson, AZ

Northeast, Mid-Atlantic, the Carolinas, FL and West

3,675

Leisure Care, LLC

Seattle, WA

Northeast, West and FL

3,503

Benchmark Senior Living

Senior Resource Group

19 20

Waltham, MA

Northeast

3,300

Solana Beach, CA

West, TX, SC, FL

3,169

Merrill Gardens

Seattle, WA

West, South, NA, PA

3,117

Belmont Village, LP

Houston, TX

West, Upper Mid-West, Mid-South, TX, FL and Mexico

2,870

Pegasus Senior Living

Dallas, TX

West, South and Northeast

2,710

Discovery Senior Living

Bonita Springs, FL

The Carolinas, FL, TX

2,641

Brightview Senior Living

Baltimore, MD

Northeast and Mid-Atlantic

2,405

Century Park Associates, LLC

Cleveland, TN

West, Mid-West, Northeast and South

2,384

Integral/Solstice Senior Living

Carlsbad, CA

Northeast, Mid-West, West and South

2,370

Oakmont Senior Living

Irvine, CA

CA, Las Vegas

2,322

Americare Senior Living

Sikeston, MO

West, South, Mid-Atlantic, OH, PA

2,316

Northstar Senior Living

Redding, CA

West, Upper Mid-West, TX, NC, FL

2,189

Prestige Care, Inc.

Vancouver, WA

West

2,183

Legend Senior Living

Wichita, KS

CO, FL, OK, KS, PA, TX

1,530

TOTAL

172,657 FIGURE 11.

Sunrise Senior Living Founded in 1981, Headquartered in McLean, Virginia, in the Washington, DC metropolitan area, the company employs approximately 32,000 people. Sunrise offers Senior Living services, including independent living, Assisted Living, care for individuals with Alzheimer’s disease and other forms of memory loss, as well as nursing and rehabilitative services.

HIGHLIGHTS

ASSISTED LIVING MANAGEMENT COMPANIES

www.sunriseseniorliving.com | CEO: Chris Winkle

Five Star Senior Living Five Star Living is one of the largest providers of Senior Living in the US with 252 communities in thirty-one states. They also have a subdivision, Agelity, that has 218 Outpatient Rehabilitation clinics in twentyeight states. 54% of their properties are in Assisted Living, but they have a mix of all types of Senior Living. www.fivestarseniorliving.com | CEO: Katie Potter

Enlivant Founded over 35 years ago, Enlivant has locations in twenty-six states and primarilyoperates Assisted Living communities. www.enlivant.com | CEO: Jack Callison

Trilogy Health Services Founded over 20 years ago, Trilogy Health Services provides multiple types of care communities with the bulk of its portfolio in Assisted Living in four mid-western states; Indiana, Kentucky, Michigan, and Ohio. www.trilogyhs.com | CEO: Leigh Ann Barney

Memory Care is a form of Senior Living that provides intensive, specialized care for people with memory issues. Many Assisted Living facilities and nursing homes have created special Memory Care units for dementia patients. There are also stand-alone Memory Care facilities.

memory care - TOP 30 Rank Company

Geography

Residents

Brookdale Senior Living

Brentwood, TN

National

9,796

Sunrise Senior Living

McClean, VA

USA, Canda and UK

6,353

Frontier Management, LLC

Portland, OR

West, Upper Mid-West, South, the Carolinas and Northeast

4,581

ALG Senior

Hickory, NC

3,277

Senior Lifestyle

LCS

Chicago, IL

National, excluding upper Mid-West

2,777

Des Moines, IA

West, Mid-West, Northeast and South

2,592

Five Star Senior Living

Newton, MA

Mid-West, Mid-Atlantic, Mid-South and FL

2,189

Pacifica Senior Living

San Diego, CA

West, the Carolinas, FL, RI

2,183

Sinceri, formerly JEA Senior Living

Jacksonville, FL

Northeast, West, South & Mid-West

1,896

Benchmark Senior Living

Waltham, MA

Northeast

1,606

Silverado Senior Living Holdings, Inc.

