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A skilled nursing and seniors housing investment advisory firm

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When you are ready to buy or sell a facility or bed licenses, our experts will guide you every step of the way.  Our services include exit strategy, growth strategy, facility and bed license transactions, and pre-disposition & acquisition consultation.

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Our extensive knowledge of skilled nursing and seniors housing companies, facilities and bed license transfers equip us to help our clients address any issue they face. Senwell offers strategic advisory services that help our clients build a better business.

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Our advisors work with financial intermediaries, lenders, capital providers, consultants and appraisers to value skilled nursing and seniors housing operations, facilities and bed licenses in markets across the United States.

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Who We Are

[/et_pb_text][et_pb_text _builder_version=”3.27.4″ text_font=”Montserrat|300|||||||” text_text_color=”#000000″ text_font_size=”16px” header_2_font=”Gotham Book|800||on|||||” header_2_text_color=”#44a3aa” header_2_font_size=”31px” header_2_letter_spacing=”3px” header_3_font=”Gotham Book|||on|||||” header_3_text_color=”#44a3aa” header_3_letter_spacing=”4px” custom_margin=”|20px||20px” custom_padding=”|20px||20px” z_index_tablet=”500″ text_text_shadow_horizontal_length_tablet=”0px” text_text_shadow_vertical_length_tablet=”0px” text_text_shadow_blur_strength_tablet=”1px” link_text_shadow_horizontal_length_tablet=”0px” link_text_shadow_vertical_length_tablet=”0px” link_text_shadow_blur_strength_tablet=”1px” ul_text_shadow_horizontal_length_tablet=”0px” ul_text_shadow_vertical_length_tablet=”0px” ul_text_shadow_blur_strength_tablet=”1px” ol_text_shadow_horizontal_length_tablet=”0px” ol_text_shadow_vertical_length_tablet=”0px” ol_text_shadow_blur_strength_tablet=”1px” quote_text_shadow_horizontal_length_tablet=”0px” quote_text_shadow_vertical_length_tablet=”0px” quote_text_shadow_blur_strength_tablet=”1px” header_text_shadow_horizontal_length_tablet=”0px” header_text_shadow_vertical_length_tablet=”0px” header_text_shadow_blur_strength_tablet=”1px” header_2_text_shadow_horizontal_length_tablet=”0px” header_2_text_shadow_vertical_length_tablet=”0px” header_2_text_shadow_blur_strength_tablet=”1px” header_3_text_shadow_horizontal_length_tablet=”0px” header_3_text_shadow_vertical_length_tablet=”0px” header_3_text_shadow_blur_strength_tablet=”1px” header_4_text_shadow_horizontal_length_tablet=”0px” header_4_text_shadow_vertical_length_tablet=”0px” header_4_text_shadow_blur_strength_tablet=”1px” header_5_text_shadow_horizontal_length_tablet=”0px” header_5_text_shadow_vertical_length_tablet=”0px” header_5_text_shadow_blur_strength_tablet=”1px” header_6_text_shadow_horizontal_length_tablet=”0px” header_6_text_shadow_vertical_length_tablet=”0px” header_6_text_shadow_blur_strength_tablet=”1px” box_shadow_horizontal_tablet=”0px” box_shadow_vertical_tablet=”0px” box_shadow_blur_tablet=”40px” box_shadow_spread_tablet=”0px” inline_fonts=”Gotham Light,Montserrat”]

 Senwell Senior Investment Advisors offers merger and acquisition advisory services to the seniors housing and skilled nursing industry.  We leverage our transaction experience, relationships, deep industry knowledge in skilled nursing, seniors housing operations and bed license transactions to align our clients with their strategic objectives.

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Who We Are

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Senwell Senior Investment Advisors offers mergers and acquisition advisory services to the seniors housing and skilled nursing industry.

We leverage our transaction experience, deep industry knowledge in skilled nursing, seniors housing operations, bed license transactions and valuations, and a diverse network of relationships in the industry to assist in the sale or restructuring of businesses, development of strategic growth or exit strategies, and to explore bed license acquisitions or dispositions.

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Investment Opportunity

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Podcast

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We’ll educate you on the latest investment trends happening in one of the hottest real estate asset classes: skilled nursing and seniors housing. We’ll point out the risks, so you can reap the rewards of investing in this growing and complex industry.

