Term

Definition

25th Percentile

The breakpoint between (a) the Middle Tier and the Bottom Tier and also (b) the first and second quartiles.

75th Percentile

The breakpoint between (a) the Top Tier and the Middle Tier and also (b) the third and fourth quartiles.

Absorption

The change in the occupied units from the previous quarter.

Additional Markets

The aggregate of data collected from the 41 additional core-based statistical areas (CBSAs) in the continental United States. Data is available in these markets beginning in the first quarter of 2015.

All Markets

The aggregate of data collected from 140 of the largest core-based statistical areas (CBSAs) in the continental United States.

Allocated

An individual property's PPU is adjusted based on each property’s respective market pricing level. The allocation for office, flex/industrial and retail properties is based on square feet. For apartments, it is based on number of units. Allocated prices are not usually an accurate measure of an individual property's price, but are accurate for the entire portfolio and aggregated statistics.

Annual Absorption

The year-over-year percent change in occupied units.

Annual Inventory Growth

The change in inventory from the previous year.

Annual Rent Growth

The annual growth rate of “Average Rent” for properties reporting rent data in both the current quarter and the same quarter a year ago.

Appraised

Based on the official evaluation of a lender (seen on refinancing).

Approximate

Derived from reliable published reports attributed to industry sources or generally rumored in the marketplace. Approximately 15% of the prices are qualified as approximate.

Asking Rate

Street room rate and average of any care fees across all existing units as of the end of the month.

Assisted Living Units

The part or section of the property that provides assisted living services, not including memory care services.

Average Rent

Asking private-room rent plus the average fee for care services. For nursing care, this represents the average per diem private-pay rate for private rooms. Average rent may also be referred to as AMR for independent living, assisted living, and memory care and ADR for nursing care.

Bottom Tier

The bottom quartile (i.e., first quartile) comprised of those properties below the 25th percentile.

Campus Type

The arrangement of the units and/or buildings of the property.

Capitalization Rate (%)

The average cap rate from closed transaction

Care Segment Type

Levels of care and services provided by the property. This can also be referred to as care segment. One unit of independent living, assisted living or memory care is equivalent to one nursing care bed.

Close Price

The total sales transaction price. If joint venture interest sold, this price is based on the 100% grossed-up price.

CMS Five-Star Rating (Health Inspection)

CMS calculates a health inspection score based on points assigned to deficiencies identified in each active provider’s three most recent recertification health inspections, as well as on deficiency findings from the most recent three years of complaint inspections. Points are assigned to individual health deficiencies according to their scope and severity –more serious, widespread deficiencies receive more points, with additional points assigned for substandard quality of care. Deficiencies from Life Safety surveys are not included in the Five-Star rating calculations. Deficiencies from Federal Comparative Surveys are not reported on Nursing Home Compare or included in Five Star calculations, though the results of State Survey Agency determinations made during a Federal Oversight Survey are included. No points are assigned for the first revisit; points are assigned only for the second, third, and fourth revisits and are proportional to the health inspection score for the survey cycle. If a provider fails to correct deficiencies by the time of the first revisit, then these additional revisit points are assigned up to 85 percent of the health inspection score for the fourth revisit. CMS’ experience is that providers who fail to demonstrate restored compliance with safety and quality of care requirements during the first revisit have lower quality of care than other nursing homes. More revisits are associated with more serious quality problems. CMS calculates a total weighted health inspection score for each facility (including any repeat revisits). Note that a lower survey score corresponds to fewer deficiencies and revisits, and thus better performance on the health inspection domain. CMS bases Five-Star quality ratings in the health inspection domain on the relative performance of facilities within a state. This approach helps control for variation among states.

CMS Five-Star Rating (Overall)

CMS rates SNFs on a scale of one to five stars. The components of the Overall Five-Star Rating are health inspection, staffing, and quality measures. The method for determining the overall nursing home rating does not assign specific weights to the health inspection, staffing, and QM domains. The health inspection rating is the most important dimension in determining the overall rating, but, depending on the performance on the staffing and QM domains, the overall rating for a nursing home may be increased or decreased by up to two stars. If a nursing home has no health inspection rating, then no overall rating is assigned. If a nursing home has no health inspection rating because it is too new to have two standard surveys, then no ratings for any domain are displayed.

