Sienna Senior Living : 2024 Q1 Financial Results link to 2024 Q1 Financial Results

Report to Shareholders

Q1 2024 Sienna Senior Living Inc.

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LETTER TO SHAREHOLDERS

Dear Fellow Shareholders,

Building on last year's significant achievements across both lines of our business, we are off to a great start in 2024, with our first quarter results highlighting that we have transitioned into a period defined by stability and growth. We are grateful to the Governments of Ontario and British Columbia, who continue to prioritize seniors and the growing need for long-term care. Their investments announced to date in 2024 mark a significant step forward in alleviating the exceptional cost pressures operators experienced over the past several years. In addition, our retirement operations are benefitting from strong demand and limited new supply in many of our key markets. Construction starts of new retirement residences have reached record-low levels, and combined with the demographic shift of an aging population, we anticipate notable occupancy gains across our retirement platform in the coming years.

On a sustained growth path

Year over year, Sienna's same property net operating income ("NOI") increased by $27.6 million to $63.9 million in Q1 2024. The strong results of our long-term care operations reflect notable one-time government funding to compensate the sector for unfunded pandemic expenses and significant cost escalations in prior years and to support our operations. Also adding to the strong results was the underlying stable operating environment with fully occupied homes across Ontario and British Columbia.

With respect to our retirement operations, we continued to make steady progress towards our goal of stabilized occupancy of 95%, a level aligned with industry experts' 2026 forecast for the Canadian retirement sector as a result of tremendous demographic tailwinds and supply constraints. Sienna's same property occupancy increased by 30 basis points year over year to 88.1% in Q1 2024. With lead indicators continuing to improve, monthly same property occupancy increased for the third consecutive month in April 2024, reaching 88.9%. Our intensified focus on homes with lower occupancy, as well as annual rent increases, contributed to the same property NOI growth year over year in Q1 2024.

Crucial government funding updates provide clarity and optimism

In recent weeks, the Governments of Ontario and British Columbia provided a number of important funding updates for long-term care that are expected to have a lasting impact on the sector and the wellbeing of Canadian seniors. Included in Sienna's Q1 2024 results were $13.4 million of one-time funding in Ontario, and $13.6 million of retroactive funding from the Government of British Columbia, essentially reimbursing the Company for any unfunded pandemic costs and cost escalations due to inflation over the past four years.

Improvements to the funding of our day to day operations, combined with an enhanced construction funding subsidy, will also have a positive impact on the redevelopment momentum of Ontario's older long-term care homes. It will support the government's important goal of building 58,000 new and redeveloped long-term care spaces by 2028 and benefit the fast growing seniors' population.

As a result of these improvements, we are pleased to move forward with the redevelopment of our long-term care home in Keswick, Ontario, where we expect to start construction in Q4 2024. Located on a campus comprising both retirement residences and Class B long-term care beds, the current 60-bedlong-term care home will be redeveloped into a new, state-of-the-art160-bed community on the same site. This will be our third long-

term care redevelopment project, adding to the two projects currently under construction in North Bay and Brantford, which are expected to be completed in the second half of 2025. These projects will support the government's important goal of rebuilding Ontario's older long-term care homes and benefit the fast growing seniors' populations.

A learning organization that invests in team members' growth and development

Our success is deeply rooted in our team of 12,000, who is at the core of everything we do. Gaining alignment with our team members and continually looking for ways to increase engagement has been one of the most important factors of our success. It was a key driver for the 11% improvement of team member retention in 2023, and played a significant role in reducing our reliance on agency staff. Agency costs have now returned to pre- pandemic levels and we relentlessly focus on keeping our need for agency staffing at a minimum. These achievements will have a lasting impact on Sienna's team culture and our residents' quality of life.

Always looking for new ways to differentiate Sienna in the market, we introduced a program called "Learning Bites" in Q1 2024, which provides one hour of learning per month to all of our team members in addition to their job-specific training. This program highlights Sienna's goal of being a learning organization that strives to invest in team members' growth and development.

