Before I dive directly into the main topic of this blog, I want to reveal an eye-opening stat, as I think it adds some weight to what I’m going to discuss. Here it is. Would you believe that 10,000 baby boomers retire each day in the U.S.? It’s true. Yes, I said 10,000…EACH…day.

Now, at some point, these individuals (whether they’re your Grandma, Grandpa, Mom, Dad, Aunt, Uncle, Brother, Sister, or you, yourself) may need and/or want to move into an assisted living facility. This is why it’s so important to know what’s going on and the trends and challenges facing the senior living community.

I’ve done my best to break the topics down in an easy-to-understand format; however, don’t hesitate to reach out if you have any questions! The specific trends/challenges I’m going to discuss (in no order of importance) are:


First up is occupancy. Occupancy continues to be pressured lower by the introduction of new inventory and greater competition.

The occupancy rate for senior housing across the U.S. in the third quarter was below 88 percent, according to new data recently released by the National Investment Center for Seniors Housing & Care. In assisted living, the rate remains near its lowest point since 2006.

Why is this being discussed? Well, low occupancy could adversely impact operating results for owners/operators, which could prevent some facilities from being able to provide the services that attracted residents to begin with. Or, owners may be forced to sell, potentially causing an adverse effect on the culture of the chosen facility.


Staffing is consistently a challenge for the senior living world. Recruitment and retention have been ongoing issues, and now there’s pressure to increase wages, due in part to the $15 per hour minimum wage being instituted by some municipalities and online retailers, such as Amazon. With the national unemployment rate at 3.7 percent for September 2018 (Iowa at a 2.5 percent unemployment rate), it’s understandable why an employee would choose to leave a lesser-pay environment, such as a senior living community, when they can make a minimum $15 per hour elsewhere. Now, I’m not saying all senior living facilities have a lesser minimum wage, I’m simply making a point about the environment we live in today.

Regulatory Pressure

Between June 2017 and June 2018, 29 states made changes to regulations, statutes, and policies affecting assisted living, according to a report issued by the National Center for Assisted Living. Additionally, 9 states made changes that affect training or qualifications for assisted living staff members and many others are already reviewing state regulations to increase staff training and expand background checks.

Why is this important? While some federal rules and regulations may apply to assisted living communities, states typically establish and enforce licensing and certification requirements for assisted living communities. The ever-changing regulatory environment will determine which states are innovative and able to continue to define the role assisted living will have in the spectrum of senior care. States should enable providers to develop services supported by local consumer demand.

Resident Acuity Levels

The definition of acuity is the intensity of the level of services necessary to provide care to a resident on a daily basis, including both physical and emotional needs. As you can imagine, there are some blurred lines with respect to skilled care. Assisted living nurses are having to coordinate more clinical care than ever before — staging pressure ulcers, providing dressing changes, and watching for substance abuse and drug use. In some states, medical and recreational marijuana are a challenge, as is the opioid crisis, affecting both residents and staff or potential staff, alike.


Yes, bullying is an issue in senior living communities. I previously discussed this in a blog called, “Help Stop the Bullying.” By bullying, I mean resident to resident and, in some cases, it involves those with dementia. 

Tackling the Trends

What can senior living/assisted living leadership teams do to help combat these issues? Well, culture is the key. You need to have an environment where employees feel engaged. There are a lot of companies that have a great strategy and access to an abundance of capital, but they’re not going to be able to execute because they don’t have the ability to attract and retain employees.

At Holmes Murphy, we feel strongly that it all starts with a customer’s culture. Beliefs are powerful, and our beliefs are what drive us every day. We believe your cultural values will drive your risk management performance. We believe leading behaviors correlate with lagging outcomes, and most importantly, we believe your greatest potential is our professional responsibility. Said more simply, behaviors drive outcomes, culture drives behavior, and we feel it’s our ultimate responsibly to make you the best you can be. I’d be happy to talk with you about this if you’re struggling on employee engagement and aren’t sure what steps to take next. Additionally, if you have any questions about the trends/challenges facing senior living communities, don’t hesitate to reach out to me!