戴德梁行+投資者調查及趨勢報告：美國老年人生活及護理-英

Photoprovidedby

WatermarkRetirementCommunitiesINVESTOR

SURVEY

ANDTRENDS

REPORTU.S.

SENIOR

LIVING&

CARENOVEMBER

2023PhotoprovidedbyNationalDevelopmentIn

this

report01Key

Findings02PropertyMarkets03CapitalMarkets04Valuation

Index05Investor

Survey

Results06SeniorsHousingOutlook01KEY

FINDINGS???U.S.seniorshousingproperty

marketfundamentalscontinue

to

improve.

Stabilized

occupancy

trended

upward

overtheprior10quarters,

reaching86%,asrent

growth

remainedintactat5%throughthethird

quarterof2023.Cushman&

Wake?eld

expects

toseecontinued

improvementinproperty

marketfundamentals.Northeastmarketsareexpectedto

showthestrongestnear-termperformance.MarketsintheSouthwestandSoutheastareexpectedto

experiencedownward

pressureonoccupancyandrentgrowthintheneartermasnewsupplyisintroduced.Seculartailwindsarestrongerthanever,

asconstructionstartsto

slowto

thelowest

levelssincetheGreatFinancialCrisis(GFC).To

meetdemandatpeaklevels,supplygrowthmustincreaseby

35,000unitsperyear,beginningtoday.??A?ordabilityremainsunsolved.Withthenumberofmiddle-incomeseniorsprojectedto

doubleby

2029,over

halfofthissegmentwillnothave

adequate?nancesto

a?ordtraditionalassistedliving.Operatorswilllearnto

scale,andpartnershipsbetweenoperatingcompany(OpCo)

andpropertycompany(PropCo)willevolve.

Accelerationoftrendsandinnovationsintechnology;integratedcareandcaredeliverymodels;infrastructure;anddesignwithgreaterbranddiversi?cationarebeginningto

emerge.?Thecostofdebtisstressingshort-termvaluations,withseniorlivingtransactionvolumedown51%year-over-year(YOY),

andthepriceperunit,at$111,000,downnearly54%frompeakpricing.Mostownerswithwell-locatedpropertiesandhealthyoperatingperformanceareoptingnotto

selldueto

themarketdislocation.Skillednursingvolumewasdownonly17%,withthepriceperbedreachinganall-timehighof$109,500inthe?rsthalfof2023.???Impendingloanmaturities—totaling$16billion—expectedwithinthecoming24

months,alongwithfund-lifeexpirations,willcatalyzetransactionactivitywithincreasedinvestmentsfromthosewhoarewellcapitalizedandlessreliantonleverage.Cushman&Wake?eld’s

valuationindexreportson$32billioninaggregatethird-partyvaluationscompletedoverthepast12months.Same-storeindicesextractedfromthisdatasetindicateaYOY

increaseincapitalizationratesforseniorliving,rangingfrom75

to

125basispoints(bps),withvaluationsdecliningby

12%to

18%onaverage.Ofthemorethan90peoplewhoparticipatedinCushman&Wake?eld’s

investorsurvey,

68%expectto

seeacontinuedincreaseincapitalizationrates

over

thenext12months,withdebtmarketliquiditybeingthetopconcernof51%oftherespondents.??Mostinvestors(49%)aretargetingcore-plusinvestmentstrategies,followedby

assistedlivingat33%andactiveadultat23%.Nearly34%ofrespondentsarefocusedonopportunisticordistressedinvestmentstrategies.Marketparticipantsareunderwritingnegativeleverage:upto

oneyearfor44%ofrespondentsandupto

twoyearsfor31%ofrespondents.Still,19%ofsurveyrespondentsarenotwillingto

underwritenegativeleverage

aspartoftheirinvestmentstrategy.

