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1、INVESTORSURVEYANDTRENDSREPORTU.S.SENIORLIVING&CARENOVEMBER2023PhotoprovidedbyNationalDevelopmentInthisreportOlKeyFindings02PropertyMarkets03CapitalMarkets04ValuationIndex05InvestorSurveyResults06SeniorsHousingOutlook/UlKEYFINDINGS U.S.seniorshousingpropertymarketfundamentalscontinuetoimprove.Stabili
2、zedoccupancytrendedupwardovertheprior10quarters,reaching86%,asrentgrowthremainedintactat5%throughthethirdquarterof2023.Cushman&Wakefieldexpectstoseecontinuedimprovementinpropertymarketfundamentals. Northeastmarketsareexpectedtoshowthestrongestnear-termperformance.MarketsintheSouthwestandSoutheastare
3、expectedtoexperiencedownwardpressureonoccupancyandrentgrowthintheneartermasnewsupplyisintroduced. Seculartailwindsarestrongerthanever,asconstructionstartstoslowtothelowestlevelssincetheGreatFinancialCrisis(GFC).Tomeetdemandatpeaklevels,supplygrowthmustincreaseby35,(XX)unitsperyear,beginningtoday. Af
4、fordabilityremainsunsolved.Withthenumberofmiddle-incomeseniorsprojectedtodoubleby2029,overhalfofthissegmentwillnothaveadequatefinancestoaffordtraditionalassistedliving. Operatorswilllearntoscale,andpartnershipsbetweenoperatingcompany(OpCo)andpropertycompany(PropCo)willevolve.Accelerationoftrendsandi
5、nnovationsintechnology;integratedcareandcaredeliverymodels;infrastructure;anddesignwithgreaterbranddiversificationarebeginningtoemerge. Thecostofdebtisstressingshort-termvaluations,withseniorlivingtransactionvolumedown51%year-over-year(YOY)zandthepriceperUn什，at$111,000,downnearly54%frompeakpricing.M
6、ostownersW计hwell-locatedpropertiesandhealthyoperatingperformanceareoptingnottosellduetothemarketdislocation.Skillednursingvolumewasdownonly17%,withthepriceperbedreachinganall-timehighof$109,500inthefirsthalfof2023.,Impendingloanmaturitiestotaling$16billion-expectedwithinthecoming24months,alongwithfu
7、nd-lifeexpirations,willcatalyzetransactionactivitywithincreasedinvestmentsfromthosewhoarewellcapitalizedandlessreliantonleverage. Cushman&Wakefieldsvaluationindexreportson$32billioninaggregatethird-partyvaluationscompletedoverthepast12months.Same-storeindicesextractedfromthisdatasetindicateaYOYincre
8、aseincapitalizationratesforseniorliving,rangingfrom75to125basispoints(bps),withvaluationsdecliningby12%to18%onaverage. Ofthemorethan90peoplewhoparticipatedinCushman&WakefieId1Sinvestorsurvey,68%expecttoseeacontinuedincreaseincapitalizationratesoverthenext12months,withdebtmarketliquiditybeingthetopco
9、ncernof51%oftherespondents. Mostinvestors(49%)aretargetingcore-plusinvestmentstrategies,followedbyassistedlivingat33%andactiveadultat23%.Nearly34%ofrespondentsarefocusedonopportunisticordistressedinvestmentstrategies. Marketparticipantsareunderwritingnegativeleverage:uptooneyearfor44%ofrespondentsan
10、duptotwoyearsfor31%ofrespondents.Still,19%ofsurveyrespondentsarenotwillingtounderwritenegativeleverageaspartoftheirinvestmentstrategy.Someinvestorsareelectingtopurchaseonanunleveredbasisasdebttermsforopportunisticbuysaredilutivetoreturns. Basispointspreadsbetweenthegoingincapitalizationrate,thedisco
