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 »
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: 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: 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 »Schedule a demo
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