Irvine, CA

West, Upper Mid-West, Mid-Atlantic, TX

1,574

Watermark Retirement Communities

Tucson, AZ

Northeast, Mid-Atlantic, the Carolinas, FL, West

1,481

Merrill Gardens

Seattle, WA

West, South, NH, PA

1,460

Harbor Retirement Associates

Vero Beach, FL

Northeast, Mid-Atlantic, Mid-West, South, TX

1,249

Meridian Senior Living

Bethesda, MD

Northeast, West, Upper Midwest, South, TX

1,237

Lake Oswego, OR

Northeast, Mid-West, Mid-Atlantic, South & West

1,217

MEMORY CARE

14 15 16 17 18

Eclipse Senior Living Koelsch Senior Living

Olympia, WA

West, TX, IL

1,170

Belmont Village, LP

Houston, TX

West, Upper Mid-West, Mid-South, TX, FL, Mexico

1,118 1,116

Sonida, formerly Capital Senior Living

Dallas, TX

Mid-West, Mid-South and the Carolinas

Brightview Senior Living

Baltimore, MD

Northeast and Mid-Atlantic

1,052

Oakmont Senior Living

Irvine, CA

CA, Las Vegas

1,043

Sagora Senior Living

Ft. Worth, TX

TX, OK, FL, AL, CA

948

Northstar Senior Living

Redding, CA

West, Mid-West, TX, NC, FL

929

Validus Senior Living

Tampa, FL

South & TX

924

The Arbor Company

Atlanta, GA

Northeast, South, Mid-West & TX

912

New Perspective

Minnetonka, MN

Upper West

909

Integral/Solstice Senior Living

Carlsbad, CA

Northeast, Mid-West, West & South

896

Spectrum Retirement Communities

Denver, CO

West & Mid-West

889

Discovery Senior Living

Bonita Springs, FL

The Carolinas, FL, TX

870

Aegis Living

Bellevue, WA

West

864

TOTAL

52,287

FIGURE 12.

Frontier Management With homes in both Portland, Oregon and Dallas, Texas, Frontier Management provides guidance and ongoing support to Senior Living facilities across the country. With more than 120 locations across nineteen states, Frontier Management is one of the largest senior housing operators in the United States. www.frontiermgmt.com | CEO: Greg Roderick

HIGHLIGHTS

MEMORY CARE MANAGEMENT COMPANIES

ALG Senior ALG Senior LLC supports the essential and operational functions for a network of Senior Living facilities. ALG Senior partners with facility-level management to maintain efficiencies in human resources, accounting, marketing, and other areas as needed. ALG Senior is headquartered in Hickory, North Carolina, and its network reaches across the United States, with a heavy concentration in the Southeastern U.S. www.algsenior.com | CEO: Charles Trefzger

Pacifica Senior Living Pacifica Senior Living, a division of Pacifica Companies founded in 1978, has communities throughout Arizona, California, Florida, Idaho, Nevada, New Mexico, North Carolina, South Carolina, Oregon, Rhode Island, Texas, Washington, and Utah. www.pacificaseniorliving.com | CEO: Adam Bandel

Sinceri Senior Living Formerly JEA Senior Living, Sinceri is a premier, progressive Senior Living management company with over 35 years of experience, operating over forty communities in more than 18 states across the U.S. www.sinceriseniorliving.com | CEO: Chris Belford

Benchmark Senior Living Benchmark Senior Living was founded in 1997 by the company’s Chairman and CEO Tom Grape. Tom had long recognized the value of the consumer-centered approach to Senior Living and the many health and social benefits the philosophy offers residents. Today, Benchmark is a leader in Senior Living throughout the Northeast, offering independent living, Assisted Living, mind and Memory Care, continuing care retirement communities and respite care options in sixty-three communities across seven states. www.benchmarkseniorliving.com | CEO: Tom Grape

CONTINUING CARE RETIREMENT COMMUNITY

A continuing care retirement community (CCRC), also known as a life plan community, delivers independent living and an amenity-rich lifestyle with access to onsite higher-level care should their medical needs progress. This continuum of care ensures residents have the stability of remaining in the place they call home. These communities are often the size of a small town.

