Sherman & Roylance: Leading Innovations in Healthcare Real Estate

Across the United States, demographic realities are reshaping how real estate professionals approach healthcare facilities. People are living longer, the 80-plus age cohort is expanding rapidly, and expectations around quality, convenience, and clinical integration are rising just as fast. In this environment, Sherman & Roylance (S&R) has emerged as a trusted guide for owners, operators, investors, and lenders who need more than a conventional brokerage. Drawing on more than 150 years of collective experience, the boutique firm unites valuation expertise, data-driven strategy, and deeply rooted relationships to help stakeholders unlock value in senior housing and skilled nursing. The result is a string of high-profile transactions, innovative redevelopment projects, and thought-leadership initiatives that are influencing the broader healthcare real-estate conversation.

The Evolving Landscape of Senior Housing

Senior housing once fit neatly into distinct buckets—independent living, assisted living, skilled nursing, and memory care. Today, those lines are blurring as residents demand seamless transitions between levels of care, better access to primary and specialty services, and lifestyle amenities that rival upscale multifamily developments. According to the National Investment Center for Seniors Housing & Care, communities that pair hospitality-grade environments with coordinated clinical offerings continue to outperform in occupancy and rent growth. Investors now evaluate properties not only on cap rates and replacement cost, but also on their ability to accommodate higher-acuity residents and evolving reimbursement models.

During the 2025 NIC Spring Conference, S&R analysts underscored this trend, noting that communities designed with built-in flexibility—larger units that convert to two-bed ADLs, shelled space earmarked for on-site clinics, technology infrastructure capable of supporting telehealth—are achieving premium valuations. By constantly monitoring data sets ranging from Medicare claims to local absorption rates, the firm helps clients anticipate what the resident of 2030 will need and where supply-demand imbalances will be most acute.

Integrated Care: Blurring the Lines Between Housing and Healthcare

Integrated care was the dominant theme of S&R’s remarks in Chicago, and for good reason. Older adults with multiple chronic conditions often juggle several providers, leading to fragmented care, higher costs, and avoidable hospitalizations. Facilities that collaborate with health systems, physician groups, or home-health agencies can close those gaps, improve outcomes, and generate new revenue streams. S&R’s advisory team has facilitated joint-venture clinics inside assisted-living communities, negotiated direct-to-provider leases for dialysis suites in skilled nursing facilities, and structured remote-patient-monitoring programs that keep residents healthier longer.

One illustrative example is a 144-bed skilled nursing facility in Santa Cruz, California, that recently transferred to a new long-term operator in a multi-million-dollar triple-net lease. S&R orchestrated the transaction specifically around the incoming operator’s plan to embed an on-site primary-care group and a geriatric behavioral-health service. Within months of closing, early readmission rates dropped, bolstering both clinical metrics and operating margins.

Beyond resident outcomes, integrated care supports alternative payment models that reward providers for keeping people out of the hospital. Investors that once shied away from value-based arrangements are warming to the discipline and predictability that risk-sharing brings. By weaving clinical diligence into traditional real-estate underwriting, S&R acts as an interpreter between the worlds of property and healthcare finance, creating structures in which both sides win.

Operational Excellence Through Data and Technology

The senior-living labor market remains tight, yet increased acuity requires more specialized staff. S&R helps owners rethink staffing ratios, utilize scheduling software, and add smart-building sensors that reduce unnecessary rounding. In one Pacific Northwest portfolio, sensor-based motion detection shaved 15 percent off nightly staffing costs while simultaneously decreasing falls. Savings like that resonate with lenders and appraisers, who increasingly incorporate technology adoption into stabilized NOI projections.

Analytics also inform site selection and market entry. S&R’s internal platform layers psychographic segmentation over traditional demographic data to pinpoint neighborhoods where empty nesters are already forming waitlists for independent-living cottages or where adult children are actively seeking memory-care solutions for parents. This intelligence guided the sale of an eight-acre parcel in Austin, Texas, originally entitled for a 98-unit assisted-living community. By presenting verified demand indicators, S&R secured a price that exceeded the seller’s target by 12 percent and gave the buyer confidence to fast-track construction.

Crucially, operational excellence is not an isolated exercise; it feeds back into integrated care strategies. Facilities that can document low agency-staff usage, robust engagement scores, and real-time quality dashboards position themselves as preferred partners for hospital discharge planners and managed-care networks. S&R’s cross-functional team conducts readiness assessments, benchmarking everything from PDPM reimbursement accuracy to Wi-Fi coverage, then rolls those findings into marketing materials and lender packages.

