Association of Private Equity Investment in US Nursing Homes With the Quality and Cost of Care for Long-Stay Residents

Abstract

Key Points Question Is private equity acquisition of nursing homes associated with the quality or cost of care for long-stay nursing home residents? Findings In this cohort study with difference-in-differences analysis of 9864 US nursing homes, including 9632 residents in 302 nursing homes acquired by private equity firms and 249 771 residents in 9562 other for-profit nursing homes without private equity ownership, private equity acquisition of nursing homes was associated with higher costs and increases in emergency department visits and hospitalizations for ambulatory sensitive conditions. Meaning This study suggests that more stringent oversight and reporting on private equity ownership of nursing homes may be warranted.

Understanding the “state of play” of long‐term care provision in low‐ and middle‐income countries

“…This model is widely used in Singapore and is increasingly visible in China. With the “bricks and mortar” of these facilities under firm control of government ownership, this model has one distinct advantage of forestalling real estate speculation for profiteering which is a longstanding concern in countries, such as the United States, where private equity firms are actively involved in LTC facility ownership (Braun et al, 2021).…”

Private equity in ophthalmology: taking the long view

“…Placing the evidence about private equity's effects within this context suggests profit-driving consistent with what has been observed with other consolidated entities. A robust body of work – across different sectors of healthcare – suggests that private equity ownership is associated with higher spending and utilization of care [17 ▪▪ ,18,19 ▪ ,20 ▪▪ ]; changes in payer mix towards commercially insured populations; and reductions in staffing [21 ▪ ,22], without definitive improvement – and often with reductions – in the quality of care provided [20 ▪▪ ,23]. An analysis of private equity acquired dermatology practices found 5–17% increases in commercially insured patient volume per dermatologist, and 3–5% increases in prices for routine medical visits, without statistically significant changes in spending or utilization of specific procedures [18].…”

Private equity and its effect on patients: a window into the future

“…1) PE nursing homes have worse quality metrics, [ 7 ] staffing ratios [ 8 ] and higher mortality rates despite higher Medicare reimbursements. [ 9 , 33 ]…”