CONTINUING CARE RETIREMENT COMMUNITY (CCRC): TOP 15 Rank Company 1 2

LCS Five Star Senior Living

Geography

Communities

Des Moines, IA

West, Mid-West, Northeast and South

Newton, MA

Mid-West, Mid-Atlantic, Mid-South and FL

Century Park Associates

Cleveland, TN

West, Mid-west, Northeast and South

Brookdale Senior Living

Brentwood, TN

National

Erickson Senior Living

Baltimore, MD

Northeast, Mid-Atlantic, TX, CO, MI, FL

Watermark Retirement

Tucson, AZ

Northeast, Mid-Atlantic, the Carolinas, FL and West

Charlotte, NC

The Carolinas, CT, FL, GA

Chicago, IL

West, South and Mid-West

5 6 7

Senior Living Communities

Sunrise Senior Living

McClean, VA

USA, Canada & UK

Tutera Senior Living

Kansas City, MO

Mid-West and South

Oakmont Senior Living

Irvine, CA

California & Las Vegas

Chicago, IL

National, excluding upper Mid-West

Waltham, MA

Northeast

Senior Lifestyle

Benchmark Senior Living

Chateau Retirement

Lynnwood, WA

Washington

Omega Senior Living

Wichita, KS

KS, LA, MO, NE

TOTAL

268

FIGURE 13.

CONTINUING CARE RETIREMENT COMMUNITY MANAGEMENT COMPANIES

HIGHLIGHTS

Century Park Associates Founded in 1979, as Retirement Centers of America, with the goal of providing quality home accommodations and services for America’s growing number of active retirees. In 1988, the growing Senior Living company was formally incorporated as an independent management company, and a new name identity was created - American Lifestyle. In 2006, American Lifestyles became Century Park Associates. www.centurypa.com | CEO: Esmerelda Lee

VI Senior Living Vi Senior Living is a high-end retirement community developer, owner, and management group based out of Chicago, Illinois, United States. Vi maintains ten continuing care retirement communities in six states, including Arizona, California, Colorado, Florida, Illinois, and South Carolina. Founded in 1987 by Penny Pritzker, the privately held company houses over 4,000 residents and employs 2,700 workers as of May 2016. www.viliving.com | CEO: Randy Richardson

Tutera Senior Living Dominic F. Tutera, M.D., founded the Tutera Group, which later became Tutera Senior Living & Health Care, in 1983. His vision was Senior Living communities based on physical, emotional, spiritual, and intellectual well-being. www.tutera.com | CEO: Joe Tutera

Oakmont Senior Living Oakmont Senior Living is a recognized leader in retirement living known for providing five-star amenities, award-winning culinary programs, and professionally trained team members in purposebuilt communities www.oakmontseniorliving.com | CEO: Courtney Siegel

Senior Lifestyle Chicago headquartered Senior Lifestyle has senior care facilities across the United States. From Skilled Nursing to Short-Term Care and Affordable options, Senior Lifestyle offer a lifestyle experience. www.seniorlifestyle.com | CEO: Jon DeLuca

MARKET PENETRATION

With a market set to double in size in the next four decades in the population of residents, the assumption is that the overall revenue will also double which is an attractive opportunity in the foodservice landscape. Although it is true that many of the traditional markets have a level of self-operated foodservice operations, in Business & Industry this number is low and represents less than 5% of all operations, in Higher Education and Healthcare, probably in the region of 30%, but in Senior Living, the number of self-operated operations is more than 70%.