Someinvestorsareelectingto

purchaseonanunleveredbasisasdebttermsforopportunisticbuysaredilutiveto

returns.??Basispointspreadsbetweenthegoingincapitalizationrate,

thediscountrate

andterminalcapitalizationratehave

compressed,indicatingthatmarketparticipantsareexpectingto

seeimprovementinthecurrentinterestrateclimateover

a?ve-to

10-yearholdingperiod.Environmental,socialandgovernance(ESG)considerationscontinueto

gainnotorietyintheseniorshousingandcaresector,

with59%ofsurveyrespondentsviewingESGinitiativesasbeingapositiveattribute,butonly9%willingto

provideapremiumto

pricingwhereESGisprevalent.Cushman&Wake?eld

|

302PROPERTY

MARKETSOCCUPANCYASKING

RENTAL

TRENDSSeniorshousingperformancecontinuestoacceleratewithstabilizedoccupancytrendingupward

forthetenthconsecutivequarter.

TheNationalInvestmentCenterforSeniorsHousing&Care(NIC)reportedstabilizedoccupancyat86%forprimarymarketsand87%forsecondarymarketsforthethirdquarterof2023.Therate

ofannualrentgrowthreachedanall-timehighinthesecondquarterof2023,at5.9%inprimarymarketsand5.9%insecondarymarkets,whichtaperedslightlyinthethirdquarterto

5.4%and5.6%respectively.Assistedlivingmarkedthehighestrentgrowthat6.4%,withrentgrowthforindependentlivingaveraging5.2%.Recentvaluationsconductedby

Cushman&Wake?eld

have

identi?edannualrentgrowthinthe7%to

9%rangeinkey

marketsthroughouttheU.S.Thoughtrendinginapositivedirection,theselevelsremainwellbelowpre-pandemicaverages

of90%and90.2%,respectively.PRIMARY

MARKETSInventory

GrowthAbsorptionStabilized

Occupancy95%90%85%80%75%70%10,0005,0000-5,000-10,000Source:

Cushman

&

Wake?eld

Research.

NICMAP

Vision,

Q3

2023SECONDARY

MARKETSInventory

GrowthAbsorptionStabilized

Occupancy95%90%85%80%75%70%10,0005,0000-5,000-10,000Source:

Cushman

&

Wake?eld

Research.

NICMAP

Vision,

Q3

20234

|U.S.SENIORLIVING&CAREINVESTORSURVEYANDTRENDSREPORTABSORPTIONCONSTRUCTION

TRENDSAbsorption

has

outpaced

inventory

growthfor

nine

consecutive

quarters

as

the

numberof

occupied

units

reached

an

all-time

high

inthe

third

quarter

of

2023.

During

this

period,absorption

has

outpaced

inventory

growth

bynearly

3x.The

annual

rate

of

absorption,

whichsubsided

in

the

third

quarter

of

2023

to

4.3%in

primary

markets

and

3.9%

in

secondarymarkets,

still

wellabove

historical

averages.Slowing

construction

starts

represent

a

silverlining

for

owners.

Despite

an

increase

indevelopment

appetite

anda

robust

need

foradditional

supply

in

most

major

markets,

thelack

of

liquidity

and

costof

debt

has

restrictedconstruction

startsto

the

lowestlevel

inover

adecade.

This

decline

in

construction

starts

willonly

magnify

supply

shortages

as

our

populationcontinues

to

age.Demand

is

anticipated

to

continue

throughthe

remainder

of

2023

and

into

2024.

Withconstruction

starts

continuing

to

subside,favorable

occupancy

and

rent

growth

trendsare

expected

to

continue—a

critical

componentof

o?setting

the

increased

operatingexpenses

causedby

the

labor

shortage

andincreased

insurance

premiums

coming

outof

the

pandemic.

From

a

property

marketsstandpoint,

the

sector

will

once

againproveitsrecessionary

resilient

reputation.Valuationchallenges

varyby

region,

duetolimited

transactional

datapoints

and

shiftingproperty

market

fundamentals.

Markets

withhigh

occupancy

and

low

construction

vs.inventory

will

experience

the

greatest

rentgrowth.

On

average,

northeast

markets

presentthe

strongest

market

fundamentals.QUARTERLY

CONSTRUCTION

STARTS

-

PRIMARY

&

SECONDARY

MARKETSILALMC15,00010,0005,0000Source:

Cushman

&

Wake?eld

Research.

