Key Takeaways
- • Two Cornell University ILR School studies find that private equity ownership of New York's homecare industry has worsened low pay, wage theft, managerial negligence and unsustainable scheduling for homecare workers.
- • Per the first study, Public Partnerships LLC, a private equity-owned company, came to hold over 50 percent of homecare services in New York State after taking over the Medicaid-backed CDPAP program from roughly 600 companies, a shift backed by Governor Kathy Hochul in 2025.
- • New York State had 566,160 home health aides and personal care aides in 2023, with median annual earnings of $25,738; 87 percent of homecare workers were women and 81 percent were people of color.
- • Local 1199 SEIU has filed with the National Labor Relations Board for a union election covering over 190,000 CDPAP homecare workers, reporting more than 70,000 signed authorization cards.
- • Private equity acquisitions in the sector accelerated from 2015, with more than $7 billion changing hands in 2021, the year with the most transactions.
Summary
Two studies from researchers at Cornell University's School of Industrial Labor Relations (ILR) conclude that private equity firms rapidly acquiring New York's homecare industry have intensified low pay, poor support and exploitation of homecare workers. The first study, titled Private Equity Pathways into Home Care: The Case of New York State, released in June, found that private equity benefited from weak state-level regulations, a divided and vulnerable workforce, and the 2025 shift, backed by Governor Kathy Hochul, of more than 50 percent of the state's homecare services from 600 companies to a single business, the private equity-owned Public Partnerships LLC.
Funds' acquisitions of homecare companies began rising sharply in 2015 and continued at a steady pace through January of this year, according to the first study. Targets typically are individual for-profit homecare companies valued at hundreds of millions or billions of dollars. In 2021, the year with the most private equity transactions, more than $7 billion changed hands through purchases, sales and debt refinancing. The initial report found that mergers allowed funds to raise profits by cutting administrative positions, making it harder for workers to get support on scheduling problems or for the people they care for.
The second study, released in September, examined the experiences of homecare workers. Workers reported that after private equity acquisitions, automation was introduced and communication, wage theft, managerial negligence and scheduling all deteriorated, often leading to poorer patient care. The study, Private Equity's Impact on Home Care Workers and Patients in New York State, states that private equity owners "took advantage of the worker exploitation that is prevalent across home care." One unnamed worker said employees were not permitted to take days off for funerals or emergencies, such as a sick child, and were written up for doing so. Beyond low pay, many workers face inconsistent schedules, and some are placed in 24-hour shifts for which they are paid only 13 hours. In 2023, New York had 566,160 home health and personal care aides earning median annual wages of $25,738.
Lead study author Zoë West, a senior researcher on worker rights and equity at the ILR School's Worker Institute, told The Chief that homecare is ripe for private equity investment because of low pay, light regulation and low unionization. West said Medicaid funding, which backs homecare, also draws investors, and questioned whether public dollars should generate profits for private firms. The studies' authors expected Medicaid flows to private equity to rise further this year due to Public Partnerships' takeover of CDPAP.
The consolidation has aided organizing efforts. Local 1199 of the Service Employees International Union, which represents employees at some of the 600 prior CDPAP companies, filed with the National Labor Relations Board for an election covering over 190,000 homecare workers, according to the report, which cites the New York Times for reporting more than 70,000 signed authorization cards. Rose Ryan, a spokesperson for Local 1199, said in a statement that workers deserve sustainable wages, meaningful benefits and a voice on the job. The authors argue that unionization is among the few ways workers can counter the worst effects of private equity ownership.
Funds' acquisitions of homecare companies began rising sharply in 2015 and continued at a steady pace through January of this year, according to the first study. Targets typically are individual for-profit homecare companies valued at hundreds of millions or billions of dollars. In 2021, the year with the most private equity transactions, more than $7 billion changed hands through purchases, sales and debt refinancing. The initial report found that mergers allowed funds to raise profits by cutting administrative positions, making it harder for workers to get support on scheduling problems or for the people they care for.
The second study, released in September, examined the experiences of homecare workers. Workers reported that after private equity acquisitions, automation was introduced and communication, wage theft, managerial negligence and scheduling all deteriorated, often leading to poorer patient care. The study, Private Equity's Impact on Home Care Workers and Patients in New York State, states that private equity owners "took advantage of the worker exploitation that is prevalent across home care." One unnamed worker said employees were not permitted to take days off for funerals or emergencies, such as a sick child, and were written up for doing so. Beyond low pay, many workers face inconsistent schedules, and some are placed in 24-hour shifts for which they are paid only 13 hours. In 2023, New York had 566,160 home health and personal care aides earning median annual wages of $25,738.
Lead study author Zoë West, a senior researcher on worker rights and equity at the ILR School's Worker Institute, told The Chief that homecare is ripe for private equity investment because of low pay, light regulation and low unionization. West said Medicaid funding, which backs homecare, also draws investors, and questioned whether public dollars should generate profits for private firms. The studies' authors expected Medicaid flows to private equity to rise further this year due to Public Partnerships' takeover of CDPAP.
The consolidation has aided organizing efforts. Local 1199 of the Service Employees International Union, which represents employees at some of the 600 prior CDPAP companies, filed with the National Labor Relations Board for an election covering over 190,000 homecare workers, according to the report, which cites the New York Times for reporting more than 70,000 signed authorization cards. Rose Ryan, a spokesperson for Local 1199, said in a statement that workers deserve sustainable wages, meaningful benefits and a voice on the job. The authors argue that unionization is among the few ways workers can counter the worst effects of private equity ownership.
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