Why and How is Private Equity Involved in Assisted Living Community Development and Operations?

Authors

• Paula Carder, Portland State UniversityFollow
• Sarah Dys, Portland State University
• Jacklyn N. Kohon, Portland State University
• John R. Bowblis, Miami University, Oxford
• Yashaswini Singh, Brown University , Providence
• Sean Shenghsiu Huang, Georgetown University
• Jennifer N. Bunker, School of Nursing, Johns Hopkins University , Baltimore, MD 21205 ,
• Lindsey Smith, OHSU-PSU School of Public Health
• Momotazur Rahman, Brown University , Providence
• Kali S. Thomas, Johns Hopkins University , Baltimore

Published In

Health Affairs Scholar

Document Type

Article

Publication Date

6-1-2026

Subjects

assisted living, private equity, public policy, qualitative research

Abstract

Introduction Assisted living (AL) cares for close to 1 million older adults who need long-term services and supports in the United States. Methods This qualitative study examines private equity (PE) involvement in AL mergers, acquisitions, development, and operations based on interviews with 46 senior housing professionals (including AL owners, operators, and developers, real estate brokers, lenders, PE fund managers) and state agents (licensing and regulatory oversight staff and Long-term Care Ombudsman Program leaders). Results Participants indicate that PE involvement in AL responds to strong demographic demand and attractive financial returns, need for private funding sources, perceived social benefits, and absence of federal AL requirements. PE is primarily involved in AL through property ownership, but to varying degrees may also be involved in facility operations, including selecting and supporting qualified operators, and facility management. Conclusion A nuanced understanding of PE’s multidimensional involvement in AL—distinct from healthcare settings—and the centrality of private capital to support the growing demand for AL is needed to guide future policymaking.

Rights

Copyright (c) 2026 The Authors

This work is licensed under a Creative Commons Attribution 4.0 International License.

DOI

10.1093/haschl/qxag118

Persistent Identifier

https://archives.pdx.edu/ds/psu/45220

Citation Details

Carder, P., Dys, S., Kohon, J. N., Bowblis, J. R., Singh, Y., Huang, S. S., Bunker, J. N., Smith, L., Rahman, M., & Thomas, K. S. (2026). Why and how is private equity involved in assisted living community development and operations? Health Affairs Scholar, 4(6).