PRIVATE EQUITY IS CONTINUING TO ACQUIRE – AND BANKRUPT – NURSING HOMES

The report argues that private equity firms continue to acquire US nursing homes despite industry claims to the contrary, often using complex ownership structures to avoid transparency. It highlights a pattern of high debt, real estate monetization through REITs, and private credit risks that correlate with increased patient mortality, reduced staffing, and facility bankruptcies. Case studies of companies like LaVie Care Centers and Gulf Coast Health Care illustrate 'harrowing conditions' and regulatory failures. The document concludes that federal deregulation under the Trump administration makes state-level legislation the most viable path for protecting patients and workers.

• Private equity ownership of nursing homes is associated with an 11% increase in patient mortality, driven by declines in nurse staffing, patient well-being, and compliance with care standards.
• There is a significant lack of transparency in nursing home ownership data; for example, Portopiccolo Group acquired approximately 136 facilities between 2016 and 2022 but did not appear as an owner in CMS data as of March 2025.
• Private equity firms continue to acquire nursing homes despite industry claims of near-zero activity; PESP identified at least six private equity-backed deals in the previous three years, including Cascade Capital's $85 million acquisition of 29 Iowa nursing homes in September 2024.
• The use of Real Estate Investment Trusts (REITs) allows owners to siphon money out of facilities through sale-leaseback transactions, which can undermine financial stability and substitute registered nurse care with lower-cost staff.
• Recent bankruptcies of private equity-owned chains have revealed severe care failures; court-ordered reports for LaVie Care Centers described 'harrowing conditions' in Virginia, Mississippi, and Pennsylvania, including food shortages and unsecured chemicals.
• Private credit lenders affiliated with private equity, such as Apollo Global Management's MidCap Financial, introduce financial risks that have been linked to the collapse of nursing home operators like Atrium Health and Senior Living.
• The current Trump administration is expected to challenge private equity regulation by weakening the administrative state and deregulating the corporate sector, potentially reversing Biden-era staffing standards and ownership transparency rules.

APA

Fenne, M., O’Grady, E., & Bugbee, M. (2025). PRIVATE EQUITY IS CONTINUING TO ACQUIRE – AND BANKRUPT – NURSING HOMES. Private Equity Stakeholder Project. https://pestakeholder.org/wp-content/uploads/2025/04/PESP_Report_NursingHomes_April2025.pdf#page=12

Chicago

Fenne, Michael, Eileen O’Grady, and Mary Bugbee. PRIVATE EQUITY IS CONTINUING TO ACQUIRE – AND BANKRUPT – NURSING HOMES. Private Equity Stakeholder Project, 2025. https://pestakeholder.org/wp-content/uploads/2025/04/PESP_Report_NursingHomes_April2025.pdf#page=12.

Wikipedia

{{cite report |last1=Fenne |first1=Michael |last2=O’Grady |first2=Eileen |last3=Bugbee |first3=Mary |title=PRIVATE EQUITY IS CONTINUING TO ACQUIRE – AND BANKRUPT – NURSING HOMES |publisher=Private Equity Stakeholder Project |date=April 2025 |url=https://pestakeholder.org/wp-content/uploads/2025/04/PESP_Report_NursingHomes_April2025.pdf#page=12 |access-date=23 October 2026 |via=Climate Insights Directory}}

BibTeX

@techreport{fenne2025private, author = {Fenne, Michael and O’Grady, Eileen and Bugbee, Mary}, title = {{PRIVATE EQUITY IS CONTINUING TO ACQUIRE – AND BANKRUPT – NURSING HOMES}}, institution = {Private Equity Stakeholder Project}, year = {2025}, month = apr, url = {https://pestakeholder.org/wp-content/uploads/2025/04/PESP_Report_NursingHomes_April2025.pdf#page=12}, urldate = {2026-10-23}, note = {Indexed by Climate Insights Directory} }