Long-Term Care, Assisted Living Drove Record Health Care Deal Volume in 2018

A record-setting year for deal volume further confirms senior housing is now an institutional-grade real estate product type. Long-term care and assisted living deal volume paced a 14.4% increase over 2017, according to PricewaterhouseCooper’s (NYSE: PWC) year-end U.S. Health Services Insight report.

There were 285 health care transactions last quarter, with long-term care accounting for 35% of total deal volume. Long-term care transaction volume increased 34.2%, year over year.

Q4 2018 marked the sixth consecutive quarter with over 250 deals in the health services sector. The sector has had at least 300 deals per year since 2015, and ended 2018 with 412 transactions.


London-based professional services firm PwC analyzed data from Irving Levin Associates platforms, as well as Dealogic Equity Capital Markets Analytics, S&P Capital IQ and publicly available transaction information.

Health services deal volume and value from Q1 2017 to Q4 2018. PwC
Health services deal volume and value from Q1 2017 to Q4 2018.

In addition to six consecutive quarters with 250 or more deals, the industry has recorded over 200 deals per quarter since Q1 2014.

The Q4 numbers marked a strong bounceback over Q3, which saw dips in deal volume and value. While deal volume increased year-to-year, deal value dropped 31.4% last year, to $121.5 billion. Deal value last quarter fell to $7 billion, compared to Q3’s $15.9 billion.


There were 13 health care deals valued at over $1 billion last year. The PwC report noted Welltower’s $1.95 billion, all-cash acquisition of Quality Care Properties as one of the more notable deals. Although deal value fell last year, total value was still 1.4 times higher than 2015, and 1.7 times higher than 2016.

Industry experts at last October’s National Investment Center for Seniors Housing & Care (NIC) fall conference expressed concern about peaking valuations and the likelihood of interest rate hikes over the next 12 months.

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