This makes for a double whammy opportunity for both market growth and market penetration.

Total Market Penetration 15%

82% FIGURE 14. Self-Operated*

$18B $16B $14B $12B $10B $8B $6B $4B $2B $-

Contracted Out*

Total Market Growth: Foodservice

2020 2025 2030 2035 2040 2045 2050 2055 2060 FIGURE 7.

Hybrid

*30% in Metro Top 100 Markets

WHY SUCH LOW MARKET PENETRATION? Insourcing versus Outsourcing – what is core business? The issue with Insourcing versus Outsourcing is about whether an organization views foodservice as a core or non-core part of the business. In K-12, food and nutrition is important, but there are limited resources or financing outside educating children to make room for the complexities of managing food. In Healthcare and in universities, the line between student and patient satisfaction, and the connection with food becomes more significant. In Senior Living however, food plays a fundamental role in the quality of life of all residents no matter in which sub-sector. Senior Living is a People Business Those who work in the Senior Living sector know that its more than a vocation, it is a commitment and passion. People care

for people, and the connections that staff across the sector make, the services and support they provide is an important part of the resident’s life experience. So many of the residents have enjoyed nourishing meals at home, prepared freshly from scratch, with recipes they may have had for generations. Loss of control and quality? Another issue is the perception of loss of control, or loss of quality. This can be readily rectified by ensuring that organizations outline the expectations of each party from the very outset and memorialize them in any agreements that are entered into by all parties. Remember, these agreements should never be purely about cost with a penalty for not hitting targets, but a collaborative approach and partnership with measurement mechanisms focused on outcomes.

Whether you are in Senior Living already, or you’re considering making an investment to enter the market. Here are some important fundamentals to consider:

to the highly vulnerable, there are distinct levels of care and service that need to be understood. Creating the right offer based on the expectations resources and financial model will be the key to success.

Quality of Life is paramount: beyond providing food on a plate, providing foodservice in this market has a different take, with food events being an important part of a senior’s day – a time to connect, interact, and something to look forward to – what else can you wrap around your foodservice program to make it stand out? Nutrition is important: from healthy eating to lifestyle diets, to medical needs, you will need nutritional expertise and rigor to ensure not only consumer and medical needs are met, but also government regulations.

Home food comforts: for many residents, the food experience is not necessarily about restaurant quality food, its about home food comforts and being a familiar experience to which they can connect.

Food diversity: The generations entering Senior Living have more diverse palates than ever. Programs should be designed to accommodate and provide everything from 1950s home food favorites to international cuisines to cater to specific and more diverse demographics.

Fundamentals

Understand the nuances of the market: from wealthy and healthy Boomers,

THE FOUNDATIONS OF SUCCESS

Passion for the business: It is critical in this segment to have the passion and empathy for how to enrich and nourish the lives of seniors. This is a different level of commitment as compared to a sports stadium or business & industry client and it takes genuine passion expressed through the service delivery to care for residents as if they are family.

Staffing: The availability of staffing is a challenge as many markets, and the Senior Living segments have struggled to attract and retain staff. This has been accentuated during the pandemic as people have taken the opportunity to make career changes and think differently about their employment prospects. Retention: One of the key challenges and opportunities will be how foodservice companies create more attractive employment packages including addressing minimum wage, benefits, retirement, and counterbalance the tip culture and benefits that exist in more retail focused operations.

