Senior Housing Brokerage
Complete Guide (2026)

Senior housing brokerage is a specialized segment of commercial real estate focused exclusively on the acquisition, disposition, and advisory services for senior living and post-acute care properties.

Unlike traditional commercial real estate, senior housing brokers must understand clinical operations, regulatory compliance, reimbursement models (Medicare/Medicaid), staffing ratios, occupancy dynamics, and state-specific licensing requirements.

The senior housing brokerage market encompasses Independent Living (IL), Assisted Living (AL), Memory Care (MC), Skilled Nursing Facilities (SNF), and Continuing Care Retirement Communities (CCRCs).

The U.S. senior housing market is valued at over $350 billion, driven by aging Baby Boomers, rising demand for specialized memory care, and consolidation among institutional operators.

Transaction volume in 2026 exceeded $15 billion across 1,200+ deals, with memory care and Class A assisted living properties commanding premium valuations.

Private equity, REITs, and international investors are increasingly active in the sector, creating competitive bidding environments and compressed cap rates in primary markets.

Sell-Side Representation: Marketing properties to qualified buyers, preparing offering memorandums, coordinating tours, managing due diligence, and negotiating LOIs/PSAs.

Buy-Side Representation: Sourcing off-market opportunities, conducting financial/operational analysis, coordinating inspections, and negotiating favorable purchase terms.

Portfolio Advisory: Strategic guidance on portfolio optimization, disposition timing, 1031 exchanges, and acquisition strategies for multi-site operators.

Valuation Services: Broker Price Opinions (BPOs), market analysis, comparable sales studies, and proforma development for underwriting.

Assisted Living Facilities (ALF): Non-medical residential care with ADL assistance, medication management, and meal services. Typical 30-120 units.

Memory Care: Secure, specialized units for residents with Alzheimer's and dementia. Higher staffing ratios and programming requirements.

Skilled Nursing Facilities (SNF): Medicare/Medicaid-certified facilities providing 24/7 nursing care, therapy services, and post-acute rehabilitation.

Independent Living (IL): Age-restricted communities with amenities and services but minimal care assistance. Often part of CCRC campuses.

Continuing Care Retirement Communities (CCRC): Multi-level campuses offering IL, AL, and SNF care with entrance fees and monthly service packages.

1. Pre-Marketing Phase: Property analysis, financial audit, license verification, and offering memorandum preparation (4-6 weeks).

2. Marketing Launch: Targeted outreach to qualified buyers, confidential marketing, property tours, and initial offer collection (6-8 weeks).

3. Due Diligence: Financial review, operational audit, license transferability confirmation, environmental inspections, and lease/contract review (45-90 days).

4. Purchase Agreement: LOI negotiation, PSA execution, earnest money deposit, and contingency timeline establishment.

5. Closing Preparation: Regulatory approvals, financing coordination, staff notifications, and final walk-throughs (30-60 days post-PSA).

6. Post-Closing: License transfer filings, operational transition support, and resident/family communications.

Occupancy & Unit Mix: Stabilized occupancy (85-95%), private-pay vs Medicaid mix, and unit types (studio/1BR/2BR).

Revenue Per Occupied Unit (RevPOR): Monthly revenue per occupied bed, a key metric for assisted living and memory care valuation.

Operating Margin (NOI): Net Operating Income as a percentage of revenue; typical ranges are 25-35% for assisted living, 15-25% for SNF.

License & Regulatory Status: Current licensure, survey history, deficiency-free surveys, and certificate of need (CON) states.

Physical Condition: Age, deferred maintenance, capital expenditure needs, and recent renovations impact pricing significantly.

Market Position: Submarket occupancy trends, competitive supply pipeline, demographics, and income levels of service area.

Private Equity-Backed Operators: Largest buyer segment; focused on portfolio acquisitions, scale, and operational improvements.

Regional Operators: 5-20 property operators seeking bolt-on acquisitions in existing markets or geographic expansion.

REITs: Publicly traded real estate investment trusts acquiring properties for sale-leaseback or direct ownership (e.g., Welltower, Ventas).

Family Offices & High Net Worth Investors: Seeking stable, recession-resistant cash flow with long-term hold strategies.

First-Time Operators: Licensed administrators or healthcare professionals transitioning into ownership; often require SBA 7(a) financing.

Conventional Commercial Loans: 20-30% down, 10-25 year amortization, variable or fixed rates (currently 6.5-8.5%).

SBA 7(a) Loans: Up to $5M with 10% down for qualified owner-operators; ideal for first-time buyers but require personal guarantees.

HUD 232 Financing: Non-recourse loans for SNF/AL refinancing or new construction; lengthy approval process (6-12 months).

Bridge/Mezzanine Financing: Short-term, high-interest loans for acquisitions requiring stabilization or license corrections.

Sale-Leaseback Structures: REIT or institutional buyer acquires property and leases back to operator; unlocks equity for portfolio expansion.

License Transferability: State-specific approval required; background checks, financial disclosures, and administrator licensing verification.

Certificate of Need (CON) States: 35+ states require CON approval for new or expanded nursing home beds; adds complexity to SNF transactions.

Medicare/Medicaid Certification: SNF buyers must obtain CMS certification transfer; delays can impact closing timelines.

Survey & Deficiency History: Recent state surveys, complaint investigations, and corrective action plans are critical due diligence items.

Fire/Life Safety Compliance: NFPA 101/Life Safety Code compliance, sprinkler systems, and egress requirements vary by state and property age.

Memory Care Demand Surge: Alzheimer's prevalence driving specialized memory care development and premium valuations (10-15% above AL).

Technology Integration: Operators investing in EHR systems, family communication portals, and AI-powered clinical workflows to improve margins.

Private-Pay Focus: Shift away from Medicaid-heavy census toward higher-acuity private-pay residents with longer length-of-stay.

Labor Cost Pressures: Wage inflation (15-20% YoY) driving operator consolidation and investment in workforce management technology.

Value-Add Repositioning: Buyers targeting underperforming assets (60-75% occupancy) for operational turnarounds and repositioning strategies.