Mergers and Acquisitions in 2025

Skilled Nursing News had a great article on nursing home mergers and acquisitions (M&A) projected for 2025.

“Sufficient reimbursement, less regulation and adequate staffing are all attractive features for dealmaking, impacting operator decisions on which states and regions offer the path of least resistance when it comes to expanding their footprint.”

The article offers a valuable glimpse into the upcoming landscape with rising Medicaid reimbursement rates in states including South Carolina, North Carolina, and Virginia. This makes investment more attractive and mergers more likely. It is doubtful that the increase will lead to meaningful improvements in care quality.
Raising Medicaid rates is undeniably a positive step, particularly for states where facilities have struggled under decades of underfunding. However, while residents in higher-reimbursement states benefit from increased investment and improved care, those in low-reimbursement states face fewer options, poorer conditions, and heightened risk for serious neglect. This inequity highlights the urgent need for policy interventions to ensure all nursing home residents, regardless of geographic location, have access to safe, high-quality care.
Higher reimbursement offers nursing homes the resources to invest back into the facility and to improve quality of care, however, more money alone rarely solves the more systemic issues at hand. Without strong accountability and oversight, facilities may channel these funds into places they should not be going (right back into the owners’ pockets), prioritizing shareholder returns over quality improvements.
The core issue isn’t just money; it’s how the money is used. Many struggling facilities require systemic restructuring, not just financial support. Chronic understaffing and outdated infrastructure are problems that demand targeted reforms alongside funding and without connecting funding to enforceable regulations, facilities can continue to operate below acceptable standards. Without safeguards, the cycle of neglect and underperformance will continue, regardless of the funding.