Literature Review

Why private equity healthcare investment may rise in 2025 Modern Healthcare - Mergers & Acquisitions; by Alex Kacik; 12/12/24 Private equity investment in healthcare is expected to pick up in 2025 but still fall short of the highs of 2021, merger and acquisition advisers said. Private equity-linked healthcare transaction volume is poised to rebound after a sluggish 2024 as interest rates cool, state-led oversight bills lose momentum and a new presidential administration begins. Corporate investors will likely prioritize deals that involve healthcare information technology and other administrative support services over physician practices, industry observers said. 

University of Michigan Health-Sparrow nurses authorize strike as contract negotiations continue CBS News, Detroit, MI; by Elle Meyers; 12/12/24 Union officials representing the University of Michigan Health-Sparrow nursing staff have been working for months for an improved contract, but leaders say they're not close to a deal. "The hospital so far is not making offers that are going to keep up competitive. It's not going to allow us to make sure we maintain our level of care or quality of care," said Jeff Breslin, a registered nurse and the president of the Professional Employees Council of Sparrow Hospital. The University of Michigan bought Sparrow last April. Bresil says he was hopeful for positive change. "They had promised to come in and build new facilities, improve other facilities that we have, which is great, but you've got to take care of the people as well, and frankly, I'm disappointed that this is the direction things are taking," he said. Breslin said contract negotiations between the nurse's union and the hospital began last August. Their contract expired in October, and they still haven't reached a deal. He says nurses want to see more competitive pay, better staffing levels and an improved health plan. 

Hospice's legacy carried on by new local ownership PRLOG Press Release Distribution, Meridian, ID; by Doctor's Hospice of Idaho; 12/11/24 The locally owned and operated hospice facility known for its dedication to celebrating the lives of patients and providing exceptional care, Doctor's Hospice of Idaho, announced that they have been acquired by Kristopher Stice, Capital Eleven and Willowbridge Group. This strategic move marks a significant step towards further enriching the local hospice care landscape while continuing the legacy established by Cody Freston. "We are thrilled to embark on this journey with Doctor's Hospice of Idaho, a facility deeply rooted in the community it serves. Our vision is to build upon the legacy established by Cody Freston and bring a renewed focus on patient care and employee well-being." said Ashley Copeland, newly appointed CEO/Administrator of Doctor's Hospice of Idaho. "By combining our years of experience in hospice care with the values upheld at Doctor's Hospice of Idaho, we aim to create a world-class hospice that starts from within."

CareTrust REIT expands in the Midwest with $97M deal Modern Healthcare; by Diane Eastabrook; 12/10/24 CareTrust REIT has acquired a 46-facility skilled nursing and senior housing portfolio in the Midwest for $97 million. The San Clemente, California-based real estate investment trust said in a Monday news release the facilities include more than 3,800 beds and were purchased through a bankruptcy sale of the assets from an unnamed debtor. It did not disclose the names or specific locations of the facilities.

Why repeat offender nursing homes elude accountability Modern Healthcare; by Diane Eastabrook and Tim Broderick; 12/10/24 Fallbrook Rehabilitation and Care Center stands out as one of the worst among the more than 1,200 nursing homes in Texas and the nearly 15,000 facilities nationwide. Over a three-year period at the skilled nursing facility in Houston, one patient died after staff did not notice her ventilator had disconnected.  ... The Texas Department of Health and Human Services cited Fallbrook for more than 50 other health and safety violations. Fallbrook was fined about $640,000 between April 2021 and July 2023, according to Modern Healthcare analysis of April 2024 CMS data. The amount was among the top 30 fines paid by nursing homes nationally and was more than six times the average fine other Texas nursing homes with CMS one-star ratings were assessed during that period. Yet the 200-bed nursing home collected more than $20 million in reimbursements from Medicare, Medicaid and health insurance companies in 2021 and 2022, ... The ownership groups can control facilities through convoluted webs of individuals, private equity investors, limited liability companies, real estate investment trusts and other trusts that often transfer money to related companies or third parties with ownership interests in the nursing homes. The Human and Human Services Department Office of Inspector General has identified this as a problem.

A healthcare system’s moral bankruptcy goes viral MedCity News; by Neal K. Shah; 12/5/24 Brian Thompson's murder was chilling, but the social media response of this tragedy was equally shocking, if eye-opening. It shows a massive collapse of public trust in our healthcare system, a system so broken that it bankrupts families, denies life-saving care, and treats death as an acceptable cost of doing business. When UnitedHealthcare CEO Brian Thompson was gunned down outside a Manhattan hotel ..., something chilling happened: thousands of Americans responded not with horror, but with dark jokes and scathing comments about the health insurance industry. People shared stories of being denied coverage by the company and drew parallels comparing the CEO’s death to the ways they’ve been mistreated by America’s healthcare system. ... The tragedy of Thompson’s death is compounded by a cruel irony: He was rushed to Mount Sinai  — a healthcare system whose hospitals UnitedHealth removed from its network only a few months ago, leaving thousands of patients scrambling. Even in death, he couldn’t escape the byzantine system his company helped create.