Our multifaceted approach to attracting and retaining an engaged team also includes the placement of students, temporary foreign workers and internationally educated nurses, programs that are of particular importance at communities with significant staffing challenges.

2024 - The Year of Senior Living

A year ago, we first outlined in detail how our initiatives to grow occupancy, reduce agency staff and address government funding shortfalls were expected to have a positive impact on our financial results and ability to grow and serve more seniors for generations to come. Since then, quarter after quarter, we have seen successes on all fronts.

With five quarters of growth behind us in both business segments, the momentum is on our side as we continue to unlock the growth potential within our long-term care and retirement platforms. Recent government funding announcements for long-term care, coupled with strong industry-wide occupancy forecasts for the retirement sector as a result of an aging population and supply constraints, affirm our commitment to our diversified approach to owning both retirement and long-term care homes.

Combined with the flexibility provided by our strong balance sheet and the continued support of our stakeholders, 2024 is shaping up to become The Year of Senior Living.

On behalf of our management team and our Board of Directors, I want to thank all of you for your continued support and commitment.

Sincerely,

Nitin Jain

President and Chief Executive Officer

Sienna Senior Living

Management's Discussion and Analysis

Q1 2024 Sienna Senior Living Inc.

Cultivating happiness in daily life

MANAGEMENT'S DISCUSSION AND ANALYSIS

BASIS OF PRESENTATION	1
ADDITIONAL INFORMATION	1
REVIEW AND APPROVAL BY THE BOARD OF
DIRECTORS	1
COMPANY PROFILE	2
NON-IFRS PERFORMANCE MEASURES	2
KEY PERFORMANCE INDICATORS	7
FIRST QUARTER 2024 SUMMARY	9
BUSINESS UPDATE	11
OUTLOOK	20
SIGNIFICANT EVENTS	23
OUR PURPOSE, VISION AND VALUES	23
COMPANY STRATEGY AND OBJECTIVES	24
ENVIRONMENTAL, SOCIAL AND
GOVERNANCE (ESG) RESPONSIBILITY	25
INDUSTRY UPDATE	28
BUSINESS OF THE COMPANY	28
QUARTERLY FINANCIAL INFORMATION	29
OPERATING RESULTS	30
JOINT ARRANGEMENT	30
ADJUSTED REVENUE, ADJUSTED OPERATING
EXPENSES, AND ADJUSTED NOI	31
CONSOLIDATED NET OPERATING INCOME	32
NET OPERATING INCOME BY SEGMENT
RETIREMENT	34
LONG-TERMCARE	35
DEPRECIATION AND AMORTIZATION	36
ADMINISTRATIVE EXPENSES	36
SHARE OF NET LOSS IN JOINT VENTURES	36
NET FINANCE CHARGES	37
TRANSACTION COSTS	37
INCOME TAXES	37

BUSINESS PERFORMANCE	38
ADJUSTED FUNDS FROM OPERATIONS	38
FIRST QUARTER 2024 PERFORMANCE	39
CONSTRUCTION FUNDING	40
MAINTENANCE CAPITAL EXPENDITURES	40
RECONCILIATION OF CASH FLOW FROM
OPERATIONS TO ADJUSTED FUNDS FROM
OPERATIONS	42
FINANCIAL POSITION ANALYSIS	42
LIQUIDITY AND CAPITAL RESOURCES	43
LIQUIDITY	43
DEBT	44
CREDIT RATINGS	48
FINANCIAL COVENANTS	48
EQUITY	51
CAPITAL DISCLOSURE	52
CONTRACTUAL OBLIGATIONS AND OTHER
COMMITMENTS	52
CRITICAL ACCOUNTING ESTIMATES AND
ACCOUNTING POLICIES	52
SIGNIFICANT JUDGEMENTS AND ESTIMATES .	53
RISK FACTORS	53
CONTROLS AND PROCEDURES	54
FORWARD-LOOKING STATEMENTS	54