NICMAP

Vision,

Q3

2023MARKET

LEVEL

PERFORMANCEAnnualRentGrowth

(%)15%Constructionvs.Inventory

(%)StabilizedOccupancy95%90%85%80%75%10%5%0%Source:

Cushman

&

Wake?eld

Research.

NICMAP

Vision,

Q3

2023Cushman&Wake?eld

|

5LONG-TERM

DEMAND

TRENDS

POINTTO

SIGNIFICANT

SUPPLY

SHORTAGEConsumerdemandisexpectedto

overwhelmthemarketwithinthenext

?ve

years,atalllevels,withnetdemandprojectedto

turnpositiveasearlyas2025.approximately26,000unitsperyear,

withcurrentlevels

muchlower

asconstructionstartsdecline.To

meetdemandatpeaklevels

fortheover-80populationsegment,estimatedfor2045,thesectormustincreaseannualsupplygrowthby

35,000unitsperyear,

beginningnow.Theaverage

ageatmove-inforseniorlivingpropertieswillrangefrom75

foractiveadultto

83yearsofageforassistedliving,accordingto

theAmericanSeniorsHousingAssociation(ASHA).Thispopulationsegmentwillexpandsigni?cantlyover

thenextdecade.AFFORDABILITY

REMAINSLARGELY

UNSOLVEDThenumberofmiddle-incomeseniorswillnearlydoubleby

2029,astheover-80

populationincreases.Accordingto

theNationalInvestmentCenterforSeniorsHousing&Care,60%ofthispopulationsegmentwillhave

mobilitylimitations,with20%requiringhighhealthcareorfunctionalneeds.Lookingattheover-80demographic,demandwascalculatedbasedonamarket-extractedpenetrationrate

of7.9%

from2016,whenstabilizedoccupancywas91%.Supplygrowthwasestimatedbasedonatrailing?ve-year

average

of80+

LONG

TERM

DEMAND

OUTLOOKDemand

(80+)Supply

(Avg.)Population

(80+)353.53.02.52.01.53025Equilibrium20Supply

Shortage151051.00.50Source:

Cushman

&

Wake?eld

Research.

NICMAP

Vision,

Q3

2023With

an

additional

35,000

units

in

new

constructionannually

required

to

meet

peak

demand,

over

half

ofmiddle-income

seniors

will

not

have

adequate

?nancesto

a?ord

assisted

living.6

|U.S.SENIORLIVING&CAREINVESTORSURVEYANDTRENDSREPORT03CAPITAL

MARKETSINVESTMENT

TRENDSTheaverage

priceperunitwas

reportedat$111,000inthesecondquarterof2023,downnearly54%frompeakpricingrealizedinthe?rstquarterof2022.Duringthisperiod,ownerswhowere

notableto

achievetheirtargetedexitpricesimplywere

notsellers,ortheyexitedatadiscountdueto

anincreasedcostofdebt—atrendthatwilllikelycontinueinthenear-term.Seniorshousingandcareinvestmentactivitystalledto

nearly$3.2billioninthe?rsthalfof2023,markinganapproximate51%declineYOYanddown71%fromthesecondhalfof2022.Second-quartertransactionvolumeforseniorshousingtotaled$400million,thelowest

reportedsincetheGFC,highlightingthemarketdislocationbetweenthestrengtheningmarketfundamentalsforthesectorandthechallengingdebtmarkets.Transaction

activityfornursingcarefaredslightlybetter,

witha?rst-halftotalvolumeof$1.5billion,downonly17%YOY.Thegapbetweenbuyersandsellershasyet

toclose,asevidencedby

thelimitedvolumeoftradesduringthe?rsthalfoftheyear.

Cushman&Wake?eld

isstillseeingvaluationsabove$650,000perunit,thoughdealslikethishaven’thitthemarket.VALUATION

TRENDSNursingcarevaluationssuggestadi?erentnarrative,withtheaverage

priceperbedof$110,000downslightlyfromthepriorquarter,

butup5%YOY.