CMS Five-Star Rating (Quality Measure Long Stay)

Most nursing homes will have three QM ratings: an overall QM rating, a long-stay QM rating, and a short-stay QM rating. For nursing homes that have only long-stay QMs, the overall QM rating is equal to their long-stay QM rating. Measures for Long-Stay residents (defined as residents who are in the nursing home for greater than 100 days) that are derived from MDS assessments are: percent of residents whose need for help with activities of daily living has increased; percent of residents whose ability to move independently worsened; percent of high-risk residents with pressure ulcers; percent of residents who have/had a catheter inserted and left in their bladder; percent of residents with a urinary tract infection; percent of residents who self-report moderate to severe pain; percent of residents experiencing one or more falls with major injury; percent of residents who received an antipsychotic medication. Measures for Long-Stay residents that are derived from claims data are: number of hospitalizations per 1,000 long-stay resident days; number of outpatient emergency department (ED) visits per 1,000 long-stay resident days.

CMS Five-Star Rating (Quality Measure Short Stay)

Most nursing homes will have three QM ratings: an overall QM rating, a long-stay QM rating, and a short-stay QM rating. For nursing homes that have only short-stay QMs, the overall QM rating is equal to their short-stay QM rating. Measures for Short-Stay residents that are derived from MDS assessments are: percent of residents who made improvement in function; percent of SNF residents with pressure ulcers that are new or worsened; percent of residents who self-report moderate to severe pain; percent of residents who newly received an antipsychotic medication. Measures for Short-Stay residents that are derived from claims data are: percent of short-stay residents who were re-hospitalized after a nursing home admission; percent of short-stay residents who have had an outpatient emergency department (ED) visit; rate of successful return to home and community from a SNF.

CMS Five-Star Rating (Quality Measure)

A set of quality measures (QMs) has been developed from Minimum Data Set (MDS) and Medicare claims data to describe the quality of care provided in nursing homes. These measures address a broad range of function and health status indicators. Most nursing homes will have three QM ratings – an overall QM rating, a long-stay QM rating, and a short-stay QM rating. For nursing homes that have only long-stay or only short-stay QMs, the overall QM rating is equal to their long-stay or short-stay QM rating. QM ratings are based on performance on a subset of 12 MDS-based QMs and five measures that are created using Medicare claims. These measures were selected for use in the rating system based on their validity and reliability, the extent to which nursing home practice may affect the measures, statistical performance, and the importance of the measures.

CMS Five-Star Rating (RN Staffing)

Adjusted Registered Nurse (RN) staffing hours are used in calculating staffing stars for CMS Five-Star ratings. Five-Star staffing measures are derived from data submitted each quarter through the Payroll-Based Journal System (PBJ), along with daily resident census derived from Minimum Data Set, Version 3.0 (MDS 3.0) assessments, and are case-mix adjusted based on the distribution of MDS 3.0 assessments by Resource Utilization Groups, version IV (RUG-IV group).

CMS Five-Star Rating (Staffing)

Adjusted Registered Nurse (RN), Licensed Practical Nurse (LPN), and Certified Nursing Assistant (CNA) staffing hours are used in calculating staffing stars for CMS Five-Star ratings. Five-Star staffing measures are derived from data submitted each quarter through the Payroll-Based Journal System (PBJ), along with daily resident census derived from Minimum Data Set, Version 3.0 (MDS 3.0) assessments, and are case-mix adjusted based on the distribution of MDS 3.0 assessments by Resource Utilization Groups, version IV (RUG-IV group).

Combined Campus

Properties offering at least two types of service, except where independent living and nursing care are jointly offered.

Community Type

Community Type (i.e. Independent Living Community, Assisted Living Community, Memory Care Community, Nursing Care Community, or CCRC/LPC) is a new categorization where each Community is classified by its plurality care segment, except for those properties where both Independent Living and Nursing Care care segments are present, which are defined as CCRC/LPCs, and where: (1) Memory Care(MC) is considered a distinct care segment and not a subset of Assisted Living(AL); and(2) CCRC/LPCs are not included in other community types.

Confirmed

Information reported directly from a participant in the deal (the buyer, seller or broker) or from public records. Most prices are confirmed via two or more independent sources; however, RCA does not guarantee its accuracy. Approximately 75% of the prices are qualified as confirmed.

Construction vs. Inventory (%)

The number of units under construction divided by the inventory currently in the market.

Continuing Care Retirement Communities (CCRCs)

Properties that offer at least independent living and nursing care services.

Contract type

Within entrance fee communities, a legal agreement between a resident and a property outlining a payment structure for future care delivery.

Deficiency

Nursing homes that participate in the Medicare and/or Medicaid programs have an onsite recertification (standard) inspection conducted annually, on average. Inspections are unannounced and are conducted by a team of health care professionals who spend several days in the nursing home to assess whether the nursing home is in compliance with federal requirements. These inspections provide a comprehensive assessment of the nursing home, reviewing facility practice and policies in such areas as resident rights, quality of life, medication management, skin care, resident assessment, nursing home administration, environment, and kitchen/food services. Deficiencies may be cited during an inspection based on findings of non-compliance with CMS regulations.

