16857: Private Equity Ownership on U.S. Nursing Homes: Finances, Patients, and Workforce (session 25461)

Financial opportunities have driven a growing trend of private equity firms purchasing nursing homes in the United States. This shift has sparked concerns about its impact on workforce dynamics, costs, and care quality. Drawing on agency theory, this systematic review synthesizes findings from 12 studies examining the effects of private equity ownership on U.S. nursing homes. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The review included English-language, peer-reviewed articles from 2000 to 2024 that examined the effects of private equity ownership on U.S. nursing homes. Financial outcomes were mixed: while short-term profitability was evident, long-term financial strain due to high debt and rising expenses often undermined sustainability. Quality of care showed isolated improvements, such as reduced catheter use, but declined overall, with lower star ratings and more deficiencies. Workforce impacts included fewer registered nurse hours, greater reliance on lower-skilled staff, and higher turnover, affecting care quality and resident outcomes. The findings highlight tensions between the need for resident-centered care and private equity’s profit-driven strategies. Short-term cost-cutting measures frequently jeopardize workforce stability and care quality, threatening long-term financial and operational viability. Policy implications include the need for stricter regulations, transparency in financial practices, and incentives promoting resident-centered care. This review highlights the importance of aligning financial strategies with ethical care obligations. Achieving this balance is essential to protect residents and sustain operations in private equity-owned nursing homes.

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