Onatrailingfour-quarterbasis,theaverage

priceperbedfornursingcarereachedanall-timehighof$109,500.Pricedislocationandanelevated

interestrateenvironmentcontinuedto

hindervaluations,asevidencedby

thedeclineinpriceperunitpaidforseniorshousingto

thelowest

level

sincetheGFC.SENIOR

LIVING

&

CARE

ROLLING

FOUR-QUARTER

TRANSACTION

VOLUMESeniors

Housing

RollingNursing

Care

Rolling$30$25$20$15$10$5$-Source:

Cushman

&

Wake?eld

Research.

NICMAP

Vision,

Q3

2023SENIOR

LIVING

&

CARE

ROLLING

FOUR-QUARTER

PRICINGPrice

Per

Unit-

SeniorsPrice

Per

Bed-

Nursing

Care$200$150$100$50$0Source:

Cushman

&

Wake?eld

Research.

NICMAP

Vision,

Q3

2023Photoprovidedby

WatermarkRetirementCommunitiesINVESTMENT

YIELDSTotal

annualizedreturnsforseniorshousingfellinrecentquarters,primarilydrivenby

theincreasingcostofdebt,achallenginglabormarketandanincreaseincostsofotherkey

operatingexpenses.Asoperatingexpensesbeginto

pullbackto

morenormalizedlevels,thecostofcapitalremainsaloomingconcernasinvestor

spreadsbetweencapitalizationrates

andthe10-yearTreasurycompressto

thelowest

levels

inover

adecade.at3.97%.Duringthisperiod,theaverage

capraterecordedforseniorhousingwas

8.1%

andmovedupto

9.3%.Lookingattheaverage

spreadbetweenthe10Yandcapitalizationrates

over

thepasttenyears,seniorshousinghasaveraged

a465basispointspreadwithacurrentspreadofonly212basispoints.Thiswouldindicatecontinuedupwardpressureoncapitalizationrates

asthemarketcontinuesto

adjustto

thehighercostofcapital.TheFederalReservebeganraisinginterestratesinMarch2022,with11hikestakingplacesince.Inthethirdquarterof2023,the10-yeartreasury(10Y)averaged

4.38%,markingnearlya300basispointincreaseduringthisperiod.Thelasttimethe10Ywas

atthislevel

was2002andthe10YwasShort-termreturnswillbechallengedthrough2025,primarilydrivenby

capitalreturns,asoccupancyandrentgrowthcontinueto

improveandoperators?ndways

to

reduceoperatingexpenses.8

|U.S.SENIORLIVING&CAREINVESTORSURVEYANDTRENDSREPORTCAPITAL

FLOWCapitalsourcesare

shiftingasinvestorsseekrisk-adjustedreturns.Riskpremiumsare

adaptingto

thelackofliquidityandcurrentpricinginthedebtmarkets,andassuch,are

reconsideringwhichpropertytypesare

likelyto

deliverthebestrisk-adjustedreturns.2023hasproven

to

betheyearofportfoliooptimizationforseniorshousinginvestors,asthemarketadjuststo

thecurrenteconomicclimateandvaluationsreset.Cross-borderinvestmentwas

almostnonexistentinthe?rsthalfof2023,withinstitutionalinvestorsbeingthelargestsellersofseniorshousingrealestate,divestingnearly$560millionyearto

date.NET

ACQUISITIONS

BY

BUYER

TYPE

(BILLIONS)$8$6Privateequityisselectivelyactivebutislargelyin“wait-and-see”mode,giventhecostof?nancingandthepotentialforassetpricereductions.PubliclylistedREITs

have

acquirednearly$4.6billioninseniorshousingpropertiesyear

to

date,representing60%oftotalinvestmentdollarsinthesector.$4$2$0-$2-$4-$6However,

thesameREITs

have

divestednearly$4.5billionover

thesameperiod.Privatecapital,thesecond-largestinvestor

inseniorshousingyear

to

date,hasacquirednearly$2.7billion,with$2.5billionindivesturesover

thesameperiod.PrivateREIT/ListedInstitutionalCross-BorderSource:

RCA

and

Cushman

&

Wake?eld

ResearchCAPITALIZATION

RATES

VS.

10

YEAR

TREASURY

(BASIS

POINTS)Spread-

SeniorsSpread-

Apts.Avg.

Spread-

Apts.Avg.

Spread-

Seniors85075065055045035025015050Source:

Cushman

&

Wake?eld

Research.

