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That path to improving length of stay, which boosts occupancy and operating margin for senior living providers, is not easy to navigate.
That’s because senior living operators face myriad challenges in keeping residents satisfied and thriving in their communities. Providers must develop sound operations with unique lifestyle offerings and improved care offerings to improve length of stay.
Providers also face a number of hurdles that are largely beyond their control, from rising acuity forcing a move as a resident ages, to residents moving closer to family and, ultimately, residents passing away..
And while providers must work hard to retain residents, move-outs are usually an unwelcome situation for consumers, as well.
“Moving out of a community is truly a last resort,” said Watermark Retirement Communities COO Jeff Slichta. “It’s expensive, it’s time-consuming, the hassle for everyone involved [is significant].”
The good news is that several operators who spoke with Senior Housing News reported improvements in occupancy and length of stay compared to past years.
Resident turnover and length of stay both have a significant influence in operational efficiency and financial performance.
In assisted living communities, the median annual resident turnover rate was approximately 46.8% in 2024, according to data provided by Direct Supply. And while the data is not specific to senior living, the National Apartment Association estimates that the cost of unit turnover ranges between $1,000 to $5,000 per unit including repairs, maintenance and new marketing spends to attract the next resident.
What recent industry data shows about unit turnover, length of stay
Many dynamics influence a resident’s decision to leave a community, and the reasons vary across the continuum. In independent living, residents typically move to be closer to family. In assisted living, residents move to higher levels of care and in memory care, the leading cause of move-outs is natural death, senior living executives told SHN.
Fort Wayne, Indiana-based Priority Life Care finds that common reasons for move-outs across the continuum include declining participation in activities, changes in acuity and financial concerns, according to CEO Sevy Petras. On length of stay, Priority Life Care saw a 22% increase in the average length of stay between 2022 and 2024 across all care levels, while keeping resident turnover due to resident dissatisfaction low, Petras said.
“Less than 1% of move-outs are completely unexpected and are due to dissatisfaction,” she said.
Priority Life Care operates 58 communities in 12 states.
Westport, Connecticut-based Maplewood Senior Living has seen improved length of stay since 2020, with assisted living improving in 2024 to 18 to 24 months, while memory care length of stay is three years longer in 2024 compared to 2020, according to Senior Vice President of Operations Eileen Duggan.
She attributes this positive trend in part to the personalization of Maplewood’s offering.
“When an operator doesn’t see personal attention or personalization as important or doesn’t put it in high regard, oftentimes that operator is not going to be successful,” Duggan said.
Maplewood operates 17 communities in five states and Washington, D.C.
In 2023, the year most recent data was available, Life Care Services reported independent living length of stay remaining “stable” at an average of two years and eight months, while assisted living average length of stay was one year and eight months, according to Senior Vice President and Director of Operations Management Mike Heselbarth.
“We know that rising acuity levels and end-of-life transitions are key factors in these changes,” Heselbarth said.
Des Moines, Iowa-based Life Care Services is part of the LCS Family of Companies and is one of the largest senior living operators in the United States, with TKTKTK communities under management.
Dallas, Texas-based 12 Oaks Senior Living reported average lengths of stay in independent living of 26 to 31 months; 20 to 24 months in assisted living; and 18 to 22 months in memory care, according to President Greg Puklicz.
“We can’t stop death, but we can do our damnedest to extend life and improve quality of life,” Puklicz said.
Dallas, Texas-based 12 Oaks operates a portfolio of 32 communities in five states.
When affordability plays into unit turnover
It’s no secret that the industry today faces rising challenges in the affordability of senior living. This hurdle is already playing out in communities nationwide as operators face unfortunate realities of move-outs tied to increased rates.
Affordability also grows as a concern as a resident moves up the continuum, with assisted living and memory care requiring intensive support that pushes prices higher than at independent living.
One key to preventing financially driven turnover is to perform necessary due diligence in the sales process.
