According to Prequin, in 1980, there were 24 private equity firms that tracked alternative assets; By 2022, about 5,000 private equity firms were controlling about 18,000 companies. Among the industries where private equity had become deeply entrenched was health care. Defenders of private equity, such as Healthcare Private Equity Association, says its members are “building strong companies to have a positive impact on health care,” but its critics say there’s an irreconcilable conflict between making profits for investors and doing what’s best for patients. Is. The nursing home industry is one of the most striking examples, he says.
Nursing homes cannot easily absorb the debt of a private-equity deal. This model relies on borrowing money to buy a company and then placing the debt on the acquired company’s balance sheet. In the case of nursing homes, companies often sell the underlying assets to real estate investment trusts – nursing homes are forced to pay rent for the facilities they already owned, while the cash received from the sale goes to investors. She goes. Sabrina T. Howell, a New York University economist who studies private equity, says nursing homes don’t have the ability to expand like a typical company because they get between 70 and 90 percent of their revenue from the federal government.
Low margins have forced many nursing homes to reduce their nursing staff.,When the pandemic came they were not prepared. Ms. Howell was a Co-author of a study concluded in 2019 that private-equity ownership could increase nursing home mortality rates by 11 percent. A New Jersey analysis found that private equity-owned facilities had higher rates of COVID-19 deaths and cases than private equity-owned nursing homes. In New Hampshire, a fifth of all Covid deaths by the end of 2020 occurred at three nursing homes owned by Genesis Healthcare, which was then controlled by Formation Capital, a private-equity firm focused on nursing homes.
Most economists who study this problem say that the incentives are misplaced. Less than 20 percent of all nursing homes meet recently proposed minimum staffing levels, according to one Kaiser Family Foundation Estimate, and Mark Parkinson, chief executive of the American Health Care Association, which represents 14,000 nursing homes. described that proposal As “baseless, unfounded and unrealistic”.
“Nursing homes are producing a good that we think is an important social function, which is why the government is essentially paying for it,” Ms Howell said. “And the strategies that lead to maximum profits are not strategies that are in the best interests of taxpayers or customers.”