Foodservice PROVIDERS

The current outsourced Senior Living market is dominated by a few companies with a large revenue and size gap between the top five organizations and the rest of the players. The high percentage of self-operated units makes for an appealing opportunity for existing players and new entrants. In the wake of the pandemic, many businesses are assessing more predictable revenue markets as a way in which to balance portfolios with more recession and pandemic proof markets. Business & Industry, Sports & Leisure, Events, even Education have taken a hit during the pandemic – and less volatile sectors like

Corrections, Healthcare, and Senior Living stand out as attractive add-ons. When you consider the projected growth of the Senior Living, the likelihood of more attention and activity in this market is very high – new market players, an increased focus by existing players, and likely consolidation through further acquisition into the future. Even before completing the writing of this report, Brookdale, one of the largest Senior Living service providers announced an out-sourcing agreement. Here is an introduction to some of the key players and the ones to watch.

k mar ems p yst ro u G

vic

ion

thomson Ho

Cul

rit

as Cu

Ser

ELIOR (CURA)

Foo

thom

n’s

tso

Whi

Ara

AV I Th

Gue

inar

isine

Inc

y. . .

s p ita l it y

vel e L t x ne ality Hospit ark) (aram

Senior Living:

Top 20 Foodservice

Compass

Market Share

Sodexo

Healthcare Services Group FIGURE 15.

Compass

Sodexo

Aramark

ELIOR (Cura)

Healthcare Services Group

AVI Food Systems

Thomson Hospitality

Guckenheimer

METZ Culinary Management

Thomas Cuisine

Whitson’s Culinary Group

Guest Services Inc.

HHS Culinary

Next Level Hospitality (Aramark)

The Nutrition Group

MMI Dining Services

Café Service Inc.

Better4You Meals

Food Management Group

highlights

foodservice management companies:Senior living

Compass Senior Living Communities British headquartered Compass Group continues to be the global foodservice powerhouse, which is the same in the USA, and in Senior Living. The Compass focus on supply chain is a leading driver of their economic engine in fueling their success, as is their strategy of acquisitions over the years. In a recent move, Compass have consolidated Senior Living operating brands including Unidine and Morrisons to create Compass Community Living. www.unidine.com | CEO: Richard Schenkel (Community Living)

ELIOR (Cura) French company, ELIOR have taken a brand by sector approach and have several branded companies operating across K-12, Higher Education, Business & Industry, Cultural Attractions, Corrections, Prepared and Community Meals, and Cura focused on Healthcare and Senior Living. ELIOR continue to grow and expand somewhat under the radar, and a major player in the North American market under the brand name of Cura. www.elior-na.com | CEO: Olivier Poirot (Group)

Sodexo Senior Living Sodexo, headquartered in Paris, is the world’s second largest foodservice organization. A major player in all traditional foodservice markets, Sodexo also has a large focus and presence in Senior Living. Making an impact, driven by purpose, Sodexo were an early entrant into the market and hence their place in the companies to watch. www.us.sodexo.com | CEO: Zeta Smith

Aramark (Next Level Hospitality) Philadelphia giant Aramark is the worlds #3 largest foodservice company with operations in twenty countries globally. In addition to foodservice, Aramark also has a substantial facilities services, uniforms, and refreshment services business. In 2021, Aramark announced the acquisition of Next Level Hospitality, a $160M revenue organization focused on Senior Living, and Aramark’s entry to the market. www.aramark.com CEO: John Zillmer (Group)

CEO: David Carpenter (Next Level)

Healthcare Services Group Founded in 1976, the original iteration was a healthcare housekeeping business. Through multiple acquisitions and regional expansion throughout the United States HSCG Corp now has over 3,000 locations that provide EV and Dietary and Dining Services. Approximately 48.1% of the company’s revenue via an on-site district management model in Senior Living. Dining and Dietary services include food purchasing, meal preparation and professional dietitian services, which include the development of menus that meet the dietary needs of residents as well as clinical consulting at an additional fee. www.hcsgcorp.com | CEO: Ted Wahl

Guckenheimer (ISS)

www.guckenheimer.com | CEO: Paul Fairhead

METZ Culinary Management Family founded and owned; METZ Culinary Management continue to make strides in growth. From a foundation of foodservice, environmental services, and housekeeping service additions, make METZ a more attractive proposition to the Senior Living market. www.metzculinary.com | CEO: Jeff Metz

