Private equity is buying America's hospitals and nursing homes. The playbook: pile on debt, sell the building, cut staff. The result, one landmark study found: patient deaths up about 11%. Typically, a private equity firm will buy a facility using a significant amount of borrowed money. That debt gets placed on the facility itself, which has to cover the payments, plus interest. In 2024, a landmark study looked at 1,674 nursing homes acquired by private equity over a twelve-year period. It found that, after a facility was acquired, its interest payments increased by 200%. Frontline aides—the people who turn patients, answer call lights, manage behavioral care—saw their hours cut by about 3%. Antipsychotic prescriptions jumped 50%—possibly because residents were being medicated in place of being cared for. The authors, economists including Atul Gupta and Sabrina Howell, estimated that all of this resulted in 20,000 deaths over their study period. A separate study of 51 private equity acquired hospitals between 2009 and 2019 found similar trendlines: Emergency department salary expenditures fell by an average of 18%. The authors, health policy scholars Kannan, Bruch, and their co-authors, found that patients bore the cost. Hospital-acquired conditions rose 25% on average: Falls. Infections. Central line complications. Of course, not every acquisition is all downside. Some facilities are distressed already. Some receive capital they couldn't have found elsewhere. But statistically, these deals produce predictable harm. The studies also point to solutions: debt caps, tying payments to outcomes, minimum staffing, ownership transparency, even restricting these deals altogether. Have you, or has a loved one, had an experience with private-equity-owned healthcare? Share in the comments if so. #PrivateEquity #Healthcare #NursingHomes #PatientSafety #HealthPolicy
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