Overview
- The quasi-experimental analysis compared 87 hospitals that entered REIT sale‑leasebacks from 2005 to 2019 with 337 matched hospitals using Medicare, financial, staffing and patient‑experience data.
- By the end of 2024, about 25% of REIT‑acquired hospitals had closed or filed for bankruptcy versus 4% of controls, reflecting an adjusted hazard of roughly 5.7.
- Fixed assets fell substantially after sale‑leasebacks, with total fixed assets down about 31% and building-specific assets down about 41% relative to non‑REIT hospitals.
- Short‑term clinical quality showed no significant changes, including 30‑day mortality and readmissions for heart attack, heart failure and pneumonia, or patient satisfaction.
- The authors urged federal and state authorities to bolster transparency and scrutiny of sale‑leaseback terms and how transaction proceeds are allocated.