Senior living projects can consider three guarantees at the start of construction: “The budget will be too low or too high, the timeline will be too short of too long; and something will do wrong,” said Peter Massey, senior vice president – development at Trilogy Health Services (Louisville, Ky.).
Massey and colleagues Greg Conner, senior vice president, treasurer, and Sandee McKnight, associate vice president – Health Center Growth, at Trilogy Health Services, shared some of the challenges of bringing senior living projects to market, from budget and lending constraints to unforeseen site conditions—and some lessons learned, during the session “Overcoming Obstacles in Construction Projects: An Owner/Operator Perspective,” at the 2025 Environments for Aging Conference + Expo in Lexington, Ky., April 26-29.
Trilogy operates more than 130 campuses across five states. By the end of the year, Massey said the owner/operator will have five new community projects under construction along with some refurbishments and additions underway on its campuses.
Construction lessons in senior living design
As it continues to grow, the panelists said the company takes lessons from previous projects to continue refining its approaches. For example, Harbor Terrace Senior Living, a new campus is Muskegon, Mich., sits on Muskegon Lake and opened in 2024. Part of a downtown revitalization effort, the new community, which houses 58 skilled nursing beds, as well as assisted living, memory care, and independent living apartments, was built on a former industrial site.
That locale presented several challenges, including wetlands conversation as well as site mitigation, the latter of which was addressed by installing a vapor mitigation barrier in the foundation. However, as the project progressed, additional soil testing was required on the site, which created delays.
Additional challenges faced by the project team included supply chain issues with sourcing materials for the water main, higher inflation rates, and banks making smaller loans. The result: The project faced a 13 percent increase in project costs and two months delay at the start, Conner said.
“We had to go back to our partners to see where they could make changes to mitigate costs,” he said.
Among the solutions were scheduling construction on sections of the project while other areas awaited test results, which helped to get the project back on track. Turning to budget issues, the owner worked with its design partners to change out the façade material to a more cost-effective siding product, which ended up being more resilient to area weather conditions, Massey said.
Through collaborative efforts like these the project was able to come in on budget. “Ultimately, it’s been a success story,” Conner said.
Overcoming renovation obstacles
On another project, Trilogy sought to renovate a building that it had acquired in 2016, including adding dialysis services and updating the skilled nursing and assisted living areas of the community. As construction began, the project team found issues with part of the building foundation, including a rotted sill plate, and insufficient insulation for fire suppression.
Engaging with engineers and inspectors, the project team was able to get certain areas of the project signed off on, which would keep construction moving, while the issues were fixed. “It’s all about relationships,” Massey said.
Another key to overcoming construction challenges, the panelists noted, is talking with and updating frontline staff on what’s going on. “They’re the one interacting with residents,” McKnight said.
Project communication is key
She added that it’s also important to be transparent and communicate daily with residents’ families, through email or daily calls, to apprise them of issues and how they’re being addressed. Such measures can help ensure communities don’t lose residents or staff during challenging times.
As project teams consider what impact tariffs might have on the senior living industry and future construction projects, Massey said he hasn’t seen any impact on costs yet. However, he added, when it makes sense, project teams are trying to buy materials upfront and store them onsite.
For more coverage of the 2025 EFA Conference + Expo, go here. And mark your calendars for the 2026 EFA Conference + Expo, to be held March 16-18, 2026, in Phoenix. For more information, visit environmentsforaging.com.
