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The report argues that Blackstone, the largest landlord in the U.S., exploits the affordable housing shortage to maximize returns. In San Diego, Blackstone increased rents by 38% across 66 properties acquired in 2021, nearly double the market average. The document details Blackstone's use of RealPage's YieldStar software for rent setting, its financial contributions to defeat California rent control initiatives, and its shift toward resuming evictions after August 2022 to increase 'economic occupancy'.

The Private Equity Stakeholder Project (PESP) supports California AB 3129, arguing that the bill is necessary to protect the financial stability of state health systems from the negative impacts of private equity consolidation. PESP cites examples of private equity-owned entities in California, such as Prospect Medical Holdings and Pipeline Health, as evidence of profiteering and poor patient care. The testimony highlights a broader trend of private equity healthcare buyouts, which peaked in 2021 with 515 deals valued at $151 billion, and argues that such investments often involve looting safety net hospitals and cutting essential services for short-term profit.

The report details the collapse of Steward Health Care, tracing its trajectory from a nonprofit system in Massachusetts to the largest for-profit private hospital operator in the US, and finally to a Chapter 11 bankruptcy filing on May 6, 2024. It argues that the system was 'pillaged' through a combination of leveraged buyouts, sale-leaseback transactions with the real estate investment trust Medical Properties Trust (MPT), and massive dividend payouts to private equity investors and executives. These financial strategies resulted in over $9 billion in liabilities, including $6.6 billion in lease obligations to MPT. The report highlights the human cost of this financial engineering, citing hospital closures, service cuts in obstetrics and behavioral health, and critical patient safety failures, such as the repossession of essential medical equipment. It concludes with policy recommendations to increase financial transparency, limit debt-funded dividends, and restrict sale-leaseback transactions in healthcare to prevent similar failures.

The Private Equity Stakeholder Project (PESP) testifies in support of California AB 3129, arguing that the bill is necessary to increase oversight of private equity and hedge fund acquisitions in the healthcare sector. PESP highlights instances of private equity-owned hospital chains in California, such as Prospect Medical Holdings and Pipeline Health, as examples of how such investments can lead to profiteering and diminished patient care. The document asserts that private equity consolidation in U.S. healthcare reached a peak in 2021 with 515 buyouts valued at $151 billion, often involving tactics like looting safety net hospitals and cutting unprofitable services.

The Private Equity Stakeholder Project argues that BlackRock's acquisition of Global Infrastructure Partners (GIP) would shift the firm from a passive investment manager to an active owner of energy infrastructure, potentially violating the Clayton Antitrust Act. The letter highlights specific conflicts of interest, such as BlackRock's simultaneous ownership of Allete (via GIP) and its major industrial customers, Cleveland Cliffs and US Steel. It further lists extensive holdings in various US public utilities to demonstrate the scale of BlackRock's influence over power market assets and requests federal intervention to protect competition and consumers.

The document outlines the risks associated with private equity's expansion into various U.S. healthcare sectors, detailing financial strategies that prioritize short-term profit over patient safety and recommending stronger regulatory oversight.

The report finds that private equity-owned companies accounted for approximately 21% of all healthcare bankruptcies in 2023, with a further wave expected in 2024. It attributes this trend to the private equity business model's reliance on excessive leverage, dividend recapitalizations, and aggressive growth strategies, which leave companies vulnerable to rising interest rates and labor costs. Case studies of firms like Envision Healthcare and Air Methods highlight how the No Surprises Act further impacted companies reliant on surprise billing. The report warns that these financial failures lead to service closures, layoffs, and threats to publicly-funded healthcare infrastructure.

The Private Equity Stakeholder Project (PESP) warns that private equity's pursuit of outsized returns in the U.S. healthcare sector leads to 'looting' of hospitals through high leverage, sale-leaseback transactions, and debt-funded dividends. The document provides case studies of firms like Cerberus Capital Management (Steward Healthcare), Leonard Green & Partners (Prospect Medical Holdings), Apollo Global Management (Lifepoint Health and ScionHealth), and Pipeline Health to illustrate how these financial tactics result in reduced access to care, staffing shortages, and declining quality of care. PESP calls for increased regulatory oversight of for-profit hospital mergers and protections against extractive financial maneuvers.

The Private Equity Stakeholder Project (PESP) testifies that private equity firms use extractive financial tactics—such as high leverage, sale-leasebacks, and debt-funded dividends—to maximize returns, often resulting in the bankruptcy or closure of hospitals. The document highlights specific cases including Prospect Medical Holdings, Steward Health Care, and Apollo Global Management's Lifepoint/ScionHealth, noting severe impacts on patient safety and staffing. PESP proposes state-level policy solutions including stricter merger reviews, financial transparency, anti-looting measures, and joint and several liability for investors.

