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class="category-tag-holder"> <a href="https://bhbusiness.com/category/addiction-treatment-business/" class="post-category post-category-tag"><span>Addiction Treatment Business</span></a> </div> <h1>Why Luxury Rehab Is an Unpopular Investment </h1> <div class="author">By <a href="https://bhbusiness.com/author/matthewblake/" class="name"> Matthew Blake</a>| October 22, 2024</div> </div> <div class="post-columns-wrapper"> <div class="main-column"> <div class="share-widget"> <span>Share</span> <ul> <li> <a href="https://www.facebook.com/sharer/sharer.php?u=https%3A%2F%2Fbhbusiness.com%2F2024%2F10%2F22%2Fwhy-luxury-rehab-is-an-unpopular-investment%2F&quote=Why%20Luxury%20Rehab%20Is%20an%20Unpopular%20Investment%C2%A0" target="_blank" title="Share on Facebook"> <img decoding="async" src="data:image/svg+xml,%3Csvg%20xmlns='http://www.w3.org/2000/svg'%20viewBox='0%200%200%200'%3E%3C/svg%3E" 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href="/cdn-cgi/l/email-protection#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" title="Send email"> <img decoding="async" src="data:image/svg+xml,%3Csvg%20xmlns='http://www.w3.org/2000/svg'%20viewBox='0%200%200%200'%3E%3C/svg%3E" data-lazy-src="https://bhbusiness.com/wp-content/themes/agingmedia/images/icon_email.svg"><noscript><img decoding="async" src="https://bhbusiness.com/wp-content/themes/agingmedia/images/icon_email.svg"></noscript> </a> </li>     </ul> </div>  <article> <div class="sponsored-article-content"> <p>Adam Nesenoff is convinced that luxury rehabilitation centers, the amenity-filled facilities to treat addiction, are a terrific investment. The problem is convincing others. </p> <p>“Banks are struggling to find what we rely upon,” said Nesenoff, who, with his brother, David Nesenoff, founded Behavioral Health Acquisitions in 2023 as a vehicle to put money into luxury rehab centers.</p> <p>As the luxury rehab industry <a href="https://bhbusiness.com/2024/10/01/behind-the-glamour-why-luxury-rehab-centers-have-lost-their-appeal/">dealt with scandal and industry changes</a> in how to treat people with substance use disorders; loans, equity investments and takeovers have cooled to near freezing levels. </p><div class="inner-content-ad"><div id="600x250_d_middle" class="adyb show-ad-label" data-ad-mapping="middle" data-ad-slot="bhbusiness/bhb_addictionweb" data-ad-targetingpos="d_middle" style="width: 100%; position: relative;" data-ad-device="desktop"></div><div class="ad-notice">Advertisement</div></div> <p>“I haven’t seen a hint of investor interest,” Rebecca Springer, lead health care analyst at Pitchbook, told Addiction Treatment Business.</p> <p>This was not always the case. Patients <a href="https://lamag.com/featured/dueling-lawsuits-between-malibu-rehab-centers-expose-the-shady-side-of-the-recovery-industry">can pay</a> up to $112,000 a month to stay at the most high-end treatment centers. For a time, investors interpreted that such high per bed revenue meant a reliably high-margin industry, according to Brad Mostowy, vice president with Fifth Third Securities, Fifth Third’s health care investment group.</p> <p>In 2014, there were 13 mergers and acquisitions in residential high-end substance use disorder (SUD) facilities, <a href="https://thebraffgroup.com/wp-content/uploads/2024/03/BH-Year-End-Report-2023.pdf">according to</a> the Braff Group, a Pittsburgh-based health care M&A advisory firm. That number climbed to 15 in 2015 and 18 by 2016, as palm tree-lined facilities in Florida, Southern California and Hawaii were the leading focus in behavioral health investment. </p> <p>But the number of mergers and acquisitions declined to 10 in 2017, per Braff’s tallies, then eight in 2018, and all the way down to no deals at all in 2022. </p> <p>One reason The Braff Group cites is there is only so much money to go around. Global investment dropped in early 2022 amid Russia’s invasion of Ukraine and a rise in inflation, among other issues.