NICMAP

Vision,

Q3

2023Cushman&Wake?eld

|

904VALUATION

INDEXTheCushman&Wake?eld

valuationindexrepresentsanaggregationofmark-to-marketvaluationconclusionsfromnearly2,200U.S.propertiesthatwere

valuedwithinthepast12months.Theaggregatemarketvalueofthisproprietarydatasettotalsapproximately$32billion,or6.8%ofthetotalestimatedmarketcapitalizationof$470

billioninstitutionalseniorshousingandcaresupply.LowerDecileLowerUpperUpperDecileMajority

Active

AdultAverageQuartileQuartileStabilizedOccupancy(%)851,31637871,97141902,24543932,49448963,26653E?ectiveMonthlyRentperRevenueUnit($)ExpenseRatio(%)CapitalizationRate(%)4.95.25.86.36.8StabilizedMarketValue

perRevenueUnit($)112,412175,912291,354391,921498,969LowerDecileLowerUpperUpperDecileMajority

Independent

LivingAverageQuartileQuartileStabilizedOccupancy(%)862,52358873,22160923,95466934,88869956,23976E?ectiveMonthlyRentperRevenueUnit($)ExpenseRatio(%)CapitalizationRate(%)5.96.36.87.27.8StabilizedMarketValue

perRevenueUnit($)86,870162,924283,242386,111511,232LowerDecileLowerUpperUpperDecileMajority

Assisted

LivingAverageQuartileQuartileStabilizedOccupancy(%)863,15666893,77769925,17572935,99178957,83480E?ectiveMonthlyRentperRevenueUnit($)ExpenseRatio(%)CapitalizationRate(%)66.57.27.98.3StabilizedMarketValue

perRevenueUnit($)99,088152,256283,223346,281562,616LowerDecileLowerUpperUpperDecileMajority

Memory

CareAverageQuartileQuartileStabilizedOccupancy(%)823,20155843,71461894,72275905,37678926,78982E?ectiveMonthlyRentperRevenueUnit($)ExpenseRatio(%)CapitalizationRate(%)7.27.98.28.78.9StabilizedMarketValue

perRevenueUnit($)89,672121,465181,697241,572355,401LowerDecileLowerUpperUpperDecileMajority

Nursing

CareAverageQuartileQuartileStabilizedOccupancy(%)7314380162882519128893372E?ectiveMonthlyRentperRevenueUnit($)ExpenseRatio(%)7881859093CapitalizationRate(%)10.539,31212.266,61413.413.914.7StabilizedMarketValue

perRevenueUnit($)120,398152,222198,904Photo

provided

by

------------------------10

|U.S.SENIORLIVING&CAREINVESTORSURVEYANDTRENDSREPORTSAME

STORE

ANALYSISSamestore

operatingandvaluationdatawere

extractedfrompropertiesCushman&Wake?eld

valuesonaquarterlyorannualbasis.ThisdataprovidesauniqueinsightintoactualYo

Ychanges.SENIOR

LIVINGOCCUPANCY

(%)EXPENSE

RATIO

(%)958090857060ClassAQ3

2022ClassBClassAClassBQ3

2023Q3

2022Q3

2023CAPITALIZATION

RATES

(%)MARKET

VALUE

PER

UNIT

($1,000)864280060040020000ClassAClassBClassAQ3

2022ClassBQ3

2023Q3

2022Q3

2023NURSING

CAREOCCUPANCY

(%)EXPENSE

RATIO

(%)9590859590858080ClassAClassBClassAQ3

2022ClassBQ3

2022Q3

2023Q3

2023CAPITALIZATION

RATES

(%)MARKET

VALUE

PER

BED

($1,000)131211300200100010ClassAClassBClassAClassBQ3

2023Q3

2022Q3

2023Q3

2022Source:

Cushman

&

Wake?eld

Valuation

InsightsCushman&Wake?eld

|

11INVESTMENT

CLASS

AND

LOCATIONALDESCRIPTIONSInvestment

Class

A:

