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Forthcoming — 2026

Who Absorbs
the Risk

Forty years inside the collision between Washington and the senior care balance sheet.
By Reginald M. Hislop, III — CEO, dealmaker, and author of Reg's Blog
Washington Policy
Senior Care Operators

Every mandate Washington writes for senior care arrives with an unstated question: who actually pays for it? Not in theory — in cash, in staffing, in the difference between a Medicaid rate and the true cost of care.

This book is forty years of answering that question from the inside — as a CEO who restructured debt and rebuilt organizations, a dealmaker who closed more than a billion dollars in transactions, and a board advisor who has watched policy intentions collide with operating reality again and again.

Policy sets the mandate. Capital markets set the price. Somewhere in between, an operator absorbs the difference — and residents live with the result.

From the Introduction
Who It's For
01
Operators & Executives
Running the daily arithmetic of census, acuity, and reimbursement against a policy environment that rarely holds still.
02
Boards & Investors
Underwriting capital decisions in a sector where the next mandate — or the next repeal — can move the financial model overnight.
03
Policymakers & Advocates
Writing the next rule, and wanting to understand where the last one actually landed once it left Washington.