11、untrateandterminalcapitalizationratehavecompressed,indicatingthatmarketparticipantsareexpectingtoseeimprovementinthecurrentinterestrateclimateoverafive-to10-yearholdingperiod. Environmental,socialandgovernance(ESG)considerationscontinuetogainnotorietyintheseniorshousingandcaresector,with59%ofsurveyr
12、espondentsviewingESGinitiativesasbeingapositiveattribute,butonly9%willingtoprovideapremiumtopricingwhereESGisprevalent.UZPROPERTYMARKETSPRIMARY MARKETSInventory GrowthAbsorption Stabilized OccupancyOCCUPANCYSeniorshousingperformancecontinuestoacceleratewithstabilizedoccupancytrendingupwardforthetent
13、hconsecutivequarter.TheNationalInvestmentCenterforSeniorsHousing&Care(NIC)reportedstabilizedoccupancyat86%forprimarymarketsand87%forsecondarymarketsforthethirdquarterof2023.Thoughtrendinginapositivedirection,theselevelsremainwellbelowpre-pandemicaveragesof90%and90.2%,respectively.ASKINGRENTALTRENDST
14、herateofannualrentgrowthreachedanall-timehighinthesecondquarterof2023,at5.9%inprimarymarketsand5.9%insecondarymarkets,whichtaperedslightlyinthethirdquarterto5.4%and5.6%respectively.Assistedlivingmarkedthehighestrentgrowthat6.4%,withrentgrowthforindependentlivingaveraging5.2%.Recentvaluationsconducte
15、dbyCushman&Wakefieldhaveidentifiedannualrentgrowthinthe7%to9%rangeinkeymarketsthroughouttheU.S.SUJ。,JoqEn10,OOO5,00-5,000MHMBJ*kMmULllLbfeMlbfi-10,000AQUOdnOOOPaZ三qasCccccc8-8-ZoZoeLoo-Oeoe00088-60Nco6-020-8一。Com58-zo09一。臂9三CxlO-SON0COSLOSOLFoeoeFOmL8oeggo0Z-OZ:0coZ-c-Source:Cushmon&VVakefieJdResear
16、ch.NICMAPsronzQ32023SECONDARYMARKETSs*uJQ-lquJN0306HOSoSOeoe0coOzo30L6oeco6oe0L8一OeoeogNONOCOZOCSI0L9oNg9-0oLSLooeS-OSeLq5eoeg5eoe20aeoNOcodo-ABSORPTIONAbsorptionhasoutpacedinventorygrowthfornineconsecutivequartersasthenumberofoccupiedunitsreachedanall-timehighinthethirdquarterof2023.Duringthisperio
17、d,absorptionhasoutpacedinventorygrowthbynearly3x.Theannualrateofabsorption,whichsubsidedinthethirdquarterof2023to4.3%inprimarymarketsand3.9%insecondarymarkets,stillwellabovehistoricalaverages.Demandisanticipatedtocontinuethroughtheremainderof2023andinto2024.Withconstructionstartscontinuingtosubside,
18、favorableoccupancyandrentgrowthtrendsareexpectedtocontinue-acriticalcomponentofoffsettingtheincreasedoperatingexpensescausedbythelaborshortageandincreasedinsurancepremiumscomingoutofthepandemic.Fromapropertymarketsstandpointthesectorwillonceagainproveitsrecessionaryresilientreputation.CONSTRUCTIONTR
19、ENDSSlowingconstructionstartsrepresentasilverliningforowners.Despiteanincreaseindevelopmentappetiteandarobustneedforadditionalsupplyinmostmajormarkets,thelackofliquidityandcostofdebthasrestrictedconstructionstartstothelowestlevelinoveradecade.Thisdeclineinconstructionstartswillonlymagnifysupplyshort
20、agesasourpopulationcontinuestoage.Valuationchallengesvarybyregion,duetolimitedtransactionaldatapointsandshiftingpropertymarketfundamentals.Marketswithhighoccupancyandlowconstructionvs.inventorywillexperiencethegreatestrentgrowth.Onaverage,northeastmarketspresentthestrongestmarketfundamentals.QUARTER
