Private equity harms: 8 documented cases
These eight cases are already graded FACT. Private-equity ownership of nursing homes was associated with about 11 percent higher patient mortality. After 2008, firms turned single-family homes into a corporate asset class. For-profit colleges ran on taxpayer money. A youth-sports roll-up drew congressional scrutiny. Steward Health Care reached bankruptcy after a sale-leaseback. A private-equity-owned ER firm built a business on surprise bills. Carlyle had a nursing-home chain sell its buildings and rent them back. Payless sponsors took dividends funded by the debt that preceded bankruptcy.
By The Black Book Audit editorial · Reviewed
The short list
- For-profit colleges: the diploma was the product — Private equity bought Education Management Corporation in a $3.4 billion deal, and the sector ran overwhelmingly on taxpayer money.
- Single-family rentals: Wall Street as landlord — After 2008, private equity turned single-family homes into a corporate asset class, and RealPage later settled a rent-pricing case without admitting liability.
- ManorCare: sell the buildings, rent them back — Carlyle had HCR ManorCare sell its buildings and rent them back, in a deal covering 338 properties.
- Payless: dividends taken before the fall — Payless sponsors took more than $350 million out through new debt, and creditors later investigated those dividends.
- Nursing homes: about 11 percent higher mortality — Private-equity ownership of a nursing home was associated with about an 11 percent increase in patient mortality.
- Surprise ER bills: the business model — A private-equity-owned firm built a business on surprise-billing emergency patients, and that model did not survive the ban.
- Steward Health Care: the bankruptcy was the plan — Steward sold its hospitals, rented them back, and reached bankruptcy in May 2024 with about $9 billion in liabilities.
- Youth sports: one company, then a congressional look — In 2024, top private-equity investors rolled youth-sports properties into one company, and Congress later opened a look at the costs.
What this list covers
This is not a ranking of every private-equity firm and not a claim that every buyout harms customers. It is eight investigations already published here. A study finding, a settlement without an admission, and a bankruptcy are different records. Ordered by the start of the period each record covers.
The documented items below link to supporting coverage and the records used to check each claim. Leads that still need review appear separately with no evidence grade.
Prepared from the linked records and reporting. The grading method explains the difference between a documented event, an allegation, and a conclusion.
The FACT label applies to the claim printed beside it. It does not establish every theory about an operation or imply that every participant committed a crime.
The records at a glance
Select a case for its sources and limits. The order follows the dates of the programs or records described.
Swipe the table sideways to read each claim →
| Case or record | Date | What is established |
|---|---|---|
| For-profit colleges: the diploma was the product | 2006 EDMC buyout | FACT Private equity bought Education Management Corporation in a $3.4 billion deal, and the sector ran overwhelmingly on taxpayer money. |
| Single-family rentals: Wall Street as landlord | After 2008; RealPage settlement 2025 | FACT After 2008, private equity turned single-family homes into a corporate asset class, and RealPage later settled a rent-pricing case without admitting liability. |
| ManorCare: sell the buildings, rent them back | 2010 sale-leaseback | FACT Carlyle had HCR ManorCare sell its buildings and rent them back, in a deal covering 338 properties. |
| Payless: dividends taken before the fall | Dividends before the 2017 bankruptcy | FACT Payless sponsors took more than $350 million out through new debt, and creditors later investigated those dividends. |
| Nursing homes: about 11 percent higher mortality | 2021 NBER study | FACT Private-equity ownership of a nursing home was associated with about an 11 percent increase in patient mortality. |
| Surprise ER bills: the business model | No Surprises Act, January 1, 2022 | FACT A private-equity-owned firm built a business on surprise-billing emergency patients, and that model did not survive the ban. |
| Steward Health Care: the bankruptcy was the plan | Bankruptcy, May 2024 | FACT Steward sold its hospitals, rented them back, and reached bankruptcy in May 2024 with about $9 billion in liabilities. |
| Youth sports: one company, then a congressional look | 2024 roll-up; scrutiny in 2026 | FACT In 2024, top private-equity investors rolled youth-sports properties into one company, and Congress later opened a look at the costs. |
For-profit colleges: the diploma was the product
Private equity bought Education Management Corporation in a $3.4 billion deal, and the sector ran overwhelmingly on taxpayer money.
The published investigation grades as FACT that for-profit colleges drew the bulk of their funds from federal student aid, Defense Department, and veterans' benefits. Goldman and private-equity owners bought EDMC in 2006. The company later collapsed. The students kept the debt.
This entry is the ownership and the funding source. It is not a finding that every for-profit campus defrauded every student.
Limit of the evidence: Taxpayer funding of a college is legal. The record here is the dependence on that funding under private-equity ownership, not a new fraud verdict.
