Executive Summary
Alexark1 LLC has established itself as one of the leading skilled nursing facility owners in Arkansas, tied with JEJ Assets LP at 33 facilities each, according to the most recent Centers for Medicare & Medicaid Services (CMS) data from January 2025. The company’s portfolio consists exclusively of skilled nursing facilities within Arkansas, with no operations in other states or healthcare sectors. Of the 33 facilities affiliated with Alexark1 LLC, 21 maintain 100% ownership by the company, while the remaining facilities have varying ownership structures.
Company Overview
Alexark1 LLC is a for-profit limited liability company with ownership stakes in numerous skilled nursing facilities across Arkansas. Several key individuals are associated with the company, including John Ponthie, Sharlot Ponthie and Ross Ponthie, who frequently have direct or indirect ownership interests in the same facilities.
The company operates within a network of related entities, including JEJ Assets LP, JEJ Management, LLC, and 4P2T1 Ops Holding LP. Many of the nursing homes where Alexark1 LLC has an interest are affiliated with Southern Administrative Services.
Alexark1 LLC‘s business model centers on holding ownership interests in a portfolio of for-profit nursing homes that operate as Limited Liability Companies (LLCs), participate in both Medicare and Medicaid programs, and provide skilled nursing and rehabilitation services. While Alexark1 LLC maintains ownership stakes, day-to-day operational management typically falls to on-site managing employees or affiliated administrative companies.
Portfolio Analysis
Geographic Distribution and Ownership Structure
Alexark1 LLC‘s 33 facilities are widely distributed across 30 counties in Arkansas, with only Hot Spring County (two facilities) and Pulaski County (two facilities) having multiple facilities. The ownership structure of Alexark1 LLC‘s facilities reveals that 21 facilities have 100% ownership by the company, while 12 facilities show null ownership percentages, indicating potential joint ventures or management agreements.
Facility Quality and Performance
The quality of Alexark1 LLC’s facilities varies considerably. Based on CMS ratings, the facilities show mixed performance:
- Average overall rating: 2.78 out of 5
- Health inspection ratings: predominantly 2-3 stars
- Quality measure ratings: predominantly 4-5 stars
- Staffing ratings: predominantly 3 stars
This pattern reveals a disparity between health inspection scores (below average) and quality measure scores (above average), suggesting strengths in clinical outcomes despite challenges in regulatory compliance.
Acquisition Timeline
Alexark1 LLC has shown significant growth in recent years:
- 2019: two facilities acquired
- 2020: three facilities acquired
- 2022: 33 facilities acquired
This dramatic expansion in 2022 represents a major strategic move that established the company as a leading player in Arkansas’s skilled nursing market.
Regulatory and Reimbursement Environment
Arkansas skilled nursing facilities operate under regulations from the Arkansas Department of Human Services (DHS), specifically the Office of Long Term Care (OLTC). These regulations include specific minimum staffing standards, with requirements for licensed nurses and direct care staff per resident that vary by shift.
For reimbursement, Arkansas Medicaid utilizes a cost-based, facility-specific per diem rate system for nursing facilities. This methodology consists of four main cost components: direct care, indirect care, administrative/operating costs, and fair market rental. The direct care component is calculated from the facility’s actual allowable Medicaid costs and is subject to a ceiling set at 105% of the 90th percentile of arrayed Medicaid direct care facility costs. The indirect and administrative/operating components are set at 110% of the median cost, adjusted for inflation, and paid as a class rate to all facilities. All three components are rebased annually.
A significant challenge in Arkansas is that Medicaid and commercial insurance reimbursement rates are reportedly among the lowest in the nation—as much as 31% below the national average for some insurers. Such low rates put pressure on SNFs’ profitability and ability to invest in care and staff.
Recent legislation (Senate Bill 236, introduced March 2025) aims to enhance oversight of healthcare mergers and acquisitions, signaling increased scrutiny on M&A activity in the sector. This evolving regulatory environment may impact future consolidation strategies within the state.
Competitive Landscape
The Arkansas skilled nursing market features several significant players alongside Alexark1 LLC:
- JEJ Assets LP: 33 facilities (tied with Alexark1 LLC)
- 4P2T1 Ops Holding LP: 32 facilities
- JEJ Management, LLC: 30 facilities
- RHC Operations Inc: 15 facilities
- ZCS AR Opco LLC: 14 facilities
- Eagle Health Systems Inc: 10 facilities
The close relationship between the top four entities suggests potential common ownership or strategic alliances.
Conclusion
Alexark1 LLC has rapidly established itself as a leading player in Arkansas’s skilled nursing market through strategic acquisitions, particularly in 2022. The company has a statewide presence, with varied facility quality and a complex ownership structure. However, the challenging regulatory and reimbursement environment in Arkansas presents ongoing operational challenges that will require continued focus on efficiency and quality improvement.
