Senior Care M&A Tanks In Q1

Senior Care M&A Tanks In Q1

After a strong fourth quarter, senior care M&A activity cooled off this winter. We thought that after 59 seniors housing and care M&A transactions were announced in December 2020, a monthly record, we had returned to some kind of “normal” in terms of dealmaking. Well that just didn’t happen in the first quarter of 2021, when despite widespread vaccination of the senior care population investor activity cooled to just 77 publicly announced deals. That is just a preliminary total but is well off Q4’s total of 127 deals. M&A in the skilled nursing sector especially slowed down, accounting for just 32% of the deals announced during the quarter. But it makes sense. If various... Read More »
Getting Very Mad

Getting Very Mad

Academics say that PE firms are responsible for the deaths of up to 20,000 Medicare patients over 12 years. Reckless. I don’t know about you, but I am really getting mad at what I am reading. Four academics just came out with a research paper on the impact of private equity on the skilled nursing industry. Backed up by equations that few of us would understand, they concluded that private equity firms are responsible for up to 20,000 deaths of Medicare patients in nursing homes over a 12-year period. Really? The study included 128 deals for 1,674 facilities and 136 unique PE firms that acquired nursing facilities. Hmm. 136 “unique” PE firms. Even over 12 years that seems like a stretch. I... Read More »
Getting Very Mad

Skilled Nursing Needs A Break

With pressure from the media, the public and government agencies, the skilled nursing industry will be losing some of its best people. Not the time for that to happen. A good friend of mine sent me an article about a New York nursing home administrator who is angry at the fact that nursing homes have been villainized and scapegoated, especially in New York. Where were the car parades in front of nursing homes, like they were in front of hospitals, thanking them for caring for the frail elderly, he asks, and risking their lives as well? Nonexistent, sadly. He couldn’t take it anymore, and moved to Michigan, where he is happily working as an administrator after 20 years in New York. He has... Read More »
Getting Very Mad

Can Skilled Nursing Be Reformed?

The American Health Care Association and Leading Age have proposed a reform agenda for skilled nursing. As usual, the problem is Medicaid. The American Health Care Association and Leading Age have proposed a policy “agenda” to address some of the problems that exist in skilled nursing facilities today, which were obviously highlighted by the impact of the pandemic.  As part of the reforms, they want enhanced infection control practices, 24-hour RNs, 30-day minimum supply of PPE, better recruiting and retention of staff, improved oversight systems, and a shift to all private rooms. There is little here to disagree with, except that they expect Medicaid to pick up most of the $15... Read More »
Getting Very Mad

Is Brookdale Bottoming Out

Even though Brookdale Senior Living reported its lowest census levels ever in February, the month-to-month declines were low and may signal a bottom soon. As most of you know, I have been pretty negative about where things were going last year, and how long it might take for the industry to dig out of its hole. But my gut tells me things are beginning to turn around. Brookdale Senior Living just reported on its February occupancy, and I believe it is the first major seniors housing company to report average occupancy for the month below 70%. It hit 69.4%. That’s the bad news. The good news is that the monthly decline of 60 basis points was the smallest since last March. And the month-end... Read More »
Getting Very Mad

Home Health vs. Assisted Living

If people need care and full-time supervision, there is no cost comparison between assisted living and home health. Here’s a real life example. A friend recently asked for some advice (true story) about her 85-year old mother who was hospitalized, then went to a rehab facility, and then had the decision between moving back home or to an assisted living community. I think the family was inclined to assisted living, but mom wanted to go home, of course. The assisted living community in Connecticut, operated by a well-respected regional chain, offered $4,300 per month for a one-bedroom unit, but after the assessment admitted that she may be bumped up a care level or two. Given the... Read More »