Private equity’s expanding role in nursing homes and other healthcare settings is raising alarms from coast to coast, with state lawmakers introducing legislation in an effort to reduce its control over the sector, according to a new report and legislative tracker from the Private Equity Stakeholder Project.
“PESP’s analysis shows that 2025 marked a turning point in the state-level policy landscape,” the organization said.
“From Massachusetts to Oregon, states are moving to close the gaps that have allowed private equity to reshape healthcare with little scrutiny,” PESP Senior Policy Researcher Michael Fenne said in a statement. “Lawmakers are beginning to connect opaque ownership structures and profit extraction to real-world impacts on patients, workers, and their communities.”
According to PESP’s latest analysis, half a dozen states — California, Indiana, Massachusetts, New Mexico, Maine and Oregon — enacted laws this year to increase ownership transparency and prohibit risky financial maneuvers. Illinois and Pennsylvania advanced bills granting their attorneys general new powers to review and block private equity-backed healthcare deals deemed contrary to the public interest.
State proposals have failed in Colorado and Connecticut, but bipartisan debates continue on the topic.
“States are developing the oversight frameworks needed to bring accountability, transparency, and continuous access to the healthcare system,” Fenne said
According to PESP, state bills addressing private equity in healthcare mostly address transparency and reporting, approval and enforcement authority, targeted prohibitions against specific financial practices linked to properties in financial distress and strengthening prohibitions against non-clinicians controlling medical decision-making through management service organizations.
“Together, these reforms reflect a growing state-level movement to increase accountability in healthcare finance and ensure that business practices align with patient and community needs,” PESP said.
Kathleen Steele Gaivin. (2025, November 20). States reach a ‘turning point’ on private equity in nursing homes, healthcare.
https://www.mcknights.com/news/private-equity/