21、LYCONSTRUCTIONSTARTS-PRIMARY&SECONDARYMARKETS一00INozgIeweIUIoooIMMO-I6_03gI6-0c-II20oIIo-I二0舄Iz-ozo-I9-0ZgI9-03。-Is-ooIg-0Zo-IBP-OZgIHagI8-OZDe20Zo一de-StabilizedOccupancyMARKETLEVELPERFORMANCEAnnualRentGrowth(%)Constructionvs.Inventory(%)Source;Cushman&WakefieldResearch.NICMAPVision,Q32023LONG-TERMD
22、EMANDTRENDSPOINTTOSIGNIFICANTSUPPLYSHORTAGEConsumerdemandisexpectedtoOVerWhelmthemarketW计hinthenextfiveyears,atalllevels,withnetdemandprojectedtoturnpositiveasearlyas2025.Theaverageageatmove-inforseniorlivingpropertieswillrangefrom75foractiveadultto83yearsofageforassistedliving,accordingtotheAmerica
23、nSeniorsHousingAssociation(ASHA).Thispopulationsegmentwillexpandsignificantlyoverthenextdecade.1.ookingattheover-80demographic,demandwascalculatedbasedonamarket-extractedpenetrationrateof7.9%from2016,whenstabilizedoccupancywas91%.Supplygrowthwasestimatedbasedonatrailingfive-yearaverageof80+LONGTERMD
24、EMANDOUTLOOKapproximately26,000unitsperyear,withcurrentlevelsmuchlowerasconstructionstartsdecline.Tomeetdemandatpeaklevelsfortheover-80populationsegmentestimatedfor2045,thesectormustincreaseannualsupplygrowthby35,000unitsperyear,beginningnow.AFFORDABILITYREMAINSLARGELYUNSOLVEDThenumberofmiddle-incom
25、eseniorswillnearlydoubleby2029,astheover-80populationincreases.AccordingtotheNationalInvestmentCenterforSeniorsHousing&Care,60%ofthispopulationsegmentwillhavemobilitylimitations,with20%requiringhighhealthcareorfunctionalneeds.Demand(80+)Supply(Avg.)Population(80+)Equilibriumsuo三工353025201510SUo三一16q
26、oe等0NNqoe4Oe。(N寸寸。CN*0NWOeWeOqoe6COOeoCMZeoS9co0NSeONkcoo(NWoeNSOeOcoe6eoN8N0eNeoS9eo(NSeoeqeoCN30NeeoNOeoo 5 ， $3C$2$2$1$1$ $SUO=SHoeOco Oeozoe Owg 6eos 650 8-0ec* 0oL Zoeoco ZLOeOL 9 L Oeoe 980 90Noco nooe 5Oeo- So&co 65eo- doco eoe。一 Loe0co -oeo- ooN0fo 0-02。一 6NOC9 60Oeo- 8Z0CO 800ZUKg9oeg9-020-
27、S-O20gS-Oso-oeocoEo2oo20-e-oogZ-Oso-二oe二Oeo-00NeS20-60OeOg68e0Leooeoe8-$0INVESTMENTYIELDSTotalannualizedreturnsforseniorshousingfellinrecentquarters,primarilydrivenbytheincreasingcostofdebt,achallenginglabormarketandanincreaseincostsofotherkeyoperatingexpenses.Asoperatingexpensesbegintopullbacktomor
28、enormalizedlevels,thecostofcapitalremainsaloomingconcernasinvestorspreadsbetweencapitalizationratesandthe10-yearTreasurycompresstothelowestlevelsinoveradecade.TheFederalReservebeganraisinginterestratesinMarch2022,with11hikestakingplacesince.Inthethirdquarterof2023,the10-yeartreasury(IOY)averaged4.38
29、%,markingnearlya300basispointincreaseduringthisperiod.Thelasttimethe10Ywasatthislevelwas2002andthe10Ywasat3.97%,Duringthisperiod,theaveragecapraterecordedforseniorhousingwas8.1%andmovedupto9.3%.1.ookingattheaveragespreadbetweenthe1OYandcapitalizationratesoverthepasttenyears,seniorshousinghasaveraged
30、a465basispointspreadwithacurrentspreadofonly212basispoints.Thiswouldindicatecontinuedupwardpressureoncapitalizationratesasthemarketcontinuestoadjusttothehighercostofcapital.Short-termreturnswillbechallengedthrough2025,primarilydrivenbycapitalreturns,asoccupancyandrentgrowthcontinuetoimproveandoperat