Excellentqualityassets,newer

than10yearsofageandlocatedindesirablemarketlocations,primarilyinprimarymarketsbutcanbeinsecondarymarkets.Constructionanddesignelementsincludesteelframeorreinforcedconcrete,high-end?nishes,top-qualityFF&E,state-of-the-arttechnology,

andlifestyle-enrichedamenitiesthatare

superiorto

themarketandtargetahighnet-worthpopulation.InvestmentClassAnursingcarepropertiesare

typicallylocatedonornearahealthcarecampuswithstate-of-the-arttherapyspaceandequipment.Residentroomsare

primarilyprivatewithaqualitymixthatoutperformsthemarket.Fornursingcare,InvestmentClassBmeansfunctionaldesign,primarilyprivateandsemiprivateresidentrooms,andadherenceto

lifesafetycode.Thepayor

sourceisprimarilyMedicaidwithacensusmixandprivatepay

rates

consistentwiththemarket.Investment

Class

C:Average

to

fairqualityassetslocatedinsecondaryortertiarylocations,withane?ectiveageolderthan25years.Constructioniswoodframe.Thesepropertiescontainamenitiesand?nishesthatare

inferiortothemarket,may

containdeferredmaintenanceorrequireothercosmeticimprovementsto

maintaincompetitiveness.Residentroomsmay

nothavefullbathroomsorkitchenettes.Fornursingcare,propertiesare

locatedwithlittleto

noaccessto

healthcareproviders.Theimprovementsfeatureamoreinstitutionaldesignandfunctionalobsolescence,withahighpercentageofsemi-privateorward

rooms,outdatedmechanicalsystems

andinadequateventilationsystems.Investment

Class

B:Goodto

average

qualityassets,withane?ectiveagebetween10and25yearsandlocatedinprimaryandsecondarymarketlocations.Constructioncanconsistofsteelframe,reinforcedconcreteorwoodframe.Building?nishes,FF&E,technologyandamenitiesare

consideredadequateoraverage

to

themarket.MARKET

LOCATIONPRIMARY

MARKETSSECONDARY

MARKETSMarketlocationsconsistentlyknownasgatewayorestablishmentmarketshave

largepopulationbasesandGDP,

withhigherbarriersto

entry.Demographicgrowthandtheeconomicbaseoutperformnationalandregionalaverages.Thesemarketlocationsare

in-migrationdestinationsforpeopleandbusinesses.Populationandjobmarketsare

growingfasterthantheU.S.locationsthatcanbedescribedasmoresuburban,withmediumto

low

barriersofentry.12

|U.S.SENIORLIVING&CAREINVESTORSURVEYANDTRENDSREPORT05INVESTOR

SURVEY

RESULTSMorethan90oftheindustry’smostin?uentialleadersrespondedto

Cushman&Wake?eld’s

InvestorSurvey.

Theseparticipantsare

transactionalandspecializeintheseniorshousingandcaresector.Theintentionofthissurvey

was

to

garnerkey

insightsthatprovideexpectationsfortheyearahead.CAPITALIZATION

RATES

BY

LOCATION

&

INVESTMENT

CLASSSurvey

respondentswere

askedto

selectthemostappropriatecapitalizationrate,

appliedto

year-onestabilizednetoperatingincome,inclusiveofmarketlevel

managementfeesandreplacementreserves.Primary

MarketsInvestmentClassAInvestmentClassBInvestmentClassCCapitalization

Rates

(%)ActiveAdultLowHigh7.0AverageLowHigh7.5AverageLowHigh8.0Average4.54.56.06.510.05.05.56.26.98.011.67.44.55.55.96.87.48.512.37.75.56.07.06.77.5MajorityIndependentLivingMajorityAssistedLivingStandAloneMemoryCareNursingHome7.58.59.08.56.06.510.56.09.010.010.514.510.08.29.110.013.59.010.014.09.07.012.06.513.28.5CCRC/LPCSecondary

MarketsCapitalization

Rates

(%)ActiveAdultInvestmentClassAInvestmentClassBInvestmentClassCLowHigh8.0AverageLowHigh8.5AverageLowHigh9.5Average5.06.06.57.06.26.87.25.06.06.57.56.67.26.06.57.07.57.37.9MajorityIndependentLivingMajorityAssistedLivingStandAloneMemoryCareNursingHome8.59.010.010.511.09.59.57.78.49.514.09.210.514.59.58.511.97.510.515.09.59.012.98.010.06.011.06.012.06.515.510.5CCRC/LPCAvg.

