New York, New York — Skilled nursing facilities are pulling in real estate capital at a pace the sector hasn’t seen in years, and one of the more active private equity voices in the space says three forces are behind the rush.
Jonathan Slusher, partner and head of senior living and healthcare at Northwind Group, told industry sources this month that buyers are increasingly treating skilled nursing as part of America’s “social infrastructure” — a framing that’s helping break the stigma some institutional capital still attaches to the space. Northwind has investments in more than 400 health care properties across 25 states and is one of several firms leaning harder into SNFs in 2026.
The shift isn’t subtle. Nearly 40% of respondents to a recent industry outlook survey said they plan to purchase nursing home assets this year. Capital providers say deal flow has picked up after a slower stretch, and they aren’t waiting on the Federal Reserve rate cuts that still haven’t materialized.
The supply story
Slusher’s first reason: not enough beds are being built. Most states have certificate of need (CON) laws that force operators to prove demand before adding capacity, and several have outright moratoriums on new beds. High construction costs make new builds even harder to pencil out.
“You have to prove out the need for additional beds. Some states have a moratorium on additional beds, and most states have strict regulatory requirements to build a new building,” Slusher said.
That dynamic protects existing facilities. Slusher said Medicaid programs in most states want existing homes running at full capacity rather than diluting the market with new construction.
The generational handoff
The second driver is demographic — but not on the patient side. Many independent operators are family businesses, and the next generation isn’t taking the baton. Older owners are looking for buyers who’ll preserve their legacy in the community, which has opened the door for capitalized owner-operators backed by firms like Northwind.
That transition is fueling refinancings too. As newer owner-operators build track records, they’re going back to the capital markets to recapitalize the portfolios they’ve assembled.
Operations are steadying
The third force is operating fundamentals. They’ve stabilized, and other major REITs are reporting the same. CareTrust REIT closed roughly $865 million in mostly skilled nursing deals in April alone, and PACS Group recently posted strong first-quarter results tied to managed care gains and rising occupancy.
The catch, in Slusher’s view, is that more supply will eventually be needed as the senior population grows — but Medicaid rates have to keep pace. Without reimbursement that tracks labor and operating costs, new capacity won’t come online no matter how loud the demand signal gets.
Not every observer is convinced the rush will hold. Critics argue some of the capital chasing skilled nursing still doesn’t fully price in regulatory risk, including recent CMS proposals to scrutinize how nursing homes code their Medicare claims. Slusher said the firms Northwind backs put culture and clinical performance first.
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