31、orsfindwaystoreduceoperatingexpenses.CAPITALFLOWCclP计Qlsourcesareshiftingasinvestorsseekrisk-adjustedreturns.Riskpremiumsareadaptingtothelackofliquidityandcurrentpricinginthedebtmarkets,andassuch,arereconsideringwhichpropertytypesarelikelytodeliverthebestrisk-adjustedreturns.2023hasproventobetheyear
32、ofportfoliooptimizationforseniorshousinginvestors,asthemarketadjuststothecurrenteconomicclimateandvaluationsreset.Privateequityisselectivelyactivebutislargelyinwait-and-see*mode,giventhecostoffinancingandthepotentialforassetpricereductions.PubliclylistedREITshaveacquirednearly$4.6billioninseniorshou
33、singpropertiesyeartodate,representing60%oftotalinvestmentdollarsinthesector.However,thesameREITshavedivestednearly$4.5billionoverthesameperiod.Privatecapitalthesecond-largestinvestorinseniorshousingyeartodate,hasacquirednearly$2.7billion,with$2.5billionindivesturesoverthesameperiod.Cross-borderinves
34、tmentwasalmostnonexistentinthefirsthalfof2023,withinstitutionalinvestorsbeingthelargestsellersofseniorshousingrealestate,divestingnearly$560millionyeartodate.NETACQUISITIONSBYBUYERTYPE(BILLIONS)$8PrivateREIT/ListedInstitutionalCross-BorderSource:RCAandCushmon&VVokefieWResearchCAPITALIZATIONRATESVS.1
35、0YEARTREASURY(BASISPOINTS)Avg. Spread - SeniorsSpread-SeniorsSpread-Apts.,Avg.Spread-Apts.850Source:CUshmCrC&WakefieldResearch.NICMAPVision,Q32023U4VALUATIONINDEXTheCushman&Wakefieldvaluationindexrepresentsanaggregationofmark-to-marketvaluationconclusionsfromnearly2,200U.S.propertiesthatwerevaluedwi
36、thinthepast12months.Theaggregatemarketvalueofthisproprietarydatasettotalsapproximately$32billion,or6.8%ofthetotalestimatedmarketcapitalizationof$470billioninstitutionalseniorshousingandcaresupply.MajorityActiveAdultLowerDecileLowerQuartileAverageUpperQuartileUpperDecileStabilizedOccupancy(%)85879093
37、96EffectiveMonthlyRentperRevenueUnit($)1,3161,9712,2452,4943,266ExpenseRatio(%)3741434853CapitalizationRate(%)4.95.25.86.36.8StabilizedMarketValueperRevenueUnit($)11Z412175,912291,354391,921498,969MajorityIndependentLivingLowerDecileLowerQuartlleAverageUpperQuartileUpperDecileStabilizedOccupancy(%)8
38、687929395EffectiveMonthlyRentperRevenueUnit($)2,5233,2213,9544,8886,239ExpenseRatio(%)5860666976CapitalizationRate(%)5.97.26.36.87.8StabilizedMarketValueperRevenueUnit($)86,870162,924283z242386,111511,232MajorityAssistedLivingLowerDecileLowerQuartileAverageUpperQuartileUpperDecileStabilizedOccupancy
39、(%)8689929395EffectiveMonthlyRentperRevenueUn什($)3,1563,7775J755,9917,834ExpenseRatio(%)6669727880CapitalizationRate(%)66.57.27.98.3StabilizedMarketValueperRevenueUnit($)99,088152,256283,223346,281562,616MajorityMemoryCareLowerDecileLowerQuartileAverageUpperQuartileUpperDecileStabilizedOccupancy(%)8284899092EffectiveMonthlyRentperRevenueUnit($)3,2013,71447225,3766,789ExpenseRatio(%)5561757882CapitalizationRate(%)7.27.98.28.78.9StabilizedMarketValueperRevenueUnit($)89,672121,46518L697241,572355,401MajorityNursingCareLowerDecileLowerQuar