Strategic Transactions That Shape Communities

While S&R is best known for off-market, single-asset transactions, the firm’s transactional scope is broad—development sites, distressed assets, portfolio recapitalizations, and sale-leasebacks all sit within its wheelhouse. A recent $8.3-million sale of a 55-bed Monterey, California, assisted-living and memory-care community illustrates how creativity and confidentiality converge. The asset had struggled with occupancy after the pandemic; however, S&R identified a regional operator with a track record of turning around boutique coastal properties. By limiting the process to a short list of vetted buyers, the firm preserved staff morale, shielded the brand from rumors, and drove a quick closing that allowed reinvestment into resident-facing improvements.

S&R’s success also extends to debt workouts and bankruptcy advisory. In markets where aging physical plants meet rising wage pressure, some facilities require restructuring rather than a traditional sale. The firm’s healthcare-bankruptcy specialists collaborate with legal counsel and receivers to evaluate whether capital improvements, operator replacement, or adaptive reuse will unlock the most value. For lenders, that granular operational insight can mean the difference between a steep write-down and a viable path to stabilization.

The ripple effects of these transactions extend beyond the balance sheet. When a community finds the right steward, residents stay in familiar surroundings, frontline employees keep jobs, and local hospitals retain a discharge destination that eases bed shortages. In that sense, S&R’s deals act as quiet economic-development projects, reinforcing healthcare infrastructure that underpins regional quality of life.

Adaptive Reuse: Breathing New Life into Aging Facilities

With construction costs elevated and entitlement timelines lengthening, adaptive reuse has become a linchpin strategy. S&R recently facilitated the acquisition of a dormant 53-bed assisted-living facility in West Orange, New Jersey. Rather than raze and rebuild, the buyer—sourced through S&R’s private network—will modernize the building envelope, add energy-efficient mechanical systems, and re-license selective wings for memory care. The transaction demonstrates how repositioning can trim years off development schedules while preserving much-needed beds in supply-constrained markets. Moreover, adaptive projects often qualify for green-building incentives and historic-tax credits that lower cost of capital, benefits that S&R’s capital-markets team weaves into financing packages.

Financing Insights: Educating the Market

Access to capital can make or break even the most promising concept. Recognizing this, S&R hosts periodic webinars and in-person workshops that decode the financing landscape. A February 2024 session attracted operators, developers, and community bankers eager to understand HUD LEAN timelines, mezzanine structures, and the growing role of debt funds. By sharing best practices—such as common underwriting pitfalls or how to craft a data-rich pitch deck—S&R demystifies complex processes and elevates industry standards. The firm’s thought-leadership content is archived online, allowing smaller or emerging operators to upskill and compete for capital on more equal footing.

The Sherman & Roylance Difference: Confidentiality, Expertise, Results

Much of S&R’s impact stems from a unique operating philosophy: fewer listings, deeper engagement. Every mandate begins with a forensic analysis of the asset’s operational strengths and weaknesses, followed by a tailored marketing plan that restricts information to a vetted circle of buyers or tenants. Because decision makers know they are competing for exclusive opportunities, offers arrive faster, diligence proceeds smoothly, and closings face fewer last-minute concessions. That approach has helped S&R facilitate more than $5.5 billion in transactions while earning a reputation for discretion among high-profile owners—from family offices to publicly traded REITs.

The team’s multidisciplinary background further distinguishes the firm. Brokers hold credentials in appraisal, former administrators sit on strategy calls, and analysts routinely scrub CMS star-rating datasets. Whether valuing a 20-bed residential care home in an affluent suburb or negotiating a nine-figure skilled-nursing portfolio, S&R brings the same rigor. Clients appreciate that valuations are not cookie-cutter multiples of EBITDAR but take into account building age, payor mix, provider partnerships, and the sometimes-overlooked human capital that drives operational success.

Looking Ahead: Trends to Watch in Healthcare Real Estate

The next decade will likely see hybrid models that bundle active-adult units, assisted-living apartments, and wellness-center amenities onto the same campus, supported by technology that allows residents to age in place longer. Policy signals also point to a continued shift toward home-and-community-based services, meaning facilities must articulate clear value propositions—specialized rehab beds, complex-care programs, or hospitality standards no house call can replicate. Finally, capital markets appear poised to reward operators who can document environmental, social, and governance (ESG) performance, from energy-efficient retrofits to workforce-development initiatives.

Conclusion

Sherman & Roylance occupies a distinctive niche at the intersection of real estate, healthcare delivery, and capital formation. By anticipating industry shifts—integrated care, data-led operations, adaptive reuse—and backing insight with hands-on execution, the firm helps clients not only navigate change but leverage it for competitive advantage. As aging demographics accelerate and quality expectations climb, stakeholders will increasingly seek partners who can translate complex challenges into strategic opportunities. With a proven track record, an exclusive process, and unwavering commitment to resident outcomes, S&R stands ready to shape the next chapter of healthcare real estate.

Sources: NIC Spring Conference highlights; Austin development site sale; West Orange adaptive reuse; Financing options webinar.