North Carolina
Very High Risk
Private Equity Risk Score
86/100- North Carolina is among the top 10 states for the share of hospitals controlled by private equity.
- North Carolina is among the 10 states with the highest average rate of readmission after discharge at private equity-controlled acute care hospitals compared to the average for all hospitals in the state.
- North Carolina is among the top 10 states for the number of layoffs at private equity-controlled companies as a share of the state’s total private sector workforce.
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Risk score from 0 to 100, Higher score = Greater risk.
Private Equity Risks
Workers and Jobs
Risk Score: 43/100
- Share of private sector workforce at private equity-controlled companies (Average 2018-2022) 8.8% 375,000 jobs
- Change in the share of workforce controlled by private equity from 2018 to 2022 24.3%
- Layoffs at private equity-controlled companies (2015-2022) 4,604
- Employee deaths and hospitalizations at private equity-controlled companies (2018-2022) 31
Health Care
Risk Score: 79/100
- Share of hospitals that are private equity-controlled 13.3%
- Average Medicare patient survey rating of private equity-controlled acute care hospitals (1 = lowest, 5 = highest) 2.9
- Rate of readmission after discharge from private equity-controlled acute care hospitals 14.6%
- Share of nursing homes that are private equity-controlled 16.2%
- Average Medicare quality rating of private equity-controlled nursing homes (1 = lowest, 5 = highest) 2.0
- Substantiated complaints per private equity-controlled nursing home (2019-2022) 18.2
- Share of population in a metro area where single private equity firm controls over 30% market share of one or more physician specialties 19.7%
Housing
Risk Score: 82/100
- Percentage of homes purchased by medium, large and mega investors (2018-2022) 9.9%
- Change in share of homes purchased by medium, large and mega investors from 2018 to 2022 90.5%
Public Pensions
Risk Score: 68/100
- Share of state pension assets invested in private equity 6.4%
- Share of state pension assets covered by private equity fee disclosure (including carried interest) 0.0%
- Share of state pension assets covered by responsible contractor policy 0.0%
Policy Solutions to Address Private Equity Risks
Workers and Jobs Adopted?
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Severance for mass layoffs: For mass layoffs, require 90 days advance notice and require employers to pay one week of severance pay for each year of employment
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Bonding for unemployment insurance: Require private equity-controlled companies with high debt ratios to post a bond to the unemployment insurance system to cover unemployment insurance taxes in the event of a bankruptcy
Health Care Adopted?
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Review of health care mergers: Require notice, public review or approval process for hospital and other health care mergers
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Medical debt collection: Regulate medical debt collection
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Nursing home staffing: Require specific percentage of Medicaid or overall revenues in nursing homes to be spent on staffing costs for patient care
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Hospital fees: Limit hospital facilities fees
Housing Adopted?
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Good cause evictions: Prohibit evictions of tenants for reasons other than specified causes, such as non-payment of rent
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Rental cost caps: Cap annual rent increases statewide at inflation plus a small percentage or allow local jurisdictions to cap rent increases
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Tenants' right to purchase: Give tenants of mobile home parks and multi-family housing advance notice of sales and first right of refusal to purchase
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Landlord registry: Create a mandatory registry to identify beneficial ownership of all corporate landlords with multiple holdings
Public Pensions Adopted?
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Fee disclosure: Require disclosure of all fees paid to each private equity fund by state pension funds
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Compliance with all state laws: Require signed affirmation from private equity fund managers that all of their portfolio companies comply with state labor laws, environmental laws and health codes