</p><div class="inner-content-ad"><div id="600x250_e_middle" class="adyb show-ad-label" data-ad-mapping="middle" data-ad-slot="bhbusiness/bhb_addictionweb" data-ad-targetingpos="e_middle" style="width: 100%; position: relative;" data-ad-device="desktop"></div><div class="ad-notice">Advertisement</div></div> <p>But specifically in behavioral health, investors began to latch onto other investor models, including outpatient providers that used partial hospitalization programs (PHP) and intensive outpatient services (IOP). Deals involving outpatient providers that use PHP, IOP and counseling jumped from three in 2014 to 17 by 2023, according to The Braff Group. </p> <p>“When it comes to private equity investments, there is generally a thesis around a sector,” Brad Mostowy told ATB. </p> <p>If luxury rehab enjoyed a thesis of high margins in the mid-2010s, today, outpatient clinics promise an “expanding continuum of care and ancillary services to capture the largest patient populations they can,” Mostowy said. </p> <p>Luxury, meanwhile, is a niche market with a major acquisition period that has come and gone, Mostowy said. </p> <p>Access to the largest patient populations hinges on providers being able to negotiate with insurers to provide in-network care. Generally, outpatient as well as mid-to-budget priced residential treatment centers have been able to offer in-network, while luxury rehab centers have not. </p> <p>Nesenoff, for example, said that while insurance covers some of his patients’ up to $85,000-a-month stays at clinics he co-owns in Florida and Hawaii, he has so far not secured in-network payers.</p> <p>Asked why luxury rehab investment has dropped, Nancy Weisling, senior advisor at The Braff Group, also cited the payer problem.</p> <p>“The simple answer is out-of-network insurance reimbursement,” Weisling said. “Buyers and investors don’t like this payer source.”</p> <p>Lenders can also balk, Nesenoff said, perceiving in-network coverage as a provider’s key asset. Consequently, luxury rehab “is not even a discussion” some banks are willing to have. </p> <p>Still, Nesenoff, a self-described contrarian investor, said his centers are already profitable, and that enhanced insurance will expand the client base. He said that Behavioral Health Acquisitions has in the pipeline about “half-a-dozen deals to acquire other centers.”</p> <p>“I feel like this year I might be one of the biggest buyers in the space,” Nesenoff said.</p> </div> <div class="author-block single-post-author-block"> <img alt='' src="data:image/svg+xml,%3Csvg%20xmlns='http://www.w3.org/2000/svg'%20viewBox='0%200%20100%20100'%3E%3C/svg%3E" data-lazy-srcset='https://secure.gravatar.com/avatar/e482004538a71fd08d0c6b790bddb0a8?s=200&d=mm&r=g 2x' class='avatar avatar-100 photo' height='100' width='100' data-lazy-src="https://secure.gravatar.com/avatar/e482004538a71fd08d0c6b790bddb0a8?s=100&d=mm&r=g" /><noscript><img alt='' src='https://secure.gravatar.com/avatar/e482004538a71fd08d0c6b790bddb0a8?s=100&d=mm&r=g' srcset='https://secure.gravatar.com/avatar/e482004538a71fd08d0c6b790bddb0a8?s=200&d=mm&r=g 2x' class='avatar avatar-100 photo' height='100' width='100' /></noscript> <div class="author-bio-and-links"> <h3 class="author-name"><a href="https://bhbusiness.com/author/matthewblake/">Matthew Blake</a></h3> <div class="author-bio"> <p>Matthew Blake is a freelance reporter based in Chicago, who has covered the people, trends and issues facing many industries including health care, housing, the law, and media and entertainment.</p> </div>  <ul class="author-links"></ul> </div>  </div>  </article> </div> </div> <div class="bottom-ad"> <div id="790x225_footer" class="adyb show-ad-label" data-ad-mapping="footer" data-ad-slot="bhbusiness/bhb_addictionweb" data-ad-targetingpos="footer" style="width: 790px; height: 225px; position: relative;" data-ad-device="desktop"></div> </div> </div> </div> </div> </main> </div> </div> <footer id="colophon" class="site-footer" role="contentinfo" style="background-color: #23272e;"> <div class="wrap"> <div class="grid-container"> <div class="grid-col grid-col-1-of-5"> <div class="footer-section"> <h3 class="footer-section-title">About</h3> <nav id="footer-menu-1" 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