“You’d be surprised at how many operators aren’t doing financial discovery when they’re working to move someone in, and that’s a critical step in the process,” Petras said.
These conversations are vital and must be done on a quarterly basis as acuity needs increase, Duggan added.
“You must ask the right questions while also understanding there are potential financial constraints that might lead to a resident moving,” Duggan said. “That’s why it’s important we reach out to families to create a comfortable environment to share those concerns before it’s too late.”
Proactive financial counseling and communication can help prevent residents leaving, as operators may have some flexibility to make accommodations in limited circumstances, Heselbarth said.
“But it all starts with being honest and transparent,” Heselbarth said.
While the dynamics around improving length of stay remain the same as in the past, Petras said she feels the industry now has an opportunity to have greater insights into resident care.
“As operators, we’re having more tools and resources to be able to monitor those reasons that impact length of stay and move-outs better than we did in the past,” Petras said.
To that end, LCS has launched a major data science effort to glean insights from all aspects of operations, something Heselbarth views as critical for improving length of stay and reducing resident moves.
“We’re going to be able to use this data to influence length of stay in a proactive manner that moves it in a positive direction,” Heselbarth said.
Improving unit turnover, length of stay
While operators may take varied approaches to improving resident retention and length of stay, it’s clear that operators must have defined strategies in place between all departments of operations to make an impact.
To reduce unit turnover and improve length of stay, Priority Life Care teams conduct regular care conferences and emphasize communication with families of residents on a monthly or quarterly basis, a common practice among operators that spoke with SHN. Communication among departments, from marketing to engagement and care staff to the culinary team, is critical in identifying changes in acuity, Petras noted.
Continuity among care staff is another key factor in improving length of stay and reducing resident turnover, with Maplewood and 12 Oaks leaders identifying a direct correlation between improved resident satisfaction and having the same care staff on shifts together.
“We have to train staff to develop genuine relationships with our residents that focus on compassionate, personalized interactions, and that really creates an environment of emotional support,” Duggan said.
Having these relationships between care staff and residents reduces anxiety among residents and improves the type of information shared by residents to care staff to inform personalized care planning, Puklicz said.
xBut employee retention has remained a significant challenge for senior living operators in recent years as rising wages, burnout and a more competitive jobs market has complicated operators’ ability to retain staff.
“We’re trying to tackle that issue head on,” Puklicz said. “It’ll hopefully have an impact on staff retention, resulting in resident retention and greater length of stay.”
Improving resident satisfaction also has a two-fold impact, Heselbarth said. Not only are residents happier, but improving quality of life could lead to longer lengths of stay. LCS implemented a resident ambassador program to create a “peer buddy system” for new residents while developing personalized life enrichment and programming plans.
“We have to actively work to prevent resident isolation and that’s coupled with maintaining an ongoing dialogue with residents and their families,” Heselbarth said. “The overall goal is creating a supportive environment that residents feel connected and valued in, which can reduce their likelihood of leaving the community.”
Tucson, Arizona-based Watermark – which operates 37 communities in 15 states – recently implemented a pulse survey program to gauge resident satisfaction throughout the year, polling residents on various aspects of care, life enrichment and daily community living. This has helped Watermark community staff identify dissatisfaction sooner and resolve issues quicker, Slichta said.
“You must identify resident concerns before they become critical,” Slichta said.
That’s coupled with managing directors at the community following up on complaints within four to six weeks, Slichta added.
To positively impact length of stay, operators that spoke with SHN all highlighted the importance of having robust wellness programming, an oft-cited area that can play a role in improving resident satisfaction and creating positive lifestyle habits.
By crafting programs that target physical and mental health, combined with multiple types of programming, operators can make an impact, Duggan said.
Through involving all frontline departments within its wellness program, 360Well, Slichta said Watermark can make a positive impact on resident turnover.
“We’re focused on resident well-being to create engaging experiences that encourage longer stays,” Slichta said. “But that trust you build across independent living, assisted living and memory care is critical.”
