Josh Simpson, 38

Josh Simpson co-founded T7 Capital to build what he thought health care real estate needed: a boutique advisory shop focused on the operating businesses that ultimately drive value in the most vital niche sector. 

Simpson spent more than a decade at Meridian Capital Group, where he helped grow a once-small practice into a multibillion-dollar business. At Meridian’s peak, Simpson said, the health care group was producing roughly $6 billion to $7 billion in annual transaction volume. But the platform itself was still largely a commercial mortgage brokerage.

That distinction shaped the thesis for T7: Health care real estate is fundamentally different because the value of the assets depends so heavily on the operator, licensing, reimbursement, care delivery and business performance.

“We found that our world was really not as much a real estate world as it was a health care-focused operating business,” Simpson said.

T7 has arranged more than $5 billion in transactions since launching a little over a year ago, including roughly $3 billion in debt, equity and sales between March 2025 and year end, and another $2 billion so far in 2026. The firm’s work has largely centered on senior living, skilled nursing facilities and behavioral health, including major financings, refinancings and sale-leaseback transactions.

One of the firm’s recent assignments included facilitating CareTrust REIT’s $380 million acquisition of a 15-property skilled nursing portfolio in California. T7 has also arranged a $500 million multistate acquisition financing and several smaller refinancings.

“We’ve already closed close to $5 billion of transaction volume on the T7 platform, and we’re very excited,” Simpson said.

Simpson said COVID stalled construction for years, creating a buildup of demand and a shortfall of supply. But, while more commercial real estate investors advance on the health care scene, Simpson said it requires specialized knowledge.

“It’s certainly complicated enough that it should be handled by somebody that’s dedicated to that particular field,” he said.

T7 is hiring more investment sales specialists and building out new office space. Simpson credits the growth to the firm’s strategy and to his longtime business partner, Ari Adlerstein.

“The success of T7 is certainly more than myself,” the Yeshiva University graduate said. “I owe a lot to my partner, and I’d be remiss if I didn’t recognize that.”

Simpson has participated in more than $35 billion of health care transactions throughout his career.