Basis of Presentation

The following Management's Discussion and Analysis ("MD&A") for Sienna Senior Living Inc. (the "Company" or "Sienna") provides a summary of the financial results for the three months ended March 31, 2024. This MD&A should be read in conjunction with the Company's unaudited condensed interim consolidated financial statements ("interim consolidated financial statements") for the three months ended March 31, 2024. This material is available on the Company's website at www.siennaliving.ca. Additional information about the Company, including its most current Annual Information Form ("AIF") can be found on the System for Electronic Document Analysis and Retrieval + ("SEDAR+") at www.sedarplus.ca.

All references to "we", "our", "us", "Sienna", or the "Company", unless otherwise indicated or the context otherwise requires, refer to Sienna Senior Living Inc. and its direct and indirect subsidiaries. For ease of reference, the "Company" is used in reference to the ownership and operation of senior living residences and its third party management business. Subsidiaries of the Company are the direct owners and operators of such residences.

Financial information has been prepared in accordance with International Financial Reporting Standards ("IFRS"). In this document, "Q1" refers to the three-month period ended March 31; "Q2" refers to the three- month period ended June 30; "Q3" refers to the three-month period ended September 30; and "Q4" refers to the three-month period ended December 31.

With the exception of this MD&A's Business Update, Outlook and Environmental, Social and Governance ("ESG") Responsibility sections, or unless otherwise stated, all dollar amounts referred to in this MD&A, including tabular amounts, are expressed in thousands of Canadian dollars.

This MD&A contains forward-looking information based on management's expectations, estimates and projections about the future results, performance, achievements, prospects or opportunities for Sienna and the senior living industry as of the date of this MD&A. Please refer to the "Forward-looking Statements" section and the "Risk Factors" section of this MD&A for more information.

Additional Information

Additional information relating to the Company can be found on the Company's website at www.siennaliving.ca, by accessing the Company's public filings on SEDAR, or by contacting David Hung, the Company's Chief Financial Officer and Executive Vice President, at 905-489-0258 or [e-mail].

Review and Approval by the Board of Directors

This MD&A is dated as of May 9, 2024, the date this report was approved by the Board of Directors of the Company, and is based on information available to management of the Company as of that date.

Sienna Senior Living Inc. - Q1 2024 Management's Discussion and Analysis

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Company Profile

The Company and its predecessors have been operating since 1972. The Company is a senior living provider serving the continuum of independent living ("IL"), independent supportive living ("ISL"), assisted living ("AL"), memory care ("MC") and long-term care ("LTC" or "Long-term Care") through the ownership and operation of senior living residences in the Provinces of British Columbia, Saskatchewan and Ontario. As at March 31, 2024, the Company owns and operates a total of 82 senior living residences: 40 retirement residences ("RRs" or "Retirement Residences") (including the Company's 50% joint venture interest in 12 residences in Ontario and Saskatchewan); 34 LTC communities; and eight senior living residences providing both private-pay IL/AL and funded LTC (including the Company's joint ownership in two residences in British Columbia). The Company also provides management services to an additional 12 senior living residences in the Provinces of British Columbia, Ontario and Alberta.

The table below represents the number of suites or beds owned and operated or managed by the Company, by business segment.

	Retirement	Long-term Care	Total (1)
Owned Residences	Residences	Suites	Residences	Beds (2)	Residences	Beds / Suites
100% Owned - operating	27	3,208	40	6,198	67	9,406
Partially Owned - operating (3)	13	1,367	2	374	15	1,741
Total Owned	40	4,575	42	6,572	82	11,147
Managed Residences	9	826	3	526	12	1,352
Total	49	5,401	45	7,098	94	12,499

Notes:

1. 79.9%, 15.5%, 4.1% and 0.6% of total beds/suites are located in Ontario, British Columbia, Saskatchewan and Alberta, respectively.
2. 180 of the LTC beds are privately funded.
3. We have a 50% ownership in 12 retirement residences (1,217 suites), a 70% ownership in one retirement residence (150 beds), a 70% ownership in one long-term care community (256 beds) and a 77% ownership in one long-term care community (118 beds) as at March 31, 2024.

