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Kramer NIC - Mon pm

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1917 1920 1923 1926 1929 1932 1935 1938 1941 1944 1947 1950 1953 1956 1959 1962 1965 1968 1971 1974 1977 1980 1983 1986 1989 1992 1995 1998 2001 2004 2007 2010 2013 2016 Happy Birthday More than 82 Times to Nearly 10 Million Number of Persons Alive by Year of Birth Estimates as of 2017, Millions 10.9 Million Persons 82 + Alive (born prior to 1935) Rhode Island Health Care Association Current Trends and Future Drivers in Skilled Nursing 2.0 Robert Kramer, Founder and Strategic Advisor National Investment Center for Seniors Housing & Care January 19, 2018 Greatest Generation Silent Generation Baby Boomer Generation X Millenials Post Millenials Source: U.S. Census, NIC MAP ® Data Service 5.0 4.5 4.0 3.5 3.0 2.5 1.5 1.0 0.5 0.0 Copyright © 2018 National Investment Center for Seniors Housing & Care 12

Medicaid RPPD Climbs Slowly to Five-Year High of $203 in 3Q 2017 Copyright © 2018 National Investment Center for Seniors Housing & Care 13