Forcura and Axxess announce palliative care software integration Bluefield Daily Telegraph, Jacksonville, FL; Business Wire; 12/9/24 Forcura, a healthcare workflow management company, announced a strategic partnership enhancement with Axxess, the leading global technology platform for healthcare at home, by expanding connectivity to Axxess’ palliative care platform. Consequently, Axxess’ palliative care client organizations now can manage the workflow associated with onboarding and coordinating care for patients through a bi-directional API integration with Forcura. Together, Forcura and Axxess can provide shared home health, hospice, home care and palliative care clients a seamless interoperable experience.

VitalCaring’s PE backers considering appeal of Encompass, Enhabit lawsuit Hospice News; by Jim Parker; 12/6/24 Nautic Partners and The Vistria Group, the private equity backers of home health and hospice provider Vital Caring, are mulling a potential appeal of a federal court’s recent decision in a dispute with Encompass Health (NYSE: EHC) and Enhabit Inc. (NYSE: EHAB). A federal judge in Delaware on Monday ordered VitalCaring, Nautic and Vistria to share 43% of future profits Encompass Health and Enhabit Inc. The two companies allege that the founders of VitalCaring, including CEO April Anthony, used unethical practices to get the company off the ground, adversely affecting the two plaintiffs. Anthony previously served as CEO of Encompass Health’s home health and hospice segment. The two private equity firms, co-defendants in the lawsuit, are now considering their legal options.

Creach Family Holdings announces acquisition of HealthRev Partners EIN Presswire, Stuart, FL; by Careficient, Inc.; 12/3/24 Creach Family Holdings announces acquisition of HealthRev Partners Expanding Healthcare Technology Solutions for Home Health and Hospice Providers. Creach Family Holdings, a privately held investment firm focused on healthcare technology and tech-enabled services, announces the acquisition of HealthRev Partners, a provider of technology-driven revenue cycle management (RCM) solutions serving the home health and hospice market. This acquisition complements Creach Family Holdings’ portfolio, including Careficient, a leading electronic medical record (EMR) provider for home health and hospice agencies. By combining HealthRev Partners’ RCM expertise with Careficient’s EMR platform, Creach Family Holdings aims to provide an integrated suite of solutions that streamline operations, optimize revenue cycles, and improve patient care. 

Delaware Court of Chancery awards damages and other relief to Encompass Health and Enhabit for misconduct by April Anthony, other former officers, and private equity firms Vistria Group and Nautic Partners Associated Press (AP) - Business Wire, Birmingham, AL and Dallas, TX; 12/4/24 On Monday, Encompass Health and Enhabit won their lawsuit in the Delaware Court of Chancery related to breaches of fiduciary duty by April Anthony, Luke James, and Chris Walker while they served as the senior officers at Encompass Health’s former home health and hospice division, which is now Enhabit. The Court awarded judgment against private equity firms Vistria Group and Nautic Partners and the home health and hospice business now known as VitalCaring Group for aiding and abetting “the egregious breaches of the duty of loyalty” by Anthony, James, and Walker. The case was the subject of a 7-day trial in December 2023. After considering “the damning record presented at trial,” the Court found that, while employed by Encompass Health, Anthony, James, and Walker usurped acquisition opportunities falling within Encompass Health’s line of business, used Encompass Health’s confidential information, and swayed key Encompass Health employees to join them with the promise of equity in the home health and hospice competitor that Anthony now heads. 

Addus closes $350M Gentiva Personal Care deal Hospice News; by Jim Parker; 12/2/24 Addus HomeCare Corporation (Nasdaq: ADUS) has closed its $350 million acquisition of Gentiva’s personal care business. Gentiva’s personal care segment brings in annual revenues of close to $280.0 million. Post-transaction, Addus will continue with a leverage ratio of less than 3x, with the ability to further that amount with the influx of revenue resulting from this deal, Addus Chairman and CEO Dirk Allision said in a statement. ... Addus provides personal care, home health and hospice to more than 48,500 patients across 22 states. Its total revenue reached $289.8 million in the Q3 of 2024, a 7% year-over-year increase. Its personal care revenues reached $215.4 million that period.

Big Bend Hospice’s promise to North Florida [New parent company, Seven Oaks Health] Tallahassee Democrat; by Bill Wertman, "Your Turn"; 11/29/24 As CEO of Big Bend Hospice, I see every day how vital our mission focused hospice care is to families across North Florida. Yet, in today’s healthcare landscape, nonprofit hospices like ours are increasingly rare. Only about 30% of hospices nationwide operate as nonprofits (CDC, 2020), and for-profit hospices have made up nearly all new providers in recent years (Hospice News, 2022). These changes mean that the type of personalized, community-centered care that Big Bend Hospice provides is at risk of disappearing. In 2024 alone, 12 hospice acquisitions took place, with about half involving nonprofit organizations (Hospice News, 2024). This trend is forcing many nonprofits to either consolidate or scale back services. For Big Bend Hospice, the choice was clear: expand our offerings to meet more in-home healthcare needs, while keeping compassion and family-centered care at the forefront. To accomplish this, we established Seven Oaks Health, our new parent company. With Seven Oaks Health, we’re creating a sustainable model that enables us to support families from diagnosis through end-of-life, especially in the rural areas we’ve served for over 40 years. By broadening our services, we’re ensuring that more families have access to high-quality care wherever they call home.