Alfredo Sanchez learned plenty in nursing school, but nothing prepared him for his first job in the trauma intensive care unit at Crozer-Chester Medical Center in Delaware County, Pennsylvania.

The EKG machine, for instance, was fickle; it had a frayed cord that had to be held just so. Then the machine finally died, and Sanchez had to get other over-stretched nurses to cover his critically ill patients while he raced around the hospital, looking for an EKG that worked. When he ran out of canisters for bodily fluids, he had to scavenge for them elsewhere in the hospital. At one point, his unit ran out of the suction tubes used to keep intubated patients’ airways clear. The water machine was laden with bacteria, and all the nurses knew not to use it. The staff continually raised these problems to management, to no avail.

Sanchez, 42, who worked at Crozer-Chester in 2024 after serving in the Army for 20 years, was a paramedic before he became a nurse. In the ICU he took care of people with gunshot wounds, people who had been in life-threatening car accidents, people who had just had major surgery. But as staffing and supply budgets were cut to the bone, he feared for his patients’ survival.

On one shift, a patient who had been shot in the head had to share their nurse with two other critical patients. Another day, a patient needed a common medication to prevent an impending stroke. But when Sanchez went to the dispensing system, that medication was missing. He hustled to another floor—they were out, too.

“You start to panic,” Sanchez said. He finally found the medication on a third floor. When he asked the hospital’s pharmacy what was behind the shortages, he discovered that the department had been cut so much that one person was doing the job previously done by three people.

“The majority of our patients were not wealthy. Many of them were minorities,” Sanchez said. “The injustice of it. It feels like a war zone. The public doesn’t know what’s behind the curtain. It’s a hospital. You wouldn’t know that the EKG machine is broken, that they’re missing supplies or that they are going to really struggle to have the right staffing for you.”

Of all the things he learned on the fly, Sanchez said, the most important was this: “When I took the job, I had no idea what private equity was.”

From 2010 until 2021, Crozer-Chester Medical Center was owned by Prospect Medical Holdings, a company which was in turn majority-owned by Leonard Green & Partners, a private equity firm. Experts say that the ownership group extracted hundreds of millions of dollars from Prospect Medical, which owned not only Crozer-Chester but multiple safety-net hospitals in five states. Leonard Green and Prospect Medical did this by loading the hospitals up with debt.

When Leonard Green exited Prospect Medical in 2021, the Rhode Island attorney general investigated and found that the ownership group “realized hundreds of millions of dollars and would leave behind a system that is highly leveraged, that is, where liabilities greatly exceed assets.” Prospect Medical continued to own Crozer-Chester until the company closed that hospital and others amid the company’s bankruptcy in 2025, leaving residents with nowhere to go for care.

What Sanchez experienced was Crozer-Chester’s death throes. What he saw shocked him deeply, