Private Equity and Hospital Assets

According to a recent JAMA (Journal of the American Medical Association) research letter private equity firms invested $505 billion in healthcare acquisitions from 2018 to 2023. These financial infusions can enhance resources for care. However, these firms have occasionally sold the land and buildings of acquired hospitals, using the proceeds to repay investors and leaving … Read more

Sr. Living Capital Access Still Challenged

Last week, a report from NIC (National Investment Conference) dropped covering the fourth quarter (2023) lending activity in senior living. As in prior quarters, capital access remains challenged. Data for the report came from 17 lenders, including banks, commercial real estate services, financial services companies, government sources, investment management firms, and real estate investment trusts. … Read more

Record Bankruptcies in Health Care in 2023

As the economy continued to struggle through a high inflationary cycle with restrictive Federal Reserve policy in-place to curb inflation, providers struggled to stay afloat in the turbulent economic waters. Significant financial headwinds in 2023 have only modestly abated at the start of 2024. Labor supply issues (shortages) of direct care staff (other disciplines as well) … Read more

Friday Feature: The Good Acquisition

Organizational expansion is truly a tale of two options (primarily): add capacity organically (build or start from scratch) or acquire an existing business. Both have pluses and minuses, but when it comes to scale on a more rapid basis and movement into a new market area, acquisition tends to make more sense versus an organic … Read more

Senior Housing/Senior Living Debt Review

Senior housing in the form of CCRCs, Independent Living and Assisted Living (including memory care) is a large user of debt financing. While equity has become more prevalent via increasing private equity interests in senior living, operators, especially non-profits, continue to rely heavily on bank and bond financing. Private equity and venture capital investment trends … Read more

SNFs and Stranded Assets

Lately I’ve written rather extensively on what is occurring in the SNF sector to (rather) dramatically shift the fortunes for companies such as HCR/ManorCare, Kindred, Genesis, Signature, et.al. and a series of REITs that hold SNF assets (physical).  In addition to my writings, I’ve consulted/conversed with numerous investment firms concerned and interested in this shift.  Underlying all of my … Read more