In a major stomach-churning investigation titled, “Overdoses, bedsores, broken bones: What happened when a private-equity firm sought to care for society’s most vulnerable,” theWashington Post chronicled the horrific practices that preceded the bankruptcy of ManorCare. In 2007, the Carlyle Group, a pirate equity group, bought ManorCare nursing homes for $6.1 billion and $4.8 billion of that was financed with debt.
The argument
There are countless examples of poor customer service after private equity buys companies. Here is one from the healthcare sector. Under the ownership of the Carlyle Group, one of the richest private-equity firms in the world, the ManorCare nursing-home chain struggled financially until it filed for bankruptcy in March. During the five years preceding the bankruptcy, the second-largest nursing-home chain in the United States exposed its roughly 25,000 patients to increasing health risks, according to inspection records analyzed by The Washington Post. The number of health-code violations found at the chain each year rose 26 percent between 2013 and 2017, according to a Post review of 230 of the chain’s retirement homes. Over that period, the yearly number of health-code violations at company nursing homes rose from 1,584 to almost 2,000. The number of citations increased for, among other things, neither preventing nor treating bed sores; medication errors; not providing proper care for people who need special services such as injections, colostomies and prostheses; and not assisting patients with eating and personal hygiene. Here is the educational sector. We have seen the same story in industry after industry where outcomes of care worsen and prices rise. A study of the education industry that examined 88 buyout deals found that not only did tuition costs rise when they were bought by pirate equity groups, but learning outcomes fell as well. Student debt also rose, as did defaults due to the substandard education that was offered. Everyone lost, except for the pirate equity groups, which extracted fees and dividends.
Premises
Counter-arguments
Two vivid failures do not establish an economy-wide pattern. For every distressed buyout there are firms that private equity recapitalised, restructured and grew, and rigorous studies find mixed effects on employment, productivity and quality rather than uniform decline. Selecting the worst cases — a bankrupt nursing-home chain, for-profit colleges — and generalising ignores base rates and survivorship, and the correlation with bankruptcy partly reflects that private equity often buys firms that are already troubled. Anecdotes across two sectors cannot carry a conclusion about private equity's effect on the whole economy.
Rejecting the premises
[Rejecting P2] A recurring anecdote in two sectors is not evidence of a general pattern; broad studies of private equity find mixed, not uniformly negative, outcomes. [Rejecting P1] Worse outcomes at acquired firms may reflect that private equity buys already-distressed companies, not that its ownership causes the decline.
Further reading
When Investor Incentives and Consumer Interests Diverge: Private Equity in Higher Education https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3371413