Senior housing operating coverage worksheet

How to use

Use this worksheet to score operator quality and size senior housing CRE debt by acuity level. The matrix walks the operator-quality screen (occupancy, margin, survey history) against the acuity-level pricing band. Lender bench is acuity-and-operator-tier dependent.

Section 1. Operator quality scoring

Operator scoring is the senior housing underwriting differentiator, more important than the building, the location, or the rent roll. Score each dimension and band the operator into top-quintile, mid-quintile, or bottom-quintile.

• Portfolio occupancy, top-quintile > 90%; mid 85% to 90%; bottom < 85%.
• Operating margin, top-quintile > 25%; mid 20% to 25%; bottom < 20%.
• AHCA / state survey history, top-quintile deficiency-free or minor citations only; bottom immediate-jeopardy or substandard-quality citations.
• Tenure-in-place, top-quintile 5+ yr in current portfolio; bottom < 2 yr.
• Owner-operator vs. third-party-managed, owner-operator preferred.
• Labor-cost trend, top-quintile holding labor flat as % of revenue; bottom showing margin compression.

Section 2. Acuity-level pricing bands (2026)

Pricing band is acuity-and-operator-quality dependent. Bands below assume top-quintile to mid-quintile operator on stabilized asset; bottom-quintile excluded from agency and most bank programs.

Senior housing pricing by acuity level (2026 stabilized, top-mid quintile operator)

Section 3. Sizing math by lender

Sizing on senior housing is multi-constraint, DSCR, debt yield, LTV. The binding constraint depends on lender, acuity, and operator tier.