Thomas Cuisine

www.thomascuisine.com | CEO: Alison Patt

Thompson Hospitality Thompson Hospitality, based in Virginia, is one of the largest, minority owned management company in the country. Celebrating 25 years in 2021, they have holding in Senior Living, Higher Education and own a multitude of private restaurants. www.thompsonhosplitality.com | CEO: Warren Thompson

watch list

Thomas Cuisines Is an award winning, privately held contract foodservice company based in Idaho whose portfolio includes Senior Living, Healthcare, Corporate Dining, Higher Education and Sports and Leisure. Their management philosophy is one of sustainability in supporting local growers, creating menus that are additive free and whole food based to reduce waste.

foodservice management companies: senior living

Since the acquisition of Guckenheimer by Danish facilities services organization, ISS, the opportunity to double down and expand food as part of the combined services offering is significant across all markets including Senior Living. The opportunities presenting themselves as a result of the acquisition remain to be seen how they will play out.

According to the International Council on Active Aging, trends for the future in Senior Living encompass a variety of factors. Most notably, creating multi-use and multi-generational communities with resources for seniors as well as the workers that care for them. By expanding the built and unbuilt environments to include different housing options, proper green space planning and virtual healthcare spaces that promote a culture of wellness and a lifestyle of continued personal growth. Another key trend is integration of technology in spaces for both staff and residents by providing Internet connections, software and hardware that are available both indoors and outdoors. Wearable technologies, including activity trackers and heart rate monitors, and rooms outfitted with smart utilities, remote monitoring, voice-activated systems, and in-house channels embedded in living and service areas.

Trends

Staffing will continue to be a challenge in an industry that suffered shortages pre-Covid. In addition to recognition, increased wages and benefits, on-site healthcare, dining, and other amenities will be important considerations for attracting and retaining employees. Professional development and advancement opportunities, along with flexible work schedules and options for affordable housing near the workplace, could help relieve staff turnover while reducing travel time and the need for employees to hold second jobs.

Rising healthcare expenditure Increased awareness in healthcare benefits Access to easy-to-use services Tele-medicine is on the rise Greater adoption of technology Continual care becoming more attractive to people aged 50+ Aging in place is increasing in popularity and accessibility

Dining trends in Senior Living focus on restaurant style dining with an emphasis on venue design and menus that provide sustainable, local, whole food-based choices that also decrease waste. Menus must have wide variety and preferably be available twenty-four hours a day, seven days a week. For those Seniors with specific texture or temperature needs there has been a rise in the production of foods that are not necessarily pureed, but ground and reshaped. Other trending options include traditional retail style grab and go, snack carts and multiple dining venues on site. Lastly, but perhaps most importantly, Food as Entertainment or Eatertainment is a must. Examples include traditional holiday events and celebrations to hosting a local celebrity chef to pop-up events in non-traditional venues.

53% 45% 22% 30% 19% 31% 42%

of Senior Living facilities offer made-to-order items offer on-the-go foods feature a convenience store or micro-market offer snack carts or snack stations use foodservice management firms outsource some food preparation to commissaries use tablet ordering

Here are some of the opportunities we have identified as part of our research and conversations with key people within the Senior Living market:

THE BOOMERS ARE HERE!

Opportunities

The Boomer generation have been the most impactful generation of the past one hundred years - better educated, well-traveled, with more disposable income than ever before. Here are just some implications on the Senior Living market:

DISPOSABLE INCOME

The Boomer generation are wealthier per capita than previous generations. Home ownership, raising real estate values, stock investments and gains and higher income to cost of living ratios means that they are not only more discerning but have a greater wallet share opportunity for the right offerings.

MORE TECHNOLOGY SAVVY

As the Boomer generation enters the Senior Living market, most are technology savvy which is a watershed on previous generations. For operators in this space, this represents a transformational opportunity to better engage with residents, utilizing similar tools to those in other sectors including Higher Education and Business & Industry.

