ManorCare Sells Pair of Therapy, Staffing Businesses to Private Equity Investor

Skilled nursing giant HCR ManorCare has sold a pair of business lines to Grant Avenue Capital, according to an announcement from the private equity firm released earlier this week.

The New York City-based Grant Avenue will roll the two entities — Heartland Rehabilitation and MileStone Staffing Services — into a new brand known as H2 Health.

The two businesses don’t have a direct connection to the Toledo, Ohio-based ManorCare’s core skilled nursing facility operations: Heartland runs 60 outpatient therapy centers in seven states, while MileStone provides temporary and travel workers to a range of clients — from skilled nursing facilities to correctional systems to schools.


“HCR ManorCare has created leading, regional platforms in the outpatient rehab and caregiver staffing sectors,” Buddy Gumina, founder and managing partner of Grant Avenue Capital, said in the statement. “Looking forward, we will build upon the great foundation of H2 Health to expand the reach of the business and thereby provide world-class care to a broader base of patients.”

The terms of the deal were not disclosed, and a spokesperson for Grant Avenue declined to comment on the deal beyond the information included in the public announcement. A spokesperson for ProMedica, the non-profit health system that has owned ManorCare since 2018, did not respond with a formal comment as of press time.

ManorCare continues to operate skilled nursing facilities and memory care centers in 27 states under the larger ProMedica umbrella; the Toledo, Ohio-based health system also owns a portion of ManorCare’s real estate in a joint venture arrangement with real estate investment trust (REIT) Welltower Inc. (NYSE: WELL).


“I look forward to working with our dedicated and patient-focused management team, clinicians, and employees to grow our breadth of services over the years to come,” Guy Sansone — a member of Grant Avenue’s advisory board, founding partner of Kiawah River Health Partners, and the CEO of H2 Health — said in the Grant Avenue releasee.

Private equity has thrown its weight around in the health care world in recent years, with skilled nursing providers in particular pegging non-public investors as the top buyer of SNFs in 2020, according to a recent SNN reader survey.

In total, private equity firms started the year with $1.5 trillion in available capital, data firm Prequin reported in early January.

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