Spread

by

InvestmentClass

and

Location

(bps)Capitalization

Rates

(%)ActiveAdultInvestmentClassSpreadsPrimaryMarketsInvestmentClassSpreadsSecondaryMarketsLocationSpreadsPrimaryvs.SecondaryLow44.855.349.547.1High72.1Average116.9Low40.048.949.049.4107.350.7High65.666.374.547.8101.9112.7Average105.6115.2LowHigh68.446.630.651.1Average73.253.031.161.944.825.938.781.2MajorityIndependentLivingMajorityAssistedLivingStandAloneMemoryCareNursingHome68.279.360.381.378.1123.5128.7107.3158.9114.3123.597.248.830.917.077.736.2209.2163.360.631.5CCRC/LPC66.0Source:

Cushman

&

Wake?eld

Investor

SurveyCushman&Wake?eld

|

13UNLEVERED

YIELD

&

TERMINAL

CAPITALIZATION

RATESWithlimitedtransactionaldata,investorsare

moreoftenrelyingondiscountedcash?ow

analysis.Thepercentageofsurvey

respondentsrelyingonthediscountedcash?ow

analysisincreasedfrom54%to74%

over

thepastyear.

Key

underwritingassumptionsare

summarizedbelow.AVERAGE

BASIS

POINT

SPREADGoing

In

Capitalization

Rate

vs.

Discount

Rate

(Unlevered

IRR)40%20%0%150-175175-200200-225225-250250-275275-300Source:

Cushman

&

Wake?eld

Investor

SurveyGoing

In

vs.

Terminal

Capitalization

Rate60%40%20%0%25-5050-7575-100100-125125-150150-175Source:

Cushman

&

Wake?eld

Investor

SurveyPhotoprovidedbyNationalDevelopment14

|U.S.SENIORLIVING&CAREINVESTORSURVEYANDTRENDSREPORT20232022Survey

compositionInvestment

SalesLender7%4%Thesurvey

participantswererepresentedprimarilyby

investmentsalesprofessionals,privateequity,institutionalinvestorsandREITs,totaling71%ofrespondents.Theremaining29%wasmostlyrepresentedby

lendersanddevelopers.Thisrepresentationisconsistentwithpriorsurveys.11%21%24%13%Institutional

InvestorPrivate

EquityREIT13%14%10%10%17%19%14%Developer23%Other20232022Preferred

underwriting

methodologyOfthesurvey

respondents,74%

areincreasinglyrelyingondiscountedcash?ow

analysisforunderwritingvaluations.Thisisexpectedwhenvolatilityincash?owincreasesoruncertaintyincapitalmarketassumptionsexists.26%46%YesNo54%74%Underwriting

leverageGiventhecurrentinterestrateenvironment,mostmarket6%19%35%Not

underwritingnegative

leverageparticipantsare

willingto0

to1

yearacceptnegativeleverage

intheirunderwriting.44%are

acceptingupto

oneyearofnegativeleverage,followedby

31%acceptingupto

twoyears.19%ofrespondentsindicatethattheyare

notunderwritingdealsthatrequirenegativeleverage.31%1

to2

years2

to3

years38%Greater

than3

years44%Cushman&Wake?eld

|

1520232022Active

Adult8%6%Preferred

property

typesMajority

IndependentLivingThegreatestopportunityforinvestment,accordingto

33%ofrespondents,isassistedliving.Active

adult,oneofthefastestgrowingsegmentsofseniorliving,hassurpassedindependentlivingashavingthesecond-highestopportunityforinvestment.12%17%23%25%Majority

AssistedLiving5%4%Stand

AloneMemory

Care20%21%33%27%Nursing

CareLPC/CCRCInvestment

strategiesAnoverwhelming49%ofsurveyparticipantsare

targetingcore-plusinvestmentstrategies,highlightinginvestors’long-termviewofthesector.

Thisisasteepcontrasttothe34%ofmarketparticipan