While all of healthcare suffered during the Covid-19 pandemic, nursing homes were hit particularly hard. At the start of the pandemic, nearly half of all Covid deaths were people living or working in long-term care facilities, according to data from KFF. By early 2022, more than 200,000 people had died from the virus, making up roughly 23% of all Covid-related deaths in the US, KFF found. Part of this can be attributed to the fact that nursing home residents tend to be at higher risk for contracting viruses due to their age, and living close together means it’s easier for illness to spread. But some of the blame may lie in the fact that nursing homes are chronically short-staffed and run on extremely thin margins—often 3% or less in 2020, according to a survey from the American Health Care Association and National Center for Assisted Living (AHCA/NCAL), a trade group that represents long-term care facilities. And the fact that private equity (PE) firms are increasingly buying up nursing homes is making those troubles worse, some experts argue. PE firms own somewhere between 5% to 13% of nursing homes in the US as of 2025, though a lack of transparency into ownership structures makes it virtually impossible to know the exact number, according to an April 2025 report from the nonprofit Private Equity Stakeholder Project (PESP). PE-owned facilities tend to see a drop in care quality.—MA | 
