Who Owns the Nursing Home? Follow the Money.
Private equity firms own more than 1,500 U.S. nursing homes. The research on what happens after they take over is consistent across a decade of peer-reviewed studies: staffing drops, care quality declines, and people die at higher rates. No study has found that PE ownership improves care.
How the Money Moves
Leveraged buyouts: PE firms buy nursing homes using borrowed money, then load the debt onto the facility itself. The nursing home pays back the debt from its operating revenue, money that would otherwise go toward staffing and care.
Related-party transactions: A PE firm buys a nursing home, then creates a separate company that owns the building. The nursing home pays rent to the real estate company owned by the same investors. Money flows out through multiple channels, all going to the same pockets.
Short hold periods: The typical PE investment cycle is three to five years. The goal is to maximize returns within that window, then sell. Long-term care quality is a long-term concern. PE operates on short-term math.
Genesis HealthCare: The Current Crisis
Genesis filed for bankruptcy in July 2025 after years of private equity ownership and wealth extraction, despite receiving $665 million in COVID relief funding. More than 200 lawsuits alleging malpractice, wrongful death, and other injuries have been frozen during bankruptcy. Between 2011 and 2025, Genesis was charged with $14 million in nursing home violations.
The Trump administration indefinitely suspended the off-cycle Medicare revalidation process for nursing homes. This was the tool designed to force facilities to disclose their true owners. That disclosure requirement is now gone. The ownership is hidden. The profits flow out. The staffing drops. The residents pay the price.
ProPublica Nursing Home Inspect: projects.propublica.org/nursing-homes
NursingHome411: nursinghome411.org
Eldercare Locator: 1-800-677-1116
Sources:
NBER: How Patients Fare When Private Equity Funds Acquire Nursing Homes
Chicago Booth Review: When PE Takes Over, Mortality Rates Jump
U.S. Right to Know: When Profit Kills (Feb 2026)
U.S. Right to Know: PE in Health Care Puts Patients’ Lives in Danger (Dec 2025)
Center for American Progress: 5 Consequences of PE Expansion (Oct 2025)
Americans for Financial Reform: Stop PE Nursing Home Profit Extraction
Truthout: Genesis HealthCare Bankruptcy (Dec 2025)
AHCJ: Private Equity and the Money Behind Nursing Homes (Feb 2026)
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