The Company is traded on the Toronto Stock Exchange ("TSX") under the symbol "SIA".

The Company's business is carried on through a number of wholly owned limited partnerships and joint ventures formed under the laws of the Province of Ontario.

As at May 9, 2024, the Company had 72,967,166 common shares outstanding.

Non-IFRS Performance Measures

In this MD&A, the Company uses certain supplemental measures of key performance that are not measures recognized under IFRS and do not have standardized meanings prescribed by IFRS. These performance measures are net operating income ("NOI"), funds from operations ("FFO"), operating funds from operations ("OFFO"), adjusted funds from operations ("AFFO"), earnings before interest, taxes, depreciation and amortization, and impairment loss ("EBITDA") and maintenance capital expenditures ("maintenance capital expenditures", and collectively with NOI, FFO, OFFO, AFFO and EBITDA, the "Non-IFRS Measures"). These terms are defined in the following table and reconciliations to the most comparable IFRS measures are referenced, as applicable.

Sienna Senior Living Inc. - Q1 2024 Management's Discussion and Analysis

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The Company also uses the following key performance indicators (the "Key Performance Indicators"): Occupancy, Total Adjusted Revenue, Total Adjusted Operating Expenses, NOI, OFFO and OFFO per share, AFFO and AFFO per share, EBITDA, Adjusted EBITDA, AFFO Payout Ratio, Debt to Adjusted Gross Book Value, Weighted Average Cost of Debt, Debt to Adjusted EBITDA Ratio, Interest Coverage Ratio, Debt Service Coverage Ratio, Weighted Average Term to Maturity, Same Property, and Development and Other to assess the overall performance of the Company's operations.

These Key Performance Indicators and Non-IFRS Measures should not be construed as alternatives to net income or cash flow from operating activities determined in accordance with IFRS as indicators of the Company's performance. The Company's method of calculating these measures may differ from other issuers' methods and accordingly, these measures may not be comparable to measures presented by other publicly traded entities.

Non-IFRS Measure	Definition	Reconciliation
Total Adjusted Revenue	Total Adjusted Revenue is defined as	N/A
	revenue, including the Company's share
	of revenue in Equity-Accounted Joint
	Ventures (as defined below) on a
	proportionate consolidated basis.

Total Adjusted Operating	Total Adjusted Operating Expenses is
Expenses	defined as operating expenses, including
	the Company's share of operating
	expenses in Equity-Accounted Joint
	Ventures (as defined below) on a
	proportionate consolidated basis.
Equity-Accounted Joint Ventures	Equity-Accounted Joint Ventures is
	defined as the Company's interest in
	Sienna-RSH Niagara Falls LP and Sienna-
	Sabra LP joint ventures.
Net Operating Income ("NOI")	NOI is defined as property revenue net of
	property operating expenses, including
	the Company's share in the Equity-
	Accounted Joint Ventures. The Company
	believes that NOI is a useful additional
	measure of operating performance as it
	provides a measure of core operations
	that is calculated prior to taking into
	account depreciation, amortization,
	administrative expenses, impairment
	loss, net finance charges, transaction
	costs, gain (loss) on disposal of
	properties and income taxes. The IFRS
	measure most directly comparable to
	NOI is "net income".

N/A

N/A

Section - Business Performance - Reconciliation of Net Income to Net Operating Income

Sienna Senior Living Inc. - Q1 2024 Management's Discussion and Analysis

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Non-IFRS Measure	Definition	Reconciliation
Funds from Operations ("FFO")	FFO is defined as NOI less certain	Section - Business
	adjustments including administrative	Performance - Adjusted
	expenses, net finance charges, current	Funds from Operations
	income taxes and SOAR program. FFO is
	a recognized earnings measure that is
	widely used by public real estate entities,
	particularly by those entities that own
	and/or operate income-producing
	properties. The use of FFO, combined
	with the required IFRS presentations, has
	been included for the purpose of
	improving the understanding of the
	Company's operating results. The IFRS
	measure most directly comparable to
	FFO is "net income".

