The Aging of America

2. The Aging of America • According to US Census Bureau data, the number of Americans 65 and older will increase from 47.8 million as of July 2015 to 98.2 million by 2060, or an increase by percentage of the total US population from 14.9% to almost 25%. • This significant increase in the number of older Americans will provide challenges and opportunities for a broad range of senior services, including retirement communities and senior rehabilitation facilities. • Not surprisingly, the 2014 American Community Survey reported that Tampa-St. Petersburg, FL had the highest percentage of adults 65+, at 18.7%; however, second was Pittsburgh, PA, 18.3%; Buffalo, #5, 16.7%; and Cleveland, #6, 16.5%.

3. Homes for Seniors • Although the senior population will increase substantially, most still prefer to live in their homes as long as possible. Recent studies report that by 2035, there will be 38 million owner households 65+ and older renter households will increase 80% to 11.5 million. • From 2009 to 2015, 4%, or 217,000, of all new single-family and multifamily housing units built were in age-restricted developments, which require at least one member of the household to be 55+. • Skilled nursing homes, where much of rehabilitation services are available for seniors, had the largest total of all nursing home types during 2017, or 14,278; followed by assisted living, 3,564; retired living, residential, 904; and intermediate care, 563.

4. A Lucrative Market • According to the National Investment Center for Seniors Housing and Care (NIC), overall occupancy in senior housing (independent living and assisted living) during Q2 2017 was 88.8%. Transaction volume totaled $4.053 billion. • The overall occupancy rate for nursing care housing/facilities was 86.5% during Q2 2017, with a total transaction volume of $566.7 million. • The NIC also reports that capital providers who invest in senior housing are looking for a strategic position in the marketplace; supply and demand, occupancy rates and new development in local and primary markets; and pricing incentives.

5. The Cost of Senior-Living Facilities • According to Genworth Financial, the 2016 national monthly median cost of a private, one-bedroom residence in an assisted-living facility was $3,628. For nursing home care, a semi-private room was $6,844 and a private room was $7,698. • NIC reported that, as of June 2017, assisted-living initial rates averaged 8.8% less than the asking rate while average initial rates for independent living properties were 1.2% more than above-year earlier levels, which was a declining rate of increase. • During the first six months of 2017, assisted living move-outs exceeded move-ins for three months while independent living properties experienced four months when the move-outs exceeded move-ins.

6. Rehabilitation and Therapy • According to various sources, most senior rehabilitation therapy occurs in nursing care facilities. The $30-billion physical therapy market is very fragmented, as the top-five companies account for just 20% of total revenues. • A majority of the 16,000 to 18,000 clinics are small businesses, generating an average of $1 million in annual revenues. The Southeast US has the largest percentage of facilities, at 26.1%; followed by the Mid-Atlantic, 20.3%, and the West, 14.2%. • The top-five companies, and their market share, as of December 2016, were Select Medical/Physiotherapy Associates, 9.4%; ATI Physical Therapy, 3.5%; US Physical Therapy, 3.2%; Athletico Physical Therapy, 2.5%; and Upstream Rehabilitation, 2.0%.

7. Serving Latino-American Seniors • With an increasing Latino-American population in the US, it is critical for retirement communities, senior rehabilitation facilities and other health care services to understand and customize care for this population. • According to a 2017 study from The Associated Press and NORC Center for Public Affairs Research, just 18% of Latino Americans 40 and older were extremely/very confident that assisted-living communities can satisfy their cultural needs. • The study also revealed that 62% of Latino Americans 40 and older doubted the US was prepared to satisfy the needs of the increasing population of seniors, with just 4% saying the country was extremely/very well prepared.

8. Advertising Strategies • TV is an excellent advertising medium to reach adults 65+, as they had a 97% monthly reach for Live+DVR/Time-shifted TV during Q1 2017, according to Nielsen; however, combining TV with direct mail and/or local talk radio may prove to be even more effective. • Since many older Gen Xers and Baby Boomers are those that must help or convince their older parents to seek assisted living and/or rehabilitation services, ad messages should emphasize how these facilities can relieve the younger adults of their caregiving efforts. • Retirement communities that welcome adults as young as 55 years of age and that have a furnished empty residence, may want to consider a monthly drawing of submitted names from this age group to win a free weekend stay to experience living in the community.

9. New Media Strategies • Advertisers in these categories shouldn’t overlook digital media to reach their target audiences, since 82% of Baby Boomer households have both a broadband Internet subscription and a PC, 86% have a smartphone and 63% have a tablet, as of Q1 2017. • Video testimonials of rehabilitation patients during and/or immediately following their treatment, which are then posted to social media, could prove to be an effective strategy for rehabilitation facilities that primarily serve seniors. • Older adults seek consumer information just like their younger counterparts, so retirement communities and rehabilitation facilities should post regular content on social media, sharing stories of residents and patients, which connect with older adults and their adult children.