Private Equity Health Care Acquisitions – April 2025

In light of continued investor interest in healthcare and the risks associated with private equity ownership of healthcare companies, the Private Equity Stakeholder Project is tracking private equity-backed healthcare acquisitions. Below is a list of private equity healthcare buyouts, growth investments, and add-on acquisitions completed during April 2025. We will continue to track acquisitions on a monthly basis.

See March 2025 acquisitions here.

In April 2025, PESP tracked 17 buyouts, 59 add-on acquisitions, and 18 growth/expansion investments.

PE acquires one of the largest US retirement rental communities

Private equity firm Fortress Investment Group announced in April that it had acquired The Village at Gainesville, which is one of the country’s largest retirement rental communities, and its largest mixed-acuity retirement rental community.[1] Fortress currently owns 16 retirement properties across the U.S.[2]

The seller, SantaFe Senior Living, is a not-for-profit organization that operates one other senior living community.[3] Prior to this sale, it had made $3 million in capital expenditures annually into The Village since 2020.[4]

The Village at Gainesville has 639 residences, including a neighborhood of 45 cottages and nine other residential buildings – including six for independent living, one for assisted living, and two memory care buildings. It also has two amenity buildings that offer dining, fitness, on-site healthcare, and other services.[5]

Last November, Gainesville-based Mainstreet Daily News reported that The Village had confiscated packets of information about Fortress Investment Group that were found in residential mail cubbies following a series of meetings about the planned sale. The materials included a PESP article on the growing presence of private equity in senior living.[6]

Recently, PESP identified eight of the largest U.S. senior living operators that are owned by private equity, which in 2024 accounted for a total combined 968 properties and 152,392 senior living units.[7]

According to Seniors Housing Business, asset managers such as private equity firms are investing in senior housing because it compares favorably to other commercial real estate asset classes. Recent data shows the 10-year annualized total return for senior housing to be the strongest of the main property types except industrial. Additionally, demand is expected to grow due to limited housing supply to meet the demands of an aging population, which makes newer buildings in growth markets attractive to private equity bidders.[8]

Private equity investment into nursing homes has received some scrutiny. As discussed in a recent PESP report, nursing homes have also had to confront financial risks as their owners take on debt in the form of private credit issued by lenders owned by private equity. In recent years, at least two nursing home companies owned by private equity firms, as well as a private equity firm that itself owned nursing homes, have filed for bankruptcy.[9]

However, less attention has been placed on private equity’s growing presence in senior living more broadly,[10] which can encompass an array of services including skilled nursing, assisted living, and memory care.

The not-for-profit senior living sector has become increasingly privatized in the last decade. According to one estimate, from 2015 to 2024, more than 950 not-for-profit, market-rate senior living communities were sold – with roughly 46% of these deals including buyers from the private sector.[11]

High dental care activity in consecutive months

Dental care has continued to be among the busiest sectors for private equity acquisitions, with at least 15 add-on acquisitions made by private equity-owned platform companies in April. A month prior, PESP identified nine DSOs that combined made at least 15 add-on acquisitions during March.[12]

Last year, seven of the 13 most active private equity-backed platform companies were dental care companies.[13] Dental care saw the highest number of deals among the healthcare sectors tracked by PESP in 2024, with 137 add-on acquisitions, 6 buyouts, and 18 growth/expansion investments.[14]

Private equity has been acquiring dental practices for at least a decade. A recent study published in Health Affairs has found that private equity affiliation with dental practices nearly doubled for the period 2015-2021, from 6.6% in 2015 to 12.8% in 2021. The study found the highest growth among dental specialties such as endodontists and oral surgeons, which more than doubled during the period.[15]

[1] “Fortress Acquires The Village at Gainesville, One of USA’s Largest Retirement Rental Communities.” 2025. Fortress Investment Group. April 17, 2025. https://www.fortress.com/media/2025-04-17-fortress-acquires-the-village-at-gainesville-one-of-usa-largest-retirement-rental-communities.

