Legacy Healthcare Financial Services LLC has established itself as a significant player in the Midwest skilled nursing facility (SNF) market, operating 38 facilities across three states according to the latest CMS data. The company maintains a strong presence in Illinois, South Dakota, and Iowa, positioning itself strategically in markets experiencing regulatory and reimbursement changes.
Portfolio Distribution
The company’s portfolio is concentrated in Illinois with 18 facilities, followed by South Dakota with 14 facilities, and Iowa with 6 facilities. All 38 properties operate within the skilled nursing facility sector, demonstrating the company’s focused approach to this healthcare segment.
In South Dakota, Legacy Healthcare Financial Services LLC shares the position of top SNF owner with two other entities – Doros Generation Trust U/A/D 1/3/12 and Gpn Family Trust U/A/D 04/28/08 – each operating 14 facilities in the state, according to CMS.
Ownership Structure
Analysis of CMS data reveals that Legacy Healthcare Financial Services LLC maintains minority ownership positions in its facilities, with ownership percentages below 5% across its entire portfolio.
Market Context
South Dakota’s skilled nursing sector has recently seen regulatory adjustments aimed at addressing facility closures, including relaxed bed redistribution policies that may facilitate transfers of available bed licenses to new operators. Additionally, the state has approved significant increases in Medicaid funding for nursing homes – 25.5% in 2023, following increases of 6% in 2022 and 10.6% in 2021.
Despite these funding increases, South Dakota SNF operators continue to face financial challenges, with facilities losing an average of $42.33 per Medicaid resident per day, totaling over $48 million annually in unreimbursed care. This financial pressure creates both challenges and potential acquisition opportunities in the market.
The broader Midwest region has experienced notable M&A activity, with transactions such as ABCM Corp.’s sale of 29 Iowa facilities to Cascade Capital Group for $85 million, and The Ensign Group’s acquisition of a 76-bed facility in Des Moines.
As regulatory and reimbursement environments continue to evolve across the Midwest, Legacy Healthcare Financial Services LLC‘s established multi-state presence positions the company to potentially leverage further consolidation opportunities in this challenging but essential healthcare sector.
