Private Equity Firm ReGen Healthcare Invests $100M in Failing Genesis Healthcare, Beginning Four-Year Collapse to Bankruptcy

Genesis Healthcare, once the largest skilled nursing operator in the United States, narrowly avoids bankruptcy by accepting a $100 million investment from Joel Landau’s private equity firm ReGen Healthcare LLC, which receives 93% equity stake and two board seats in exchange. Genesis’ downfall traces to 2007 when PE firms acquired the company in a $1.5 billion leveraged buyout, loading it with massive debt. A 2015 reverse merger with Skilled Healthcare Group created one of the largest and most indebted nursing home chains in the country with 500 facilities at its peak. By 2018, Genesis stock traded below $1 for 30-day periods, facing delisting threats from NYSE before voluntarily delisting in 2021. By March 2021, the sale of real estate assets to service debt obligations brings Genesis to the brink of collapse. ReGen’s investment and lease restructuring with Genesis’ largest landlord provides temporary relief, but the PE takeover accelerates facility decline: proportion of Genesis facilities rated above average by CMS plummets from 38% to 15%, average star rating falls from 2.98 to 2.29 stars, and 58% of Genesis homes receive below-average or much-below-average ratings. The pattern exemplifies PE nursing home extraction: acquire through leveraged buyout, load with unsustainable debt, extract management fees while cutting care quality, then leave facilities to collapse. In July 2025, Genesis files Chapter 11 bankruptcy with $709 million in secured debt and $1.6 billion in unsecured debt owed to pension funds, contractors, states for unpaid taxes, and former residents who sued for neglect and abuse. The bankruptcy demonstrates how PE firms kill nursing home chains while harming vulnerable elderly residents, with families unable to recover damages because PE owners structure deals to shield themselves from liability while extracting wealth.