Third-party senior living operator and consulting company Health Dimensions Group (HDG) has exceeded the 50-community mark thanks to new relationships with two national REITs.
Now at 52 communities primarily in the U.S. Midwest, the Minnetonka, Minnesota-based senior living provider has grown its management portfolio rapidly in the last 12 months. The company inked new relationships with real estate investment trusts (REITs) including Ventas (NYSE: VTR), while also expanding with Sabra Health Care REIT (NASDAQ: SBRA).
“The growth for us has been very purposeful,” said HDG Principal and CEO Erin Shvetzoff Hennessey. With a slate of new properties to operate, HDG is putting its head down in 2025 to improve results there before pivoting to more growth next year. Among the operator’s current efforts is right-sizing its mix of senior living and skilled nursing units.
Last October, HDG added five communities to its third-party management portfolio following a new relationship with a private equity group with properties in Iowa, Minnesota and Wisconsin, along with an additional private equity partnership for a community in Gurnee, Illinois in November 2024.
In the spring of this year, HDG took on three communities under management for Sabra and 11 communities with Ventas.
While the Ventas relationship is new, the ties with Sabra date back many years, leasing properties from the Tustin, California real estate investment trust in Green Bay, Wisconsin and Brenham, Texas, along with managing six properties under third-party agreements.
Beyond exceeding the 50-community mark, HDG is also celebrating another milestone in 2025: Its 25th anniversary in business.
REIT relationships aid HDG’s growth
Like other senior living operators, HDG is growing alongside larger REIT partners, which are expanding their holdings in senior living as construction remains low and demand is high.
HDG is “flexible” in how it works with those partners, with agreements spanning third-party management and joint venture endeavors.
“We have special relationships and we want to continue to grow,” Shvetzoff Hennessey said. “We’re looking to grow with our existing partners because we value them.”
The company’s consulting business now makes up approximately 40% of HDG’s revenue annually, and Shvetzoff Hennessey said she sees opportunities to grow HDG’s consultation business “on a similar trajectory” to its management and leased portfolio.
Since May 1, the company has not taken on any new communities and that’s by design, she said, noting that HDG leaders are now focused on integrating new communities into the fold, while also providing them with adequate resources as needed throughout the onboarding process.
“We want to make sure that we grow strategically and grow steadily versus rapid growth that can cause problems,” Shvetzoff Hennessey said.
New transition team to tackle integration
Growing operators can sometimes struggle to onboard new communities, especially if they take on multiple in a short time. At the same time, the faster they can pivot from turnaround to growth, the sooner they can turn their attention to other matters.
In response to these challenges, some operators like Brookdale Senior Living (NYSE: BKD) and Sonida Senior Living (NYSE: SNDA) have created response teams meant to improve operating results. HDG similarly launched a transition team solely dedicated to providing newly transitioned communities with resources, training and support as necessary.
“That’s everything from culture, leadership, training, systems, marketing, clinical. It’s a team that’s just focused on that, and what that allows us to do is to focus on those things we can control in operations,” Shvetzoff Hennessey said.
To help new communities mesh smoothly, the integration team monitors revenue, pace of occupancy and follow trends in community-level staffing to improve targeted retention efforts, Shvetzoff Hennessey noted.
When a new community comes online, HDG conducts a reassessment of resident care needs and through better documentation, HDG care teams have been able to identify potential revenue gaps, an effort seen across the industry recently.
Improving staffing challenges, preparing operations
In 2025, Shvetzoff Hennessey sees opportunities and challenges ahead. For headwinds, she said this year has led to more “regulatory scrutiny” in certain states, along with increased cost inflation and occupancy pressure in skilled nursing. Tailwinds include a strong rebound in senior living occupancy, combined with the wealth of M&A opportunities, she added.
Rural markets continue to pose a challenge in finding qualified talent to work in communities due to population constraints and the senior living provider continues to compete with hospitals and health systems for staff.
To improve hiring in certain areas, HDG conducts targeted recruitment of employees from its hope office leaving the final interview and training up to the communities. Some key positions the recruitment team focuses on are director-level positions for communities, spanning executive directors to wellness directors.
Securing licensed care staff has been a persistent thorn in the side of operators in recent years, and this is no different for HDG, along with some frontline culinary and housekeeping roles tougher to fill than others on the organizational chart.
In 2026, HDG will “double down” on life enrichment and curating programming for residents combined with an effort to improve retention of staff at HDG communities.
“This focus on life enrichment, on residents knowing that it improves quality, increases financial performance and occupancy, that is what makes a community great—both as a place to live and as a business,” Shvetzoff Hennessey said.
Next year will be a “continuation of growth” with scale that is “paced with our ability to provide quality results,” Shvetzoff Hennessey said, while expanding the company’s relationship with the Program of All Inclusive Care for the Elderly (PACE).
“This will be strategic and even in times of growth, we will continue to focus on our ultimate goal which is quality,” Shvetzoff Hennessey said.
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