National Church Residences Shifts To ‘wellness And Community’ For Senior Living’s Next Customers

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National Church Residences is adapting to the trends shaping senior living by focusing on affordable housing development and value-based care.

National Church Residences manages 353 affordable senior housing properties and 16 senior living communities. The Columbus, Ohio-based nonprofit operator owns and operates over 300 of these properties. In 2026, the organization continues to focus on affordability by leveraging tax credits and strong relationships with local municipalities, CEO Susan DiMickele told Senior Housing News.

In 2023, National Church Residences acquired At Your Door, a primary care group, to offer on-site primary healthcare services for older adults across National Church Residences communities and more than 100 senior living properties throughout Ohio. The organization also formed a partnership with Sound Physicians earlier this year.

In 2024, Sound Physicians achieved $114 million in shared savings across its entire network, the highest among long-term care Accountable Care Organizations (ACOs), according to data provided by National Church Residences.

These organizations brought health services directly to long-term care and assisted living communities through on-site primary care and telehealth services, resulting in fewer hospitalizations, stronger clinical outcomes, and increased shared savings for senior living communities.

This work is in preparation for a Centers for Medicare and Medicaid Services (CMS) goal of having all traditional Medicare beneficiaries in ACO relationships by 2030. Historically, senior living operators have been bypassed from financially benefiting from the quality of care and clinical outcomes they achieve, a trend that has prompted a growing number of providers to pursue value-based care structures.

A shift from care and safety to wellness and community

In recent years, senior living providers have reworked operations to focus more on wellness and lifestyle while maintaining clinical care as a baseline. This improves the overall resident experience and better reflects how older adults live prior to moving into senior living. In 2026, senior living providers face a “lead or follow” moment regarding value-based care.

Today, DiMickele sees the senior living industry experiencing a shift from “care and safety” toward “wellness and community.” Providers are now creating more programming around lifestyle and preventive medicine to match the unique preferences of older adults.

“Wellness and community are becoming more important, regardless of the level of care, and we believe that primary care is essential for prevention and getting ahead of things from a healthcare perspective,” DiMickele said. “That’s one of the reasons why we’re really committed to primary care and we’re excited to grow it.”

Through the At Your Door and Sound Physicians partnership, DiMickele said National Church Residences is able to offer primary care services and participate in a shared savings format, even if the nonprofit provider does not operate the specific community its primary care group enters.

Building out this value-based care ecosystem has not been easy, but the end result has helped mitigate risk as residents are reporting better health outcomes, more disease prevention, and broader support for aging in place, DiMickele said.

Doing it that way gives the operator the ability to scale value-based care efforts more quickly while allowing other companies to partner in the ACO plan with At Your Door and Sound Physicians, even when National Church Residences is not the operator of the community, DiMickele said.

“Regardless of whether a facility is owned by National Church Residences or an outside partner, we want to ensure that every stakeholder—including executive directors, nursing leadership, and At Your Door—is fully aligned,” DiMickele said. “We are committed to ensuring everyone operates as one cohesive unit to provide the best possible care for our residents.”

DiMickele said it is “essential” for senior living providers to become proficient in primary care in the years ahead, pointing out that the industry’s future lies in healthcare delivery and care coordination, with primary care serving as “the quarterback” of a provider’s healthcare efforts.

“Five to 10 years ago, this wasn’t even a conversation, and we’re really trying to create an environment to let others into this value-based relationship with the number one goal of improving the lives of residents,” DiMickele said. “One of our priorities is making sure that we have these pathways to create new partnerships.”

Regarding value-based care in general, DiMickele said this new revenue stream via shared savings is critical in today’s “margin-tight environment,” particularly for affordable senior housing or middle-market offerings where affordability is a constraint.

This emphasis on value-based care has helped improve resident satisfaction, and National Church Residences has a goal of achieving a Net Promoter Score of 50 or above to better gauge customer loyalty.

Inside the National Church Residences development pipeline

Amid tough development conditions, National Church Residences has pushed through challenges by using federal tax credits and local funding to build a capital lineup that makes affordable senior housing development possible in 2026, DiMickele said.

For example, National Church Residences recently completed Berwyn East Place, an 88-unit affordable senior housing property in Columbus, Ohio. The effort was made possible through a partnership with UnitedHealth Group, which provided $12 million in equity administered through the National Affordable Housing Trust.

Currently, National Church Residences has 16 affordable senior housing projects in development, spanning renovations and new communities. Renovations are a key element of the organization’s development thesis as they allow for repositioning units and interior spaces to keep properties current and comfortable for existing residents, DiMickele said.

In 2018, the federal tax credit program was updated to allow for income averaging within affordable housing developments to reach a broader portion of the middle market, DiMickele said. This has helped increase access for older adults who cannot afford luxury price points but earn too much to qualify for traditional income-restricted subsidies.

“You have to be creative in today’s market,” DiMickele said.

That creativity is paying off; the provider is working closely with municipal leaders in Columbus after the city passed a bond issuance that allocates $500 million for affordable housing.

Zoning, planning, and site design can take “months or even years,” she said, even with National Church Residences’ extensive development experience and deep bench strength. While funding may be hard to track down, moving forward with new growth is vital to meet incoming demand, DiMickele said.

“We need to go further,” DiMickele said. “Income averaging through the tax credit program is just scratching the surface.”

Today, DiMickele said senior living providers must adapt to the demands of the baby boomer generation. She believes the industry is “at an inflection point” because boomers are “different,” requiring shifts in operations to accommodate this new cohort.

“They view themselves more as citizens and not as passengers on a cruise ship,” DiMickele said. “That’s an important shift for us to pay attention to.”

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