A long-awaited study on the impact of private capital on assisted living communities is now available in Health Affairs. The study—supported from the outset by Argentum—offers the most comprehensive examination to date of the impact of private equity (PE) in assisted living.
Argentum welcomes the peer‑reviewed study—conducted by researchers from Johns Hopkins University, Portland State University, Brown University, Georgetown University, and Miami University—and worked with its authors to connect them with operators, developers, and financial experts and provide data and industry context from across the senior living sector. Argentum also supported efforts to publish an earlier Health Affairs Forefront op-ed directed at policymakers to slow legislative action while this research was underway.
For our members, this research is an important step toward correcting misconceptions in the media and among policymakers, and grounding the national conversation in evidence rather than assumptions drawn from unrelated health care settings, and we are grateful to those who participated. While there are some data points from state agents and others that point to positive and negative factors of PE involvement in assisted living, the overall takeaway of this study will be helpful to educate both media and policymakers.
What the Study Found
The research confirms what assisted living owners and operators experience every day: assisted living is a unique sector with unique capital needs—and PE involvement looks very different here than in hospitals or nursing homes.
- Assisted living depends on private capital.
Because there has never been a federal construction program for assisted living, private investment has always been essential. As one operator explained, PE is “a critical part of our jet fuel,” especially when a new community requires “an $80 million equity check.” - Demographic demand is driving investment.
With “74 million people…turning 80 years old from 2026 to 2044,” the need for assisted living continues to grow. - PE involvement is primarily in real estate—not operations.
The study reinforces that most PE firms invest through property ownership rather than direct operational control. This structure has been part of assisted living since its inception and differs sharply from PE activity in other health care sectors. - The private‑pay model creates incentives to compete on quality.
The companion op‑ed highlights that assisted living communities “do not rely on health insurers” and instead compete directly for residents. This means PE investors have strong incentives to enhance quality, amenities, and resident experience—not cut corners that would damage their brand.
Why This Matters for Members
As policymakers consider broad PE‑related reforms aimed at hospitals and nursing homes, this research provides a crucial reminder: those policies cannot simply be copied and pasted onto assisted living. The op‑ed warns that doing so “may compromise access to capital” and create “profound unintended consequences for a sector that serves close to one million older adults.”
Argentum is using this research to educate federal and state leaders about the distinct financing structure of assisted living and the importance of preserving access to responsible capital—whether from PE, pension funds, or other private investors.
Our Ongoing Commitment
We will continue working with the authors as they expand this research, including future analyses of the middle market and the potential impact that private equity can have in helping more seniors access the care they need. Argentum is also preparing additional materials for members to use in conversations with policymakers, reporters, and community partners.