Drive Time Trade Area

The geographic area that results from a specified travel time (in minutes) along with a specified travel flow (i.e., high, medium, or low) from a specified search point.

Entrance Fee

A property that charges a lump sum amount of money paid by a resident at the beginning of their stay that provides the right to occupy the residence. Properties generally charge at least $20,000 for this lump sum payment. This type of property generally charges a monthly fee in addition.

Estimated

Based on the offering price or market averages where no price information is available. Less than 5% of the prices are estimated.

Freestanding Campus

A property offering only a single care segment.

In-place

Cap rate is derived from the net income generated from current tenancy agreements

In-Place Rate

Room fee and any care fees as of the end of the month paid by residents who took occupancy prior to the current month.

Independent Living Units

The part or section of the property that provides independent living services.

Initial Rate

Room fee and any care fees as of the end of the month paid by residents who took occupancy during the current month.

Inventory

The number of independent living units, assisted living units, memory care units, and nursing care beds that are operational and available for residence. One unit of independent living, assisted living, or memory care is equivalent to one nursing bed.

Inventory Growth

The amount of new inventory added within a quarter minus any deletions that occur.

Life Plan Community (LPC)

Life Plan Community (LPC) is an alternative term for Continuum Care Retirement Community (CCRC).

Majority Assisted Living (Majority AL)

Properties where assisted living units and/or memory care units comprise the largest share of inventory. Residents receive personal care services such as assistance with bathing, dressing, eating, walking and toileting. Twenty-four-hour protective oversight is provided, but twenty-four-hour medical care is not. The majority assisted living properties included in NIC MAP are only market-rate properties where 80 percent or more of the residents are 55 years or older.

Majority Independent Living (Majority IL)

Properties where independent living units comprise the largest share of inventory in a seniors housing property. Majority independent living properties typically include services such as communal dining, housekeeping, transportation, emergency call and social programming services in the monthly fee.

Majority Nursing Care (Majority NC)

Properties where nursing care beds comprise the largest share of inventory. A majority nursing care property is generally a licensed long-term health care and residential property that serves persons who require constant medical supervision and/or who require significant physical assistance in transferring, management of continence and use of medical devices. The NIC MAP database does not include properties that are limited to sub-acute, properties limited to inpatient based, properties that are hospital based, or properties predominantly rehabilitation facilities where people come for short-term stays for nursing care.

Memory Care (MC) Units

The part or section of the property that provides services to persons with Alzheimer’s disease or other form of dementia. These are generally separate or secured areas, with specific programming for persons with memory impairment in addition to services provided for persons in assisted living.

Metro Market

The U.S. Office of Management and Budget (OMB) defines a set of core-based statistical areas (CBSAs) throughout the country. CBSAs are delineated on the basis of a central urban area or urban cluster—a contiguous area of relatively high population density. CBSAs are composed of counties and county-equivalents.

Middle Tier

The two middle quartiles (i.e., second and third quartiles) comprised of those properties between the 25th percentile and 75th percentiles.

Move-Ins / Move-Outs

Percent of existing inventory's units that residents occupied/vacated during the current month.

Nursing Care (NC) Beds

The part or section of a property that only provides nursing care services.

Occupancy

The average unit occupancy of reporting properties

Occupancy Rate

Percent of existing inventory's units that are occupied by residents as of the end of the month.

Patient Day Mix

Actual patient days of each payor source divided by the total actual patient days.

Payment Type

The payment plan by which residence and services are paid for.

Penetration (%)

Inventory divided by the number of households, generally the number of age 75+ households, unless otherwise noted.

PointRight® Pro 30® Rehospitalization Rate (Adjusted)

PointRight® Pro 30® is an all-cause, risk adjusted rehospitalization measure. It provides the rate at which all residents who enter skilled nursing facilities (SNFs) from acute care hospitals are subsequently rehospitalized during their SNF stay, within 30 days from their admission to the SNF. PointRight® Pro 30® is the only all-cause, risk adjusted rehospitalization measure validated by Brown University, adopted by the American Health Care Association, and endorsed by the National Quality Forum (NQF #2375). Facility’s case mix-adjusted rehospitalization rate, calculated by dividing the observed rate by the expected rate, then multiplying by the observed national average. The national average is calculated at the national level as the sum of all rehospitalizations divided by the sum of all admissions from hospitals during a calendar year. All nursing homes in a group are split into percentiles in descending order from best to worst. A lower percentile is better, and a higher percentile is worse.

