Private equity have purchased nursing homes, sold their assets like their facilities, then leased these facilities from who they sold them to, they pocket the cash from the sale, buy more properties, then use market power to drive down expenses, then use the profits to get the nursing homes to take a loan and pocket that cash, the nursing home is strained by all these burdens, but who cares when private equity already made money. Such activity may have caused 20,000 premature deaths over 12 years as service quality is cut.