GLOBAL MENUS

They are also more traveled than any previous generation with an eclectic and varied international palate. No longer will pot roasts and cheeses sandwiches and soup do it. Modern dining programs need to be not only high quality but diverse too.

THE EXPERIENCE ECONOMY Customer experience (CX) is the most important driver of satisfaction, loyalty and spend – and personalization and choice fuel success here. Henry Ford made one vehicle, one specification, and one color of the Model-T. Today, the car maker Mini produces over one million configuration options. It is no longer just about the product but the experience that goes with it, and the same applies in the Senior Living market. The Senior Living market is a unique blend of mainstream customer service with a dash of patient experience added to the mix. This is a distinction worth understanding, as the mainstream marketplace values speed, variety, choice, and quality – while the patient experience prioritizes empathy, patience, and explanation as well. As you move through the continuum of Active Living through Skilled Nursing Care, priorities tend to shift and may also include the inclusion of family within the mix as well as the direct resident. Understanding the experience priorities of each segment will help you craft your overarching experience strategy as well as prioritize your steps of customer service for your resident-facing teams.

FOOD+EXPERIENCE+COMMUNITY

Exceptional quality and varied menus are a cost of entry today. It is also about the experiences that come with it and the impact food can have on the community. Since the beginning of humankind, food has been at the very heart of the community, as has the kitchen, and what better place to start then from the heart of the Senior Living community, at all levels.

EATERTAINMENT

From the baseline of food, what else can operators do to connect the dining experience with entertainment? This should be a major focal point around designing and building the food program, think out of box, and push the envelope. Remember, for many, the dining experience is one of the only shareable experiences that becomes the highlight of the resident’s day in the form of a cohesive community event. We talk about the ubiquitous holiday celebrations and theme events, but what about cooking classes, keynote speakers, dinner dances, captains’ tables? The options are almost endless, just a bit of imagination can really elevate the resident experience.

COMMUNITY ENGAGEMENT RESOURCE

Consider the investment in community engagement resources to connect the foodservice operations with the facility’s management team and the outside community to create a cohesive and engaging Eatertainment program.

BEYOND FOOD

Then beyond the food event itself, what else can you do to contribute to the overall experience? Think classes, field trips to local farms and producers, local restaurant tours.

CONVENIENCE

Another huge driver of the consumer today is ease of use, ease of engagement, and convenience, no less so in the Senior Living market: food when you want it, meal delivery, and room service.

HOME FROM HOME

What are the extra steps you can take to make the experience feel like home? Cooking of family recipes, creation of family friendly experiences, accommodating a pet friendly environment are just some, because…as we all learned in our youth, there really is no place like home.

LONELINESS IS A THING

The pandemic has accelerated a lot of issues that already existed and loneliness, especially for senior citizens is a major issue. The pandemic has compounded the problem of absent loved ones. Loneliness can have a significant impact on happiness, mental wellbeing, and health by creating connections through food experiences.

Many Baby Boomers are a social, dinner party crowd and they like to be entertained. That is why one of the more popular senior dining trends is open exhibition kitchens and interactive stations where residents can choose their ingredients and have dishes cooked to order.

AND FINALLY, ABSENT LOVED ONES

An often missed, and crucial element to the Senior Living market is the role that absent loved one’s play. Not only are they often the decision makers for their parents and the normal source of funding, but absent loved ones are also able and willing to provide access to additional services to make their parents and grandparents have a better day and a better experience.

GIFTING MAKES THE HEART GROW FONDER

There is a substantial opportunity for service providers in this space to create gifting options. Beyond a pair of slippers, a bunch of flowers or a crossword puzzle or two, gifting brings the ability to not only increase potentially more profitable revenue but enhance the quality-of-life experience. Imagine being able to upgrade to a prime cut steak for their table, a birthday cake, pay for exercise classes, or even a bottle of wine on a Friday night. Opportunities exist to establish a gifting platform with ease of access and regular communicating options to further improve the experience for this crucial stakeholder group while also driving revenue for the operator. 38 | 4xi GLOBAL CONSULTING & SOLUTIONS. © 2022 ALL RIGHTS RESERVED.

