I have never been more bullish on the outlook for LTC census than I am right now. The turnaround we have seen since the start of the pandemic has been encouraging. The outlook for the next five years is more of the same. We should see a slow, but steady increase in our numbers.

Most of us, maybe all of us, spent the first six months of 2020 wondering if the sector would survive. There were multiple scenarios where it could have been lights out for this profession. But the millions of people who keep this sector going never gave up, and slowly, but steadily, we emerged from the darkness. It is now clear that we cannot only survive the nightmare, but we can thrive.

One of the most common questions I was asked in the early days of the pandemic was, “How long will it take skilled nursing census to recover?” No one knew. We were all guessing. But now we know. From the depth of losing about 14 percent of our census, it grew back at about 3 percent a year.

We are now back to roughly where we were when the pandemic started. When you dig into the details of occupancy it’s more complicated than this chart depicts. Closures, the way some providers report occupancy, and other factors, make this not a perfect comparison. But we are basically back to where we were in 2019.

Occupancy will continue to improve for at least the next three to five years. That is true for two reasons. The first, and most important, is that the aging of the population is finally starting to help us. I know we’ve all heard about the silver tsunami for decades and it hasn’t amounted to much. That is because the aging of the baby boomers over the last 30 years hasn’t put them in our wheelhouse. They were turning 50, then 60, and then 70. But those are not the ages of people who live in our buildings. The average age of our residents is 82.

Starting next year, the oldest of the baby boomers turns 80. That is when everything will change. The number of people over the age of 80 will increase dramatically for the next 20 years.

As we sit here today, there are roughly 15 million Americans over the age of 80. In just five years there will be 4 million more, and five years after that another 5 million more. By the time we get to 2045, the number will have almost doubled. There will be lots of customers for all long-term care services.

The second reason I’m bullish on census is that supply is declining. Since the start of the pandemic there have been more than 800 building closures.

The number of new facilities has slowed and isn’t close to making up for the closures.

When you net out the closures and new builds, there are 500 less SNFs today than there were in 2019.

These favorable trends apply to assisted living as well. The average age of an assisted living resident is also in the 80s. The assisted living customer base is on the cusp of dramatic growth. On top of that, the building of new assisted living facilities has also slowed dramatically. Those two factors are very bullish for assisted living census moving forward.

Of course, there are factors that could reduce demand. As value-based payment models grow, utilization will decline. But the decline in utilization won’t come close to the increased number of people needing our services.

And the market will respond. The world generally thinks that investing in long-term care is stupid/risky right now. But, over time, our free market is incredibly efficient. Investors will figure this out and they will build new buildings. But this will take time. It takes years to get projects up, going, and stabilized.

In the meantime, we are likely to enjoy strong census numbers. After surviving the darkness of the last five years, the future looks bright.