Capital Without Conscience

PE-owned nursing homes show 10–11% higher mortality. After acquisition, frontline care hours fall 3%, antipsychotic use rises 50%, and interest payments rise 325%. The 2024 staffing mandate projected to save 13,000 lives a year was repealed in late 2025.

488 PE-owned hospitals. Surgical mortality runs 17% higher at PE-acquired facilities; ED mortality runs 13% higher alongside an 18% cut in ED salary spend. Steward and Prospect together extracted well over a billion dollars before filing.

Institutional landlords own 25% of Atlanta's single-family rentals. RealPage algorithmic pricing settled with DOJ in November 2025 — no penalty, no admission. PE-owned mobile-home parks have raised lot rents 45% in a decade, with residents who cannot meaningfully relocate.

U.S. cropland averages $5,830 per acre and rising. The country dropped below 2 million farms for the first time since before the Civil War. Roughly 300 million acres are expected to change hands in the next two decades, at prices that have closed the next generation of farmers out.

PE-backed DSOs run 25% of U.S. dental practices, with documented incentives to extract healthy teeth. Vet prices have doubled inflation. 213 counties now have zero local news source. Investor-owned water utilities charge 59% more than public ones. The pattern repeats.

The Stanford Law Review summary, 2024: across every healthcare sector studied, private-equity acquisition has not produced the efficiency or quality gains its advocates promised. The empirical record is now too long to dismiss as anecdote.

Ownership runs through chains of LLCs designed to make accountability impossible. Patients, tenants, and farmers cannot identify who is making the decisions that govern their lives — and that is part of the design, not a bug in it.

The 21st Century ROAD to Housing Act passed the Senate 89–10 in early 2026. State attorneys general, healthcare regulators, and antitrust enforcers are converging on PE practices that were considered untouchable five years ago.

Bankruptcies at Steward and Prospect, mortality data at nursing homes, vacancies in mobile-home parks — the timelines on which capital extracts are far shorter than the timelines on which institutions, towns, and families recover.