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Senior Living & Post-Acute Care

Senior living and post-acute projects are financed on occupancy and regulated by level of care. The building has to match the license it will operate under, and renovations have to keep residents safe and census stable while work goes on around them.

Project types

Independent and assisted living

Memory care

Skilled nursing facilities

Post-acute and rehabilitation units

Continuing care retirement communities

Repositioning and renovation of existing communities

Where projects fail in this sector

These are the failure modes that recur in this sector — and the questions the firm examines to surface them early.

  • Licensure category not matched to the building

    Assisted living, memory care, and skilled nursing are licensed differently and carry different construction and life-safety requirements. We examine whether the building's design matches the license the owner intends to operate under, including any future change in level of care.

  • Phasing that ignores census

    In an occupied community, every wing taken offline is lost revenue and a set of residents to relocate. We test whether the phasing plan reflects census targets, resident moves, and the operator's capacity to manage them.

  • Memory care security and wayfinding left to finishes

    Secure perimeters, door controls, outdoor space, and wayfinding shape layouts and life-safety approvals. We look at whether these were decided with the operator before design detail, not added at the end.

  • Pro forma dates that the approvals cannot meet

    Lease-up and financing assumptions depend on an opening date. We examine whether that date allows for plan review, inspections, and licensure surveys, and what the model does if it slips.

  • Resident safety during construction under-planned

    Residents are often frail, and some cannot evacuate unaided. Interim life-safety measures, noise, dust, and access routes need planning with the operator. We look at whether those plans exist and who is accountable for them.

Common questions — Senior Living & Post-Acute Care

Why does the licensure category matter so much in senior living construction?

Because the level of care a building is licensed for determines which construction, fire protection, and life-safety requirements apply. A building designed around one category can be expensive or impossible to convert to another. Settling the intended license — and any plan to change it later — before design is one of the most consequential early decisions.

How should a community renovation be phased around residents?

Around census, resident safety, and the operator's capacity to manage moves — not only around construction efficiency. Each phase takes rooms out of service, may require relocating residents, and changes routes and noise levels for everyone else. A phasing plan that the operator has not agreed to is not yet a plan.

What does an owner's representative do for a senior living developer?

Represents the owner across the operator, design team, builder, and approving agencies, and gives investors and lenders an independent view of cost and schedule. The attention goes to licensure fit, the approval path, phasing, and whether the opening date in the pro forma can be met. It does not direct construction means, methods, sequences, or site safety.

When should a senior living investor commission an independent review?

Before capital is committed to a development, an acquisition with a renovation plan, or a repositioning. The review tests whether the program, licensure category, schedule, and budget support the financial model while the owner still has room to change them.

Talk through a project in this sector.