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Our Core Values

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+ Integrity First

+ Service Before Self

+ Excellence in All We Do

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Our Core Values

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Integrity First

Service Before Self

Excellence in All We Do

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Latest Episode

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The Investment Opportunity Podcast with Ben Bohland and Brandon Bohland

– Presented by Senwell Senior Investment Advisors

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Our Core Values

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Integrity First

Service Before Self

Excellence in All We Do

 

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Call Us:

(419) 540-1365

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Our Results

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Frequently Asked Questions

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If an operator proceeds with either acquiring or selling Beds, without including any real estate as part of the transaction, the timeline to transfer the Beds varies greatly by state. In states where Beds can be exchanged amongst operators, the most common timeline for final approval is described below from start to finish (every state is different, however, this timeline is most common):

• 45 days to discuss the initial terms of the transaction. Sometimes this is verbal, but more often than not, it is put in writing in a Letter of Intent (LOI) to purchase the bed licenses.
• 45 days to execute a Purchase Agreement. This is typically where buyer and seller representations and warranties, covenants, conditions to closing and indemnifications are added. Leave this to the lawyers.
• 45 days to file the CON application. If the transaction is in a CON state, the buyer and seller will need to work together to complete the CON application. Both buyer and seller will need to communicate a clear plan of what will happen to the selling facility post-sale, as well as detailing the plans the buyers has for the Beds. Sometimes a state will only have certain windows of time in which applications can be filed. Other states allow operators to file whenever they are ready and the application is complete.
• 90-365 days for CON review and decision. During this period, the state will often come back to the operators asking for further clarification on specific parts of the application. Once the application has no further questions, it will be scheduled to be reviewed by the CON board. There, the board will issue an approval or denial of the Bed relocation.
• 30 days to file an appeal. Some states will allow a window to file an appeal based on the CON decision rendered. If there are no appeals, the Beds are permitted to be relocated, and the buyer and seller can close on the Beds.
• If the application is appealed, the appeal process varies greatly by state. Some states will hear the appeal in the next month’s board meeting, while other states will delay the hearing. These cases can vary anywhere between 30-365 days.

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The timeline described above is an average timeline. It make take operators up to one year or more before the Beds are permitted to be relocated from one facility to another existing or new construction facility. If the decision is appealed, it can be delayed for up to two years or more.

The buyer and seller can control the timeline up until the application is filed. They can also be very responsive if the state has questions on the application. In states where this is a typical timeline, some operators have been successful in receiving approval in as little as 4-5 months. In some instances, it has taken over two years for some operators to receive approval.

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There are several ways how an operator would go about acquiring bed licenses (see Four Ways To Adjust Bed License Capacity). In this article, we would like to focus more on the ‘why’. Whether trying to grow the top line, or it being a strategic decision, operators are still out in full force acquiring bed licenses.

To be clear, when we refer to Bed Licenses (“Beds”), we are talking about the right to operate the beds, or the licenses. We are not referring to any transactions that include real estate as part of the transaction.

1)  New Construction. It’s no secret that the average age of skilled nursing facilities is much older than what patients prefer to see. Aside from the best quality care for its patients and the lowest possible re-hospitalization rates, an operator’s next best competitive advantage is a newly constructed facility. Patients are now looking for the best amenities, latest technology and ancillary services to be housed within the new facilities (see Mixed-Age Skilled Nursing Facilities Face Significant Barriers and Modern Skilled Nursing Must Have Tech Foundation). Developers and operators typically require a significant amount of beds (more than 50) before they break ground.

2)  Addition to Existing Real Estate. Similar to new construction, operators are looking for a competitive edge to showcase the new, modern amenities. They may be looking to renovate their existing facility, along with expanding their footprint. Another case where an addition to an existing facility makes sense is when an Assisted Living, Long-Term Acute Care Hospital (LTACH), acute care hospital, CCRC, etc., sees an opportunity to add a Skilled Nursing Facility or a skilled nursing wing to its property. The amount of beds needed for these types of additions vary greatly by the kind of addition, the operator, and the size of the land.

3)  Convert Existing Real Estate. Operators have little leeway when it comes to their top line. If an operator has square footage not being utilized, they will do whatever they can to increase their revenue/sqft. Sometimes this means it may make sense to convert their space to skilled nursing care. Acute care hospitals have also been known to take an entire floor of their hospital and convert it into skilled nursing. These conversions can often come with a JV partner if the operator has little to no skilled nursing experience. The amount of beds needed for conversions rely on amount of square footage the operator is willing to convert.

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4)  Convert Rooms From Private To Semi-Private. Yes, you read that right. It seems counter-intuitive in today’s market. However, there are operators who need to address immediate demand. Hospitals have significantly reduced the amount of facilities they refer patients to, therefore increasing the amount of market share those operators who remain. Some operators have seen their waitlists grow, and need a way to address the issue today. These operators will often buy beds in smaller quantities, and if successful, will acquire additional beds for an addition to their existing facility if there are no land constraints.

5)  Keep Beds Out Of Competitor Hands. All of the above-mentioned reasons could ultimately increase revenue if implemented properly. On its own, this last reason is more of a strategic move for operators. However, in almost all cases, operators will note one of the above four reasons for acquiring bed licenses, and source this reason as a supplement to the main reason why an operator acquires additional bed licenses.

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