Read the for-profit college investigation →Single-family rentals: Wall Street as landlord
After 2008, private equity turned single-family homes into a corporate asset class, and RealPage later settled a rent-pricing case without admitting liability.
The published investigation grades the post-2008 corporate-landlord model as FACT. The Justice Department's rent-pricing case against RealPage ended in a proposed settlement filed in November 2025. The company did not admit liability.
A settlement without an admission is not a finding that every corporate landlord fixed rents. It is a record that the government brought the case and the company settled it.
Limit of the evidence: Buying houses after a crash is not, by itself, a crime. The pricing case was settled without an admission.
Read the housing investigation →ManorCare: sell the buildings, rent them back
Carlyle had HCR ManorCare sell its buildings and rent them back, in a deal covering 338 properties.
Reuters reported the roughly $6 billion asset deal. Carlyle kept the operating company. It had bought ManorCare for about $4.9 billion in 2007. The published investigation grades the sale-leaseback as FACT.
The rent then had to be paid out of the nursing-home operations. That is the mechanism. It is not a finding that every resident was harmed by this one transaction.
Limit of the evidence: A sale-leaseback is a legal structure. The record establishes the transaction, not a criminal charge against Carlyle.
Read the ManorCare investigation →Payless: dividends taken before the fall
Payless sponsors took more than $350 million out through new debt, and creditors later investigated those dividends.
The published investigation grades as FACT that more than $350 million was pulled out via new borrowing, and that creditors alleged the borrowings hastened the bankruptcy. CFO.com reported that the dividends were funded by the same secured debt that drove the filing.
An investigation by creditors is not a final judgment that the sponsors committed fraud.
Limit of the evidence: A dividend recap can be legal. The record here is the extraction and the creditor challenge, not a conviction.
Read the dividend-recap investigation →Nursing homes: about 11 percent higher mortality
Private-equity ownership of a nursing home was associated with about an 11 percent increase in patient mortality.
NBER Working Paper 28474 is the record the published investigation grades as FACT. The same research found fewer caregivers and higher fees. A Chicago Booth write-up of the work also reported a large increase in antipsychotic use alongside lower nursing hours.
An association in a study is not a finding that a named home killed a named patient. It is the measured difference across the homes the researchers compared.
Limit of the evidence: The 11 percent figure is the study's estimate, not a count of deaths this site independently recounted.
Read the nursing-home investigation →Surprise ER bills: the business model
A private-equity-owned firm built a business on surprise-billing emergency patients, and that model did not survive the ban.
The Los Angeles Times reported the firm that made billions by surprise-billing ER patients. Congress banned the practice. The No Surprises Act took effect on January 1, 2022. Reporting on Envision described the ban as removing the company's pricing method, and put its obligations around $5.6 billion.
The published investigation grades the business model and the collapse as FACT. A banned billing practice is not, on this page, a criminal conviction of the owners.
Limit of the evidence: Surprise bills were a legal business until the statute. The record is the model and the law that ended it.
Read the surprise-billing investigation →Steward Health Care: the bankruptcy was the plan
Steward sold its hospitals, rented them back, and reached bankruptcy in May 2024 with about $9 billion in liabilities.
The published investigation grades the sale-leaseback and the drain as FACT. OCCRP reported on leaked documents and the cash taken out before the collapse. A Stanford policy note dated the bankruptcy to May 2024 and the liabilities at about $9 billion.
This is one hospital chain, not a finding about every private-equity health deal.
Limit of the evidence: A bankruptcy establishes the collapse and the liabilities. It does not, by itself, assign criminal liability to each owner.
Read the Steward investigation →Youth sports: one company, then a congressional look
In 2024, top private-equity investors rolled youth-sports properties into one company, and Congress later opened a look at the costs.
The published investigation grades the 2024 Unrivaled Sports roll-up as FACT, and grades as FACT that lawmakers are scrutinizing private equity's role as family costs rise. Stateline and Cronkite News reported the state and federal attention in July 2026.
Scrutiny is not a finding that the roll-up broke a law.
Limit of the evidence: A hearing and a roll-up are documented. They are not a verdict.
Read the youth-sports investigation →What we are still reviewing
These are research leads, not graded findings. Adding one requires source review and an editorial decision.
- OPEN · NOT GRADED
Deals not yet graded here
Other private-equity hospital and housing deals appear in the trade press. They stay off this list until the transaction documents are reviewed.
Research starting point ↗
What these records can and cannot tell you
Does this page say private equity is illegal?
No. It lists eight published records: a mortality study, transactions, a settlement without an admission, a statute, and a bankruptcy. Legality and harm are not the same finding.
Is the 11 percent mortality figure a body count?
No. It is the estimate in NBER Working Paper 28474 for the homes in that study. This site did not recount the deaths.
Why these eight and not a longer list?
These are the private-equity investigations already published and graded FACT, with a public URL for the claim printed here.