The Private Equity Stakeholder Project criticizes the SEC for removing scope 3 emissions requirements from its climate disclosure rule, asserting that this allows publicly-listed private equity firms to significantly underreport their carbon footprints and obscure risks associated with fossil fuel portfolios.

The Private Equity Stakeholder Project warns the Teacher Retirement System of Texas that Blackstone's acquisition of Tricon Residential will exacerbate the housing affordability crisis and harm tenants. The author highlights that Blackstone would own 9,000 single-family rental homes in Texas following the deal and cites a history of poor property management at Invitation Homes and Home Partners of America, including maintenance failures and inflated rents.

The Private Equity Stakeholder Project argues that Blackstone's acquisition of Tricon Residential will exacerbate the housing affordability crisis. Citing a history of rent hikes and poor maintenance at Blackstone-owned entities like Invitation Homes and Home Partners of America, the author calls on LACERA to demand tenant protections to mitigate social and reputational risks.

The report analyzes private equity's involvement in the multibillion-dollar Medicare Advantage sector, noting a peak in deal activity in 2021 followed by a slowdown due to interest rates and tighter regulations. It warns that private equity ownership in healthcare can lead to anticompetitive consolidation, fraud, and cost-cutting that harms patients and workers, and recommends policies such as joint liability for owners and increased regulatory scrutiny of deals.

The report examines the trend of private equity firms consolidating the U.S. veterinary care market, noting that corporate consolidators controlled nearly half of the market share in 2021. It highlights concerns that profit-driven motives lead to increased medication prices, pressure on veterinarians to meet quotas, and downward pressure on staff costs. The document details FTC interventions in large acquisitions, such as those by Mars Inc. and JAB Holdings, and argues that regulators should increase scrutiny of smaller 'roll-up' acquisitions and related industries like pet insurance to prevent anticompetitive outcomes.

The Private Equity Stakeholder Project (PESP) supports the Oregon Treasury's proposed Net Zero plan for the Oregon Public Employees' Retirement Fund (OPERF), which aims for Net Zero by 2050 and a 60% reduction in emissions intensity by 2035. PESP highlights that Real Assets and Private Equity accounted for 46% of OPERF's emissions at the end of 2022 despite representing only 35% of assets. While praising the plan's exclusion of new commitments to fossil fuel focused private funds and its use of science-based metrics, PESP calls for accelerated timelines, clearer guidance for managers, and specific action regarding the Rio Grande LNG terminal project involving Global Infrastructure Partners.

The Private Equity Stakeholder Project asserts that Global Infrastructure Partners (GIP) faces significant risks through its $3.5 billion investment and at least 46% ownership stake in the Rio Grande LNG Terminal. The document highlights financial risks stemming from volatile gas prices, rising costs, and a projected decline in global equity returns if funds fail to align with Paris Agreement goals. Environmentally, it claims the terminal could emit 163 million tons of carbon dioxide equivalent annually and may be more polluting than coal due to methane leakage. Socially, the project is opposed by the Carrizo Comecrudo Tribe of Texas, the city of Port Isabel, and other local councils in South Texas due to impacts on sacred land and local industries.

The report examines how private equity firms capitalize on the growth of Medicare Advantage, particularly through insurance brokerage, marketing, and in-home health assessment companies. It highlights a surge in deal activity peaking in 2021, coinciding with regulatory rollbacks, and details risks such as dividend recapitalizations and False Claims Act violations. The author calls for stricter antitrust enforcement and joint liability for private equity owners to protect the Medicare program.

The authors contend that private equity firms aggressively loot US health care facilities, specifically safety-net and rural hospitals, to extract profits through fees and dividends while reducing quality of care and increasing debt. Using the case of Leonard Green & Partners and Prospect Medical Holdings, the text highlights how firms profit while hospitals suffer cumulative losses. To address this, the authors propose creating joint liability for firms and their portfolio companies, increasing FTC scrutiny of mergers, improving transparency via HHS and CMS, and closing the carried interest tax loophole.

The document outlines various controversies involving CIM Group that have appeared in major media outlets, including tenant mistreatment, gentrification of minority neighborhoods, labor disputes, construction defects, and financial ties to Donald Trump. It highlights how these issues have led to public pressure on pension funds to divest from the firm.

The report alleges that Brookfield Corporation engages in greenwashing by underreporting its carbon footprint and maintaining significant fossil fuel investments, specifically through its ownership of Oaktree Capital, while publicly pledging to reach net-zero emissions.