PointRight® Pro 30® Repospitalization Rate (Observed)

PointRight® Pro 30® is an all-cause, risk adjusted rehospitalization measure. It provides the rate at which all residents who enter skilled nursing facilities (SNFs) from acute care hospitals are subsequently rehospitalized during their SNF stay, within 30 days from their admission to the SNF. PointRight® Pro 30® is the only all-cause, risk adjusted rehospitalization measure validated by Brown University, adopted by the American Health Care Association, and endorsed by the National Quality Forum (NQF #2375). Facility’s actual, unadjusted rehospitalization rate, calculated by dividing the numerator by the denominator. The observed rate measures the rate at which residents admitted to the SNF from an acute care hospital are discharged to an acute care hospital within 30 days of admission to the SNF. Numerator = number of admissions from an acute care hospital who were rehospitalized within 30 days. Denominator = number of admissions from an acute care hospital.

PointRight® Pro Long Stay™ Hospitalization (Adjusted)

The PointRight Pro Long Stay Hospitalization Measure is an MDS-based, risk adjusted measure of the rate of hospitalization of long-stay residents of skilled nursing facilities (SNFs) averaged across the year and weighted by the number of stays in each quarter. This measure is endorsed by the National Quality Forum (NQF #2827). To be considered long-stay, a resident must have a cumulative length of stay in the facility of more than 100 days as of the snapshot date. Risk adjustment based on clinical complexity allows for comparison across facilities with varying levels of resident acuity. This measure is all-payer.This measure excludes discharges from the SNF to LTACHs, IRFs, and psychiatric hospitals and excludes admissions to acute care hospitals that directly follow a discharge from the SNF to a setting other than an acute care hospital. Facility’s case mix-adjusted hospitalization rate, calculated by dividing the observed rate by the expected rate, then multiplying by the observed national average. The benchmark rate is the observed rate of (all) hospitalizations per quarter for long stay residents.All nursing homes in a group are split into percentiles in descending order from best to worst. A lower percentile is better, and a higher percentile is worse.

PointRight® Pro Long Stay™ Hospitalization (Observed)

The PointRight Pro Long Stay Hospitalization Measure is an MDS-based, risk adjusted measure of the rate of hospitalization of long-stay residents of skilled nursing facilities (SNFs) averaged across the year and weighted by the number of stays in each quarter. This measure is endorsed by the National Quality Forum (NQF #2827). To be considered long-stay, a resident must have a cumulative length of stay in the facility of more than 100 days as of the snapshot date. Risk adjustment based on clinical complexity allows for comparison across facilities with varying levels of resident acuity. This measure is all-payer.This measure excludes discharges from the SNF to LTACHs, IRFs, and psychiatric hospitals and excludes admissions to acute care hospitals that directly follow a discharge from the SNF to a setting other than an acute care hospital. Facility’s actual, unadjusted hospitalization rate, calculated by dividing the numerator by the denominator. The observed rate measures the rate at which long stay residents are discharged to an acute care hospital. The observed rate is calculated for each quarter and aggregated over four quarters. Numerator = the sum of quarterly numerators for four quarters (12-month period) where the quarterly numerator is the number of acute care hospitalizations of residents in the quarter. Denominator = the sum of the quarterly denominators for four quarters (12-month period) where the quarterly denominator is the number of long-stay residents for the quarter (cumulative length of stay as of the first day of the quarter is more than 100 days).

Polygon Trade Area

The geographic area that results from a customized delineation of a polygon shape that serves as the boundaries of the geography.

Price Per Unit

The close price divided by the inventory of the portfolio.

Pricing Qualifiers

Pricing qualifiers pertain to the closed price for transactions. Each closed price is categorized by one of four qualifiers depending on the source of the information. Prices are qualified as to the reliability of each source. Estimates of some prices are made using industry and market averages. Prices of properties sold within a portfolio may be allocated pro rata (based on size) if individual pricing is not available. In either case, the estimates are excluded from any pricing analysis.

Primary Markets

The aggregate of data collected from 31 of the largest core-based statistical areas (CBSAs) in the continental United States. Data is available in these markets beginning in the fourth quarter of 2005.

Prior year

Cap rate is derived from prior year or actual income at time of sale.

Pro forma

Cap rate is derived from anticipated net operating income from first year of ownership.

