New Canaan, Connecticut — Skilled nursing facilities changed hands at a pace not seen in years during the first quarter of 2026, with deal volume jumping 36% above the 2025 quarterly average, according to new acquisition data released Monday by LevinPro LTC.
The broader seniors housing and care market recorded 231 publicly announced transactions in Q1 2026 — a 25.5% increase from the same period a year ago, even as the quarter fell short of the record-breaking pace set in Q4 2025. Skilled nursing accounted for 36% of all deals, second only to assisted living at 46.8%.
“It was always going to be difficult to top Q4:25, which set records for the highest number of publicly announced transactions in both a single quarter and a month,” said Ben Swett, managing editor of The SeniorCare Investor. “However, investor sentiment remains strong, operations are improving, investors are getting more aggressive, more sellers are stepping off the sidelines, and the lending environment remains favorable.”
The numbers tell a story of a sector that’s attracting capital even as broader economic uncertainty rattles other industries. Monthly deal volume exceeded 70 in each month of the quarter, averaging 76 deals per month — a threshold that was first crossed in May 2024 and has since become the new floor for activity.
Strong demand, constrained supply
Despite the surge in deal count, the total number of skilled nursing facilities included in those transactions came in 18.3% below the 2025 quarterly average. That gap between buyer appetite and available inventory is something dealmakers have flagged repeatedly — there’s more money chasing fewer quality assets.
Disclosed transaction prices told a more complicated story. The $3.52 billion spent on Q1 2026 deals fell 77% from Q4 2025’s $15.32 billion, though that comparison is skewed by several blockbuster transactions that closed late last year. Billions more in deal volume were confidentially disclosed and not reflected in public figures.
On an annualized basis, 2026 is on track to surpass both 2025’s U.S. total of 702 deals and 2024’s combined total of 721 — a sign that the sector’s M&A momentum isn’t slowing down.
What it means for operators
The elevated deal activity comes at a time when nursing home operators are navigating mounting Medicaid reimbursement pressure and rising operational costs. For sellers, the window may still be open — but the pool of buyers willing to pay top dollar for lower-quality assets is narrowing.
“Values have been soaring for high-quality seniors housing communities, and cap rates have been compressing,” Swett added. “As a result of higher prices in the M&A market, development could start to pick up, driven by the anticipated demand from the baby boomers.”
The data suggests that investors aren’t waiting for policy certainty before moving. Whether that confidence holds through the rest of 2026 — as Medicaid cuts loom and federal reimbursement debates drag on — remains the open question.
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