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"These deals produce harm reliably enough that researchers can now count it."
Investigative journalist Ronan Farrow on Tuesday published a video on social media where he examines how private equity firms have been buying up hospitals throughout the US and saddling them with enormous debt burdens.
At the start of the video, Farrow notes that private equity firms such as The Carlyle Group, Cerberus, and Pinta have acquired hundreds of hospitals and nursing homes over the last 20 years.
"The pitch is generally: Infuse capital, cut inefficiency, and exit in five to seven years," Farrow explains. "And the deals work like this: A private equity firm puts some of its own money and borrows the rest. Typically, it'll borrow more than 70% of the purchase price."
"The twist is that debt doesn't sit on the firm's books," Farrow continues. "It gets placed on the facility itself, so the hospital or nursing home now carries the debt and the interest on it."
Studies now present a striking picture of what happens when private equity firms acquire hospitals and nursing homes: predictable increases in harm and deaths. One landmark study shows: patient deaths up about 11% after such acquisitions. pic.twitter.com/N6yfXJQIwW
— Ronan Farrow (@RonanFarrow) July 7, 2026
Farrow then cites research published by The Review of Financial Studies in 2023, which found healthcare facilities saw their interest payments more than triple after being acquired by private equity firms.
"In many cases," Farrow says, "private equity firms sold the nursing home's building shortly after acquiring it, returning the proceeds to investors, and then charging the facility rent on the building it used to own."
In addition to added debt burdens placed on hospitals and nursing homes, Farrow adds, the 2023 study found that private equity firms also cut staff hours after acquiring facilities, which has hurt patient care.
"The authors... found that private equity ownership can increase patient mortality by up to 11%," he says. "Over the study period, that translated to more than 20,000 lives lost."
Farrow then points to a 2025 study that found salaries of emergency room workers fall by an average of 18% in hospitals acquired by private equity firms, while hospital-acquired infections and complications rose by 25%.
Farrow concedes that not all private-equity deals turn out poorly and that some of the facilities are already in distress before being acquired.
However, he warns that "these deals produce harm reliably enough that researchers can now count it," adding that "so far, the industry has moved faster than the rules."
Research published Monday by the Private Equity Stakeholder Project (PESP) warned that private equity firms have been increasingly relying on nonprofit joint ventures to expand their reach throughout the US healthcare industry and "siphon profits from health systems and critical healthcare infrastructure."
"Private equity's healthcare playbook is evolving,” said Jim Baker, executive director of PESP. “Our research documents how private equity has increasingly relied on joint ventures with nonprofits to expand its presence in healthcare. These arrangements have received far less attention than traditional private equity buyouts, even as they become more common across hospitals and other healthcare sectors."