The developers who have grown in these lean years tend to be small to midsize regional operations that know their local markets well, had a strong portfolio before the crash and have been able to persuade banks to lend despite the dour economy. They also tend to invest in assisted-living rental properties, which are tied to health care rather than personal housing choices.

“It’s certainly not for everyone, but there are companies that really understand the markets and submarkets, and they’re very adept at building,” said David S. Schless, president of American Seniors Housing Association, an industry trade group.

Demand for nursing homes, assisted-living facilities and retirement communities is expected to balloon in the next two decades as baby boomers retire and the incidence of progressive illnesses like Alzheimer’s disease increases. The number of Americans over the age of 65 is expected to double to 71 million by 2030, and 7.7 million of them will suffer from Alzheimer’s disease, a 50 percent increase from today, according to the Alzheimer’s Association.

“It’s a great time to develop senior housing,” said Marilynn K. Duker, the president of Brightview Senior Living, a developer based in Maryland that has completed five new facilities since 2008 and has three others under construction. “As long as we can continue to get capital and have the ability to afford it, it’s an opportunity and there isn’t a lot of competition.”

The inventory of housing for older people has not been keeping pace with demographics, especially in regions like the New York metro area. New York has the fewest number of such units, including retirement communities and assisted-living facilities, available relative to the number of households with residents over the age of 75 of all the top metro markets in the country, according to the National Investment Center for the Seniors Housing and Care Industry, an industry research group.

At the height of the housing boom, there was a nationwide surplus of retirement and assisted-living housing, but with construction bottoming out, demand is now outstripping supply. New construction starts in such housing have dropped by 53 percent since the crash and now make up just over 1 percent annually of the senior housing inventory, according to the National Investment Center.

“That is pretty much an all-time low,” said Jerry L. Doctrow, an analyst at Stifel Nicolaus. “There’s not much coming in the pipeline at all.”

Here in East Northport, a town on Long Island, a 100-bed assisted-living facility developed by the Engel Burman Group that opened in March is already 50 percent full. With a lush, landscaped circular driveway, the $35 million property, called the Bristal at East Northport, resembles an upscale hotel in some ways. The lobby has a concierge and a fireplace, and opens onto a dining room with linen-covered tables. The three-story building provides residents with a library, a swimming pool, a small putting green and a billiard room. Room costs range from $3,400 a month for a shared suite to $6,000 a month for a room in the 32-bed dementia ward.

This is the seventh Bristal on Long Island built by Engel Burman, and the first since 2007, when the company sold its other Bristal properties for $320 million to Chartwell Seniors Housing REIT, of Canada, and another real estate investment trust owned by ING Real Estate Australia. A noncompete agreement expired in February, allowing Engel Burman to open the doors at the East Northport facility.

Engel Burman has several other projects under way, including the Seasons, a $150 million, 404-unit retirement community 30 minutes away in East Meadow that was financed in late 2007 before the housing market crash. At prices starting at $389,000 for a two-bedroom townhouse, all but five of the first 212 units built have been sold.

“We’re from Long Island. We know the island. We know the locations. We are still very bullish on Long Island,” said Steven Krieger, a co-founder and principal at Engel Burman.

The company is building elsewhere in the region, as well. Four properties are under contract in New York and another in northern New Jersey. The company plans to develop new assisted-living facilities at all of them. Engel Burman financed the East Northport facility with industrial development agency tax-exempt bonds, an unusual choice in an industry that generally relies on bank lending. But the company has long relied on such bonds to finance their assisted-living facilities, and without them, Mr. Krieger said, the project might not have been built at all, because of the difficulty of securing a bank loan.

When the market crashed, the company’s bond buyer, Oppenheimer Funds, was still willing to work with them. But the rates were much higher.

Industrial development agency bonds also come with strings attached. Engel Burman must set aside 20 percent of the units for low-income residents and 90 percent of the residents must have previously lived within a five-mile radius of the facility, or have an immediate family member who currently does.

Bank financing may come with fewer restrictions, but getting it is no easy feat. In 2009, for example, Ms. Duker of Brightview spent nine months trying to finance a 180-unit retirement housing development in Marlton, N.J.

A year earlier, she said, it would have taken her about three weeks to secure financing. But by 2009, her go-to bank was reluctant to invest in real estate. In the end, a small regional bank agreed to finance the $33 million development.

The faltering economy changed the calculus for many older Americans. Fewer have moved into retirement communities, and many in need of assisted-living arrangements moved in with family, changes that badly bruised industry giants. One, Erickson Retirement Communities, filed for Chapter 11 bankruptcy protection in 2009 and was subsequently acquired at auction by Redwood Capital Investments. Sunrise Senior Living, another industry leader, shut down its development arm and sold some assets to manage its debts. “Everything is much stricter than it ever used to be, and that makes it that much harder” to build, said Wayne Kaplan, the president of Premier Senior Living, an owner and operator of properties in New York, Ohio and Florida.

Because assisted living is tied to health care, it is an attractive option for skittish banks just beginning to loosen their purse strings. Unlike hotels and residential high-rises, assisted-living facilities can attract government underwriting, which make them safer bets. And assisted-living property owners have a very low default rate: less than 1 percent, according to the National Investment Center for the Seniors Housing and Care Industry.

“That kind of financial performance gives banks confidence that senior housing is different from other sectors of the real estate sector,” said William Pettit, president and chief of Merrill Gardens, a developer in Seattle that is opening a senior housing development in San Diego next month. “There’s a fundamental demand that has continued throughout the recession.”

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