Middle-Market Gap Takes Center Stage at NIC Spring Conference’s Innovation Lab
At this year’s National Investment Center for Seniors Housing & Care (NIC) Spring Conference, a pivotal discussion took place within the Innovation Lab, moderated by Jerry Taylor, co-chair of the NIC Spring Conference through 2026 with Colleen Blumenthal, Jerry led a panel of distinguished industry leaders to tackle one of the most pressing challenges in senior housing: making middle-market care sustainable.
The Panelists:
- Jason Childers, Merrill Gardens
- Joe Jedlowski, Distinctive Living
- Julie Simpkins, Gardant Management Solutions
- Terry Spitznagel, United Church Homes
Key Themes Explored:
- Innovative partnerships that enhance the sustainability of middle-market care
- Creative staffing solutions to improve service delivery
- Lessons learned from operators actively deploying new models
The middle-market has been a focal point for NIC over the past five years, highlighting the gap between low-income residents who qualify for state-assisted programs and high-income seniors who can afford premium private-pay services. This underserved segment—those who don’t qualify for assistance but also lack sufficient resources for high-end senior living—represents a significant challenge and opportunity for the industry.
Care Delivery Strategies: Bridging the Middle-Market Gap
One of the most urgent discussions centered on care delivery models that maximize efficiency without sacrificing quality. The panelists emphasized strategic partnerships with third-party healthcare providers, such as Curana Health, home health agencies, and hospice services, to enhance care coordination and improve resident outcomes.
Many middle-market seniors are still being cared for at home by family members, a dynamic that places an immense burden on loved ones. The panel highlighted the need for innovative care models that provide affordable, high-quality options for this growing demographic.
Operational Efficiencies: Rethinking Cost Structures to Serve the Middle-Market
From outsourcing transportation to reimagining meal delivery strategies, panelists shared insights on how operators can reduce costs while maintaining service quality. One key area of discussion was the role of technology in improving efficiency.
Examples included:
- Proactive care models that identify residents at risk based on health data trends
- Smart sensors (such as toilet sensors that detect urinary tract infection risks)
- Remote patient monitoring to track vital signs and intervene before a health crisis occurs
However, a couple of major hurdles remain.
There is a lack of integration between standalone technologies. Data from different devices often doesn’t communicate effectively, leaving community leadership struggling to translate insights into actionable care plans. As Jerry Taylor and the panel pointed out, many operators are overwhelmed with day-to-day operations and lack the time or technological sophistication to fully leverage these innovations.
The other major hurdle is the labor shortage. One of the most significant barriers to effective middle-market care is staffing. With a limited labor pool and an increasing demand for care, finding sustainable workforce solutions is critical. The panel examined potential strategies, including cross-training universal workers, and again, leveraging technology to reduce staff workload.
The Bigger Picture: The Reality of Aging in America
While the aging baby boomer population is often touted as a massive opportunity for senior housing, the reality is far more complex.
The top 20% of Baby Boomers hold significantly more wealth than the other 80%, with the top wealth quintile having a net worth greater than $4.4 million, while about 60% have a net worth below $185,000.
As Jerry Taylor passionately expressed, the industry cannot afford to ignore this affordability crisis. “Developers who keep talking about ‘The Silver Tsunami’ without addressing affordability, are not living in reality,” he remarked. “The biggest part of the market can’t afford what developers are building.”
The middle market isn’t just a challenge—it’s a call to action for industry leaders to rethink financial models, care strategies, and operational efficiencies to ensure that the aging population has access to the care they deserve.
Looking Ahead: Finding Solutions Together
This NIC Innovation Lab reinforced that while there is no single solution to the middle-market challenge, industry-wide collaboration will be key to progress. By fostering discussions, sharing best practices, and leveraging strategic partnerships, senior housing operators can work toward sustainable, scalable solutions.
NIC’s commitment to addressing these issues head-on ensures that the conversation will continue, pushing the industry to innovate and adapt in ways that will shape the future of middle-market senior living.
