Welcome to the golden age of senior housing credit. Health care real estate investment trusts (REIT) specializing in senior housing properties—including independent living, assisted living, and memory care facilities—are experiencing outsized net operating income (NOI) growth, rising stock prices, and strong capital inflows.1 Total enterprise value for this group has almost tripled in four years, while 2026 acquisition volume is on pace to surpass $25 billion.
Key credit metrics for the group are among the strongest in the REIT sector, and we expect much of the recent improvement to be sustained over the intermediate term. Strong internal NOI growth and steady equity issuance have reduced average net debt/EBITDA by approximately two turns to 3.6x, while net debt has declined to roughly 20% of enterprise value. High cash balances, unused revolvers, and often substantial forward equity agreements are also contributing to ample liquidity reserves…
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