S. 5112: Health Over Wealth Act

This bill would give the Department of Health and Human Services (HHS) new authority to oversee certain for-profit health care businesses, especially when those businesses are owned by private equity firms, real estate investment trusts (REITs), or similar financial structures.

Ownership disclosure and oversight

The bill would require covered health care owners to provide broad information about who owns and controls them. HHS would also be able to require audits and other reporting aimed at identifying financial practices that could affect patient care, staffing, or the stability of health care facilities.

Risk reduction and enforcement

HHS would be directed to create measures intended to reduce financial or operational risks in these businesses. Depending on what is found, the agency could use licensing-related actions or penalties to address violations. The bill also creates a private equity task force to examine how private equity ownership affects health care.

Limits on certain transactions

The bill would prohibit certain REIT transactions and asset-stripping practices that are considered harmful to health care operations. In general, this appears aimed at preventing owners from taking value out of facilities in ways that could weaken their ability to provide care.

Bankruptcy and health care plan review

The bill would update bankruptcy-related references and require courts to consider whether a proposed plan would affect access to health care in the region before confirming a health care business bankruptcy plan.

Hospital closure and service reduction requirements

If a hospital plans to close or reduce essential services, it would have to give notice, submit a mitigation plan, allow public comment, and provide reports before making the change. These steps are meant to give patients, workers, and communities more advance warning and a chance to respond before major service cuts happen.

Relevant Companies

• CSV — Carriage Services, which has relevant ownership and asset-management characteristics in health care-adjacent real estate and services contexts, though it is not a direct health care operator.
• MPW — Medical Properties Trust, a health care REIT that could be affected by restrictions on certain REIT structures and transactions involving hospitals.
• PEAK — Healthpeak Properties, a health care real estate company that could be indirectly affected by stricter rules on health care ownership and real estate arrangements.
• VTR — Ventas, a large health care REIT that could be impacted by limits on REIT deals and broader scrutiny of financial ownership in health care.
• DOC — Healthcare Realty Trust, a health care-focused REIT that could face more compliance pressure if the bill affects ownership and property-related financing structures.
• KKR — KKR & Co., a major private equity firm that could be affected by increased oversight, audits, and restrictions on private equity ownership of health care businesses.
• BX — Blackstone, which has significant health care real estate and private equity investments and could be affected by tighter rules on ownership and asset-stripping practices.
• CG — The Carlyle Group, a private equity firm that could face more disclosure, enforcement, and transaction limits if it owns or finances health care assets.
• APO — Apollo Global Management, which has health care investment exposure and could be impacted by new oversight of private equity-owned health care businesses.