Seniors Housing and Care M&A Activity Falls Under 100 Deals in Q1:23


The number of publicly announced seniors housing and care acquisitions in the first quarter of 2023 fell to 98 deals, based on new acquisition data from LevinPro LTC. This represents a 13% decrease from the 112 transactions disclosed in the fourth quarter of 2022 and a 33% decline from the 144 deals in Q1:22. In addition, the $1.35 billion spent on Q1:23 transactions fell by 31% from the $1.97 billion spent on Q4:22 transactions and by 73% from the $5.07 billion spent in the year-ago first quarter, based on disclosed prices.

“Buyers have taken a big step back from acquisitions in light of spiking capital costs and liquidity issues in the debt markets,” stated Ben Swett, Editor of The SeniorCare Investor. “Deals are a lot harder to get done, and most that close feature value-add assets that trade at low per-unit prices.”

The 98 transactions recorded in Q1:23 represent the lowest quarterly deal total since the first quarter of 2021, when 85 deals were publicly announced, and shows the impact of high interest rates on the M&A market. There were just under 280 properties involved in Q1:23’s deals for a property-per-deal ratio of 2.9, very close to the 2.7 property-per-deal rate from Q4:22. Assisted living deals made up the plurality of Q1:23 deals, accounting for 42%, followed by skilled nursing at 32%. Active adult deals made up 9% of the quarter’s total, independent living took a 7% share, and affordable senior apartments and CCRCs accounted for 6% and 4% of deals, respectively.

There were nine transactions with more than 10 properties in each, and 21 total deals with three or more properties, split roughly even between skilled nursing and seniors housing transactions. Looking at monthly M&A activity, dealmaking dropped in February and March to 28 and 30 transactions, respectively. That is down from 40 deals in January 2023 and the 44-deals-per-month average of 2022.

“As lending issues plague the senior care industry and some major loan defaults are potentially around the corner, deal activity and values will take a hit,” added Swett. “However, we will likely see all-cash buyers make opportunistic acquisitions throughout the year.”

All long-term care M&A deals dating back to 1993 can be accessed on the LevinPro database and can be purchased via a site license. All quarterly results are published in The Health Care M&A Report for all 13 sectors of health care, which is part of LevinPro HC. In addition, annual results of the seniors housing and care acquisition markets will be published this year in the 28th Edition of The Senior Care Acquisition Report. For information, or to subscribe, call 800-248-1668. Irving Levin Associates was established in 1948 and has offices in New Canaan, Connecticut, and North Bethesda, Maryland. The company publishes research reports and newsletters, and maintains databases on the healthcare and seniors housing M&A markets.