Property Type

The building or buildings and grounds that house the residents, and common areas shared by the residents.Property Type(i.e., Majority Independent Living, Majority Assisted Living, or Majority Nursing Care) is the industry’s traditional categorization where each property is classified by its plurality care segment(that’s referenced as majority) and where: (1) Memory Care(MC) is considered a subset of Assisted Living(AL); and(2) individual CCRC/ LPCs are classified according to their plurality care segment (i.e., Independent Living, Assisted Living, or Nursing Care); and therefore, property type market aggregates are inclusive of their respective CCRC/LPC properties.Properties included in NIC MAP generally include at least 25 units / beds and are market-rate properties.

Protected

Data are marked as “Protected” if there are an insufficient number of properties and/or unique stakeholders reporting data.

Quality Mix

Actual Medicare, managed Medicare/other, and Private patient days divided by the total actual patient days.

Quoted

The assumed cap rate a property has traded at. Usually derived from published reports referencing a local professional not directly involved in the property‘s trade, but knowledgeable of factors affecting the price of a particular property.

Radius Trade Area

The geographic area that results from a specified distance (in miles) from a specified search point for the radii that defines the circular geography surrounding the search point.

Rate Tiers

The quantitative classification of the market-rate seniors housing properties by property type (i.e., by majority independent living properties and by majority assisted living properties) based on each property’s property-level average market rate (AMR) which collectively within each metropolitan market are tiered by quartiles.

Relative Performance Indicator (RPI)

The sum of occupied inventory multiplied by “Average Rent” for each distinct independent living, assisted living, or memory care unit type divided by total inventory of that care segment.

Rental

A property that charges the residents for their residence and services primarily on a lease basis.

Revenue Mix

Total revenue for each payor source divided by the total revenue.

Revenue Per Patient Day (RPPD)

Total revenue divided by actual patient days for each payor source.

Secondary Markets

The aggregate of data collected from 68 large core-based statistical areas (CBSAs) in the continental United States. Data is available in these markets beginning in the first quarter of 2008.

Seniors Housing (Community Type)

The combination of Independent Living Communities, Assisted Living Communities, and Memory Care Communities.

Seniors Housing (Majority Property Type)

The combination of Majority Independent Living and Majority Assisted Living properties.

Skilled Mix

Actual Medicare and managed Medicare/other days divided by total actual patient days.

Spaces

A general term that encompasses both units and beds within a property.

Stabilized Occupancy

Occupancy of properties that are (a) at least two years old, or (b) if less than two years old, properties that have achieved occupancy of at least 95.0% since their opening.

Street Talk

The assumed price a particular property has traded at. This is usually derived from published reports referencing a local professional not directly involved in the property's trade, but knowledgeable of factors affecting the price of a particular property.

Top Tier

The top quartile (i.e., fourth quartile) comprised of those properties above the 75th percentile.

Trade Area

The geographic area surrounding a subject property or specified address that results from search using a radius, polygon, or drive time; also referred to as the Primary Market Area (PMA).

Traffic Flow

The level of traffic for the specific geography to determine a drive time trade area. NIC MAP defines high traffic flow as Thursdays at 5 PM, medium traffic flow as Wednesday at 1 PM, and low traffic flow as Sunday at 8:30 AM.

Type A (contract type)

A contract between an independent living resident and an entrance fee CCRC that covers long-term care (assisted living or nursing care) without any substantial increase in the residents’ monthly payments.

Type B (contract type)

A “modified” contract between an independent living resident and an entrance fee CCRC that covers a specified amount of long-term care (assisted living or nursing care) during a set period of time without a substantial increase in residents’ monthly payments, or at a discounted rate.

Type C (contract type)

A fee-for-service contract between an independent living resident and an entrance fee CCRC. If nursing care is needed, it is paid at the daily rate.

Type D (contract type)

A rental contract between an independent living resident and a property that offers no guaranteed access to health care services. There is no entrance fee, and monthly fees cover the cost of maintaining the unit.

Under Construction Property Count

The number of unique properties that have inventory under construction. This includes new development, as well as properties undergoing expansions.

Underwritten

Cap rate is derived using owner-provided NOI divided by a current financial institution appraisal.

Units Under Construction

The amount of inventory that is under construction. Units are considered under construction once they break ground.

Walk Score

A Walk Score measures how walkable a place is to live. Walkability is broadly defined as proximity to amenities as well as pedestrian friendliness, where pedestrian friendliness is defined by population density and road metrics such as block length and intersection density. Walk Scores are between 0-100. For additional information about Walk Scores, view the Walk Score page.

Target Year

The year that a metric references when estimating a value. This can be displayed as Current Year (CY) and Five Years (FY). Select metrics could also be measured in the Delivery Year (DY), which is intended to serve as a mid-term measurement between CY and FY.

Current Year (CY)

Year 2023. Typically updates in Fall.