[2] Lane, Mark, and Fortress Investment Group. 2025. “Fortress Acquires The Village at Gainesville Retirement Community from Santa Fe Healthcare.” Gainesville Sun. April 17, 2025. https://www.gainesville.com/story/news/2025/04/17/fortress-acquires-the-village-at-gainesville-from-santa-fe-healthcare/83137269007/.

[3] “About.” SantaFe Senior Living. Accessed May 21, 2025. https://www.santafeseniorliving.org/about/.

[4] Gaivin, Kathleen Steele. 2025. “Fortress Acquires One of Largest US Rental Senior Living Communities from SantaFe.” McKnight’s Senior Living. April 18, 2025. https://www.mcknightsseniorliving.com/news/fortress-acquires-one-of-largest-us-rental-senior-living-communities-from-santafe/.

[5] “Fortress Acquires The Village at Gainesville, One of USA’s Largest Retirement Rental Communities.” 2025. Fortress Investment Group. April 17, 2025. https://www.fortress.com/media/2025-04-17-fortress-acquires-the-village-at-gainesville-one-of-usa-largest-retirement-rental-communities.

[6] Lillian Hamman. 2024. “The Village at Gainesville Curbs Information Sharing about Fortress Purchase.” Mainstreet Daily News. November 12, 2024. https://www.mainstreetdailynews.com/business/village-gainesville-fortress-purchase.

[7] Fenne, Michael. 2025. “Private Equity behind Top Senior Housing Operators.” Private Equity Stakeholder Project PESP. March 17, 2025. https://pestakeholder.org/news/private-equity-behind-top-senior-housing-operators/.

[8] Jeff Shaw. “Can Private Equity Time the Market?” Seniors Housing Business, May 13, 2024. https://seniorshousingbusiness.com/can-private-equity-time-the-market/.

[9] “PE Is Continuing to Acquire — and Bankrupt — Nursing Homes.” 2025. Private Equity Stakeholder Project PESP. April 23, 2025. https://pestakeholder.org/reports/pe-is-continuing-to-acquire-and-bankrupt-nursing-homes/.

[10] See Private Equity Stakeholder Project PESP. “Private Equity’s Growing Presence in Senior Living,” December 1, 2023. https://pestakeholder.org/news/private-equitys-growing-presence-in-senior-living/. Kali S. Thomas, John R. Bowblis, Paula Carder, Cassandra Hua, Sean Shenghsiu Huang, Yashaswini Singh, Lindsey Smith, and Momotazur Rahman. “Private Equity Investment In Assisted Living: Distinct Impacts And Policy Considerations.” Health Affairs, June 18, 2024. https://www.healthaffairs.org/content/forefront/private-equity-investment-assisted-living-distinct-impacts-and-policy-considerations.

[11] Cathy Owen. 2024. “2024 Mid-Year Not-for-Profit Senior Living M&A Update.” Ziegler. July 22, 2024. https://www.ziegler.com/media/tdybtzyn/sl_znews_072224.pdf.

[12] Fenne, Michael. 2025. “Private Equity Health Care Acquisitions – March 2025.” Private Equity Stakeholder Project PESP. April 22, 2025. https://pestakeholder.org/news/private-equity-health-care-acquisitions-march-2025/.

[13] Bugbee, Mary, Eileen O’Grady, and Michael Fenne. “Private Equity Healthcare Deals: 2024 in Review.” Private Equity Stakeholder Project, February 20, 2024. https://pestakeholder.org/reports/healthcare-deals-2024-in-review/.

[14] Bugbee, Mary, Eileen O’Grady, and Michael Fenne. “Private Equity in U.S. Healthcare: Trends in 2023 Deal Activity.” Private Equity Stakeholder Project, March 6, 2024. https://pestakeholder.org/private-equity-healthcare-2023-trends/.

[15] Kamyar Nasseh, Anthony T. LoSasso, and Marko Vujicic, “Percentage Of Dentists And Dental Practices Affiliated With Private Equity Nearly Doubled, 2015–21,” Health Affairs. Vol. 43, No. 8: (2024): 1082–1089.  https://doi.org/10.1377/hlthaff.2023.00574.  Pg. 1084.