Operating Funds fromOFFO is FFO adjusted for non-recurring Operations ("OFFO") and OFFO items, which includes restructuring costs,

per Share	and presents net finance charges on a
	cash interest basis. Management of the
	Company is of the view that OFFO is a
	relevant measure of the operating
	performance of the Company.

Adjusted Funds from Operations AFFO is defined as OFFO plus the

("AFFO") and AFFO per share principal portion of construction funding received, less actual maintenance capital expenditures. Management of the Company believes AFFO is a cash flow measure, which is relevant in understanding the Company's ability to earn cash and pay dividends to shareholders. The IFRS measure most directly comparable to AFFO is "cash flow from operating activities".

Earnings before Interest, Taxes,	EBITDA is defined as net income
Depreciation and Amortization	excluding net finance charges, taxes,
("EBITDA")	transaction costs, depreciation and
	amortization, impairment loss, and
	including the Company's share of NOI in
	the Equity-Accounted Joint Ventures.
	EBITDA is relevant in understanding the
	Company's ability to service its debt,
	finance capital expenditures and pay
	dividends to shareholders. The IFRS
	measure most directly comparable to
	EBITDA is "net income".

Section - Business Performance - Adjusted Funds from Operations

Section - Business Performance - Reconciliation of Cash Flow from Operations to Adjusted Funds from Operations

Section - Liquidity and Capital

Resources - Financial

Covenants

Adjusted EBITDA	Adjusted EBITDA is defined as EBITDA,	Section - Liquidity and Capital
	adjusted for construction funding	Resources - Financial
	proceeds and non-recurring items.	Covenants
Sienna Senior Living Inc. - Q1 2024 Management's Discussion and Analysis	4

Non-IFRS Measure	Definition	Reconciliation
Maintenance Capital	Maintenance capital expenditures are	N/A
Expenditures	defined as capital investments, including
	the Company's share of capital
	investments in Equity-Accounted Joint
	Ventures, made to maintain the
	Company's residences to meet residents'
	needs and continually improve residents'
	experience. These expenditures include
	building maintenance, mechanical and
	electrical spend, suite renovations,
	common area maintenance,
	communications and information
	systems, furniture, fixtures and
	equipment. Please refer to the
	Maintenance Capital Expenditures
	section of this MD&A for additional
	financial information.
Occupancy	Occupancy is a key driver of the	N/A
	Company's revenues.
AFFO Payout Ratio	Management of the Company monitors	N/A
	the AFFO payout ratio, which is
	calculated by dividing dividends per
	share over AFFO per share.
Debt to Adjusted Gross Book	This ratio is calculated by dividing total	N/A
Value	debt (including the Company's share of
	debt in Equity-Accounted Joint Ventures)
	over Adjusted Gross Book Value.
	In conjunction with the debt service
	coverage ratio, management of the
	Company monitors this ratio to ensure
	compliance with certain financial
	covenants.
Weighted Average Cost of Debt	This is a point in time calculation which is	N/A
	useful in comparing interest rates, either
	period over period, or to market rates.
Debt to Adjusted EBITDA Ratio	This ratio is calculated by dividing total	N/A
	debt (including the Company's share of
	debt in Equity-Accounted Joint
	Ventures), over Adjusted EBITDA.
Interest Coverage Ratio	Interest coverage ratio, which is	N/A
	calculated using Adjusted EBITDA divided
	by net finance charges, is a common
	measure used to assess an entity's ability
	to service its debt obligations.

Sienna Senior Living Inc. - Q1 2024 Management's Discussion and Analysis

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