• Brookdale Boosts Short Term Stability

    Brookdale Senior Living completed a series of financing transactions totaling approximately $600 million that refinanced all of its remaining 2026 mortgage debt and maturities, around $350 million, and a portion of 2027 mortgage debt maturities, approximately $200 million. The company also secured more fixed-rate debt, helping to cut rate risk.... Read More »
  • Ikaria Announces $1 Billion in Q4 Volume

    Ikaria Capital Group closed out a successful 2025, announcing several significant transactions in the fourth quarter that exceeded $1 billion in volume. The activity comprises financings in the seniors housing, skilled nursing and behavioral health sectors across multiple states and borrowers.  The largest deal was a $595.5 million senior... Read More »
  • PE Group Enters Oklahoma after Medicaid Rate Bump

    A skilled nursing facility in Oklahoma that recently benefited from the state’s Medicaid rate bump sold to a national private equity firm looking to enter the state. Built in 1967, Maplewood Care Center features 180 beds on over three acres in Tulsa. It is located close to several major hospitals and healthcare campuses, but occupancy was sitting... Read More »
  • Community Purchased through HUD Assumption

    Chad Mundy of the Knapp-Stahler Group of Marcus & Millichap sold an 82-unit assisted living/memory care community in Lewiston, Idaho. Built in phases in the early 2000s, the community featured five separate buildings, one of which was vacant after sustaining damage from a flood. As a result, occupancy was lower, based on the 89 licensed beds,... Read More »
  • The Zett Group Rounds Out Q4

    The Zett Group closed out Q4 with several closings in the Pacific Northwest. First was the sale of Fox Hollow, a 58-unit seniors housing community in Eugene, Oregon. Built in 1988 and renovated in 2003, the community features 51 assisted living units and seven independent living “cottage-style” units. Set in a nice area of Eugene, it was owned by... Read More »
60 Seconds with Monroe: Finding A Solution For LTC Funding

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 »
60 Seconds with Swett: 2023 Deal Volume at 2019 Levels

60 Seconds with Swett: 2023 Deal Volume at 2019 Levels

Dealmakers have a lot to be frustrated with in the M&A market right now, with valuations low, deal processes taking longer than ever, scarcity in the debt markets and other headwinds making their impact. But despite it all, deal volume was actually historically healthy in the third quarter of 2023.  There were 115 publicly announced transactions in the quarter. That is down from the 120 deals made public in Q2:23 and the 140 from last year’s third quarter. But the average deals per quarter for 2023 at 115 is equal to the average deals per quarter in 2019, a time of cheap and abundant capital and before anyone knew what COVID-19 was. Plus, on an annualized basis, Q3’s total would... Read More »
60 Seconds with Swett: 2023 Deal Volume at 2019 Levels

60 Seconds with Swett: SNFs Get a Bad Grade

It was unfortunate, but unsurprising, to see that in a recent Gallup poll, a plurality of those surveyed gave SNFs either a D or an F grade on overall quality of care. We say unsurprising not because we agree with that for the majority of facilities, although there are certainly those guilty of providing subpar care, but because of the general negative perception the public has on SNFs. Cases of bad care will always spread in the media and by word-of-mouth faster than the many instances of good care, and only 9% of respondents gave SNFs either B (good) or A (excellent) grades in the survey.  That is not good, but let’s face it, the skilled nursing business is also a thankless... Read More »
60 Seconds with Monroe: Finding A Solution For LTC Funding

60 Seconds with Monroe: Is Joe Biden That Tone Deaf?

We already reported on the new proposed staffing requirements for nursing homes, coming at a time when most everyone in senior living is still struggling with finding enough staff, and paying for them. Coincident with the release of the proposed rules, USA Today published an opinion piece by President Biden. Now, if anyone thinks he actually wrote it, I have a bridge to sell you. My guess is that he did not even read it. This was a staff piece. Perhaps from Joe’s basement? I will say one thing, he has been consistent in his criticism of private equity in the nursing home business, but he still gets his facts and names wrong. Not many “private equity” firms have been buying up nursing homes... Read More »
60 Seconds with Swett: SNF Values Begin to Drop

60 Seconds with Swett: SNF Values Begin to Drop

The surge in capital costs has finally eaten into the price per bed for skilled nursing facilities, at least according to our latest averages. Using data from our proprietary M&A database which includes dozens of confidential prices and property financials, the average price per bed for skilled nursing facilities in the four quarters ended June 2023 dropped 6.5% to $106,800 from its record-high of $114,200 per bed from calendar year 2022. Anecdotally, we had heard that buyers were not paying the prices they were in 2022 but that investor interest (and prices as a result) was still higher than it was before and during the pandemic. That checks out with our numbers, since the latest... Read More »
60 Seconds with Monroe: Finding A Solution For LTC Funding

60 Seconds with Monroe: SNFs and Medicare Advantage

As you all know by now, I have been enrolled in traditional, fee-for-service Medicare for nearly four years, while all my friends but one have enrolled in Medicare Advantage (MA) plans. Why? Because that is all they see advertised. Some did not even know there was an alternative. Skilled nursing operators have known for a decade or more that MA plans are stingy when it comes to payments, now up to $100 lower per patient day compared to traditional Medicare. It is now coming out that MA plans are not just stingy on what they pay providers, they are also stiffing their members as to what they will pay for, and how often. And this is affecting patient care in the post-acute setting, according... Read More »