60 Seconds with Monroe: Happy Thanksgiving
Rarely does the entire clinical staff at a nursing home walk out in protest of working conditions, but that was the case a few months ago in New Mexico. I was made aware of it when I received a call from an 82-year old woman in New Mexico who volunteers to help the elderly make decisions who are at the end of their life. The manager is a company called OpCo NM, very original, and apparently they have been buying up nursing homes in New Mexico. She believed the people running it were formerly associated with Skyline Healthcare, the company that walked away from more than 100 leased nursing homes after sucking all the cash from them. While I could not verify the connection, given what... Read More »
60 Seconds with Monroe: Are We Getting Too Big Again?
One of the consequences of the pandemic, one of many, is that the differentiation between the best operators and the not so good has been increasingly exposed. And of course, investors will seek out the best to manage their properties. But as this happens, the operators who are doing a good or even great job today will start to be spread too thin. Managing 20 communities is a lot different than 50, 100 or more. You can have the procedures and policies in place for 100 properties, but you do start to lose that personal touch, especially if the CEO is very hands on. With REITs and other investors doubling down on either their best operators, or finding others that they perceive to be top... Read More »
60 Seconds with Swett: Gloom Prevails at the NIC Conference
As always, it was great to see so many of our industry friends, and plenty of new faces, at the NIC Conference in Chicago last week. And typical of most conferences, many asked us what we thought the mood of the conference was. We wondered if it would be at all better than the grim 2022 Fall conference when the capital markets had fundamentally shifted for the worse. Unfortunately, we cannot say it was better than that. With the 10-year Treasury rate touching 5% at the start of the conference and consistent signals from the Fed that interest rates would be “higher, for longer,” any hope for an improving capital markets environment unleashing a flood of financings and M&A (at higher... Read More »
60 Seconds with Swett: Skilled Nursing M&A in 2023 and Beyond
Skilled nursing investors, operators and dealmakers have been on quite the rollercoaster the last several years, with COVID initially threatening the life of the industry quickly shifting to an exuberant M&A market that saw buyers clamor for facilities of all qualities, and paying up for them too. Now, higher capital costs have tempered some of that excitement, and the industry faces a new threat: the minimum staffing mandate. It is safe to say, the party is over, but M&A volume has not fallen off a cliff either. Neither have values. So, how are dealmakers evaluating this new market we are in, and how will investment strategies, the lending environment or valuations change? Join us... Read More »
60 Seconds with Monroe: Finding A Solution For LTC Funding
My friend Stephen Moses, president of the Center for Long-Term Care Reform, has been a consistent and persistent advocate for reforming the Medicaid system and getting Americans out of the Medicaid-dependency mindset. He just published, with the Paragon Health Institute, the follow-on to his paper “Long-Term Care: The Problem.” Available now is “Long-Term Care: The Solution.” While I was hoping for something completely new and creative, I can’t disagree with his recommendations, which include 1) stop the ability to purchase Medicaid-exempt assets, 2) eliminate the home equity exemption, 3) ban Medicaid Asset Protection Trusts, 4) disallow Medicaid compliant annuities, and 5) increase the... Read More »Schedule a demo
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