• Evans Arranges New SNF Lease

    Evans Senior Investments arranged a new lease for a skilled nursing facility in Denver, Colorado, securing a 293% increase in rent on a per-bed, per-month basis in the process. At the time of marketing, the facility was 62% occupied with minimal Medicare Part A referrals. However, the 1960s-built facility has 16 private units and is proximate to... Read More »
  • Cross River Bank Closes Large Acquisition Loan

    Cross River Bank recently closed a large acquisition loan for a portfolio of seven skilled nursing facilities and one assisted living community in Georgia, Tennessee and Missouri. Raina Yoo was the Loan Officer on the transaction. The portfolio features a total of 1,339 licensed beds, and occupancy stood at 88%, overall.  Read More »
  • Local Operator Closes Lease-to-Purchase Deal

    A skilled nursing facility in Mississippi faced a time-sensitive CHOW with frozen Medicaid rates under appeal after the outgoing operator was planning to leave before the ownership transfer occurred, posing meaningful risk to the facility’s financial performance and operational continuity. The facility was older and around 50% occupied at the... Read More »
  • Mainstay Senior Living Grows in Georgia

    Mainstay Senior Living acquired two seniors housing communities in Savannah, Georgia. The properties are located about five miles apart from each other. Grace Manor Savannah was built in 1997, while Habersham Manor was built in the late-1980s. They feature a total of 143 assisted living and memory care units. Florida-based Mainstay now has 46... Read More »
  • Private Equity Firm Divests Portfolio to Chicago Investor

    Trinity Investors, a Texas-based private equity firm, sold a 224-unit portfolio of three seniors housing communities in Alabama that it acquired in tranches between 2022 and 2023 with a regional owner/operator. After the portfolio stabilized and capital was injected into the communities, Trinity recapitalized the venture in March 2025 with... Read More »

Excessive Use Of Ultra-High Therapy in SNFs

A recent story highlighted the dramatic rise in ultra-high therapy use in SNFs, but are there legitimate reasons for it? Two days ago, The Wall Street Journal had a front page story about the sudden increase in the percentage of patient days in skilled nursing facilities using “ultra-high” therapy, which is a maximum of 720 minutes per week. Apparently, in 2002, nursing facilities gave ultra-high therapy to patients on 7% of the days they billed to Medicare, but this increased to 54% of patient days by 2013, with the percentage increasing every year. The gist of the story was that providers have been gaming the system to get the highest reimbursement. I had hoped we were getting beyond... Read More »

Senior Care Market In Confused State

Stocks are gyrating wildly, sometimes for good reason and other times not so much. Okay, I have to admit that I am confused now. When Brookdale came out with poor second quarter results, its stock tanked, as it should have. But then Capital Senior Living came out with a very upbeat quarter, and its stock jumped 10%, as it should have, but then dropped by 15% over the next several days, for little reason, other than perhaps in sympathy with Brookdale shareholders. Genesis Health announced a good quarter, and its stock jumped by 10%, as it should have, and kept on rising to a 26% gain in a week when the market as a whole tanked. Hell, it didn’t even budge when China devalued its currency. ... Read More »

Brookdale’s Second Quarter Worse Than Expected

Occupancy continues to tumble at Brookdale Senior Living, but this time the legacy Brookdale properties post huge declines. When Brookdale Senior Living closed its acquisition of Emeritus exactly one year ago, they did not expect to be having the problems they are with the transition. A transition that was supposedly ahead of schedule last December. Brookdale’s first quarter this year was a big disappointment for investors. The second quarter was even worse. And the problem this time was not just Emeritus, which saw a 50 basis point decline in occupancy sequentially. The legacy Brookdale properties had a 120 basis point decline in occupancy in just one quarter, and they are now down 190... Read More »

Seniors Housing Census Woes Continue

Brookdale Senior Living is not the only one with some recent census declines… The next few weeks will be very telling in terms of the direction of some of the major seniors housing companies. All eyes will be on Brookdale Senior Living next week as it announces second quarter results and whether it has reversed its downward occupancy trend. Brookdale’s stock price is down about 15% since June 1 and is at its lowest level in more than eight months. Those activist shareholders must be going nuts. We know NIC MAP indicated a tough second quarter in general, and we also know that the Atria Senior Living and Sunrise Senior Living properties in the Ventas stable posted a combined 40 basis... Read More »

SNF M&A; A Market Remains Robust

With at least five transactions priced over $100,000 per bed so far this month, July may be a record for high-priced SNF sales. The skilled nursing facility M&A market continues to lead the way in terms of where the post-acute sector may be heading. So far in the past three weeks, we have seen five deals close with values ranging from just over $100,000 per bed to over $200,000 per bed. Yes, a few have been in the northeast, which can be expected, but these high-priced sales go all the way from North Carolina to Texas to California. This is not a regional phenomenon. It is a change that is going on in the sector that will be part of the evolution of who takes care of the elderly, how... Read More »

Assisted Living Occupancy Declines…Again

Second quarter occupancy trends are soft again, with construction starts strong. So, are people finally beginning to believe that the development boom we have been talking about is actually starting to impact census? We are talking about assisted living and memory care, because that is where the action has been. According to the second quarter NIC MAP data, assisted living occupancy has dropped again sequentially, and is down 45 basis points from a year ago. But worse, and more to the point, trailing 12-months assisted living construction starts as a percent of existing supply has been at 4.7% and 4.8% for the past two quarters, much higher than a year ago. And, more development pipelines... Read More »