For those too young to remember, do some historical research. In the mid-1990s the senior-care industry also hid operating weakness by acquisitions, financed by a barrage of shaky convertible debt offerings. Then it all blew up. Check out histories of Mariner, Integrated Health, Grancare, Alterra, etc. Not surprising that BKD's Ohlendorf and Ferge presided over the Alterra (aka Alternative Living Services, aka Evergreen Healthcare). Be careful. With acquisitions it easy to hide weakness in internal growth. And IMO this management has abysmal track record in actually profitably operating any company versus just the cocaine of "doing deals!".
Peak of deal frenzy + "alternative care" (i.e., to nursing homes) + huge debt issues to finance acquisitions was probably about mid-1993 to mid-1995. Then (perhaps because the analysts were back to analyzing rather than deal pimping) investors started pressuring the companies for equivalent of same-store-sales (i.e., internal growth) and were alarmed at these results, plus the poor cash-flow coverage for debt payments. In late 1990s most of these firms (including Alterra/Evergreen) filed for bankruptcy. Vultures swooped in to scoop up the better assets during the prolonged bankruptcy reorganizations. Many current "managers" in this industry are the very ones who made the 1990s mess. IMO it's like the return of the living dead. It was so bad that even now, as with BKD, these companies' histories always refer to their unidentified "predecessor company" (perchance for fear you'd SEC-search the latter if supplied). Be careful.