Increasingly, communities are taking a page from the hospitality industry’s handbook by hiring renowned chefs and other culinary team members. It is now commonplace to find that a Senior Living community’s executive chef trained at the best culinary schools around the globe and come from 5-star restaurants, hotels, resorts, and clubs.

Please use the following as an aide memoire to what some consider complex references and definitions unique to the market.

Definitions

Active Living: The World Health Organization defines active living as, “A way of life in which physical, social, mental, emotional and spiritual activities are valued and are integrated into daily living.” The links between physically active living and healthy aging are well established, many studies show that even moderate physical activity helps seniors maintain independence, reduces the risk of falls and fractures, and assists in managing chronic conditions. Assisted Living: An Assisted Living residence or Assisted Living facility (ALF) is a housing facility for people with disabilities or for adults who cannot or who choose not to live independently. The term is popular in the United States, but the setting is like a retirement home, in the sense that facilities provide daily care with personal needs, a group living environment and typically cater to an older adult population. Continuing Care Retirement Communities (CCRC’s): A continuing care retirement community (CCRC), also known as a life plan community, delivers an independent living and an amenity-rich lifestyle with access to on-site, high-level care. Should a senior’s medical needs progress, services in the form of Assisted Living, Skilled Nursing and Memory care are available on-site. This continuum of care ensures residents have the stability of remaining in the place they call home. Home Care: In-home health care is a wide range of health care services that can be given in your home for an illness or injury. In-home health care is usually less expensive, more convenient, and just as effective as care you get in a hospital or skilled nursing facility. Independent Living: Independent living, as seen by its advocates, is a philosophy, a way of looking at society and disability, and a worldwide movement of disabled people working for equal opportunities, selfdetermination, and self-respect. In the context of eldercare, independent living is seen as a step in the continuum of care, with Assisted Living being the next step. Memory Care: Memory Care is a form of Senior Living that provides intensive, specialized care for people with memory issues. Many Assisted Living facilities and nursing homes have created special Memory Care units for dementia patients. There are also stand-alone Memory Care facilities. Skilled Nursing Care: Skilled Nursing Care is combination of nursing and Rehabilitation therapy care that can only be safely and effectively performed by, or under the supervision of, professionals or technical personnel. It is health care given when you need skilled nursing or skilled therapy to treat, manage, and observe your condition, and evaluate your care. Most SNC is conducted in specialized nursing homes but can also occur in at home care and in Memory Care facilities.

and further reading

Sources

We have used the following sources in the preparation of this report, and provide further sources and references for further reading: • • • • • • • • • • • • • • • •

U.S. Census Bureau Food Management Top 50 Management Companies 2021 Fermag.com Glendale Dining Services Culinary Services Group Senior Living Impact National Institute on Aging Aging McKnight’s Senior Living Argentum American Senior Housing Association National Investment Center for Seniors Housing & Care Grandview Research Foodservice Director Administration For Community Living Senior Living

• Strategic Advisory • Design for Life • Amenities & Operations

• Customer and Employee Experience • Strategic Partnerships & Growth • Innovation

INSPIRING THE FUTURE, TOGETHER

RETAIL PRICE: $499

4XI: MARKET RESEARCH

INSPIRING THE FUTURE, TOGETHER www.4xiconsulting.com | Hello@4xiconsulting.com

Senior Living Proof 5

Articles inside

Assisted Living

Skilled Nursing Care

History

Senior Living, Aging In Place

Independent, Active Living, Or CCRC’s

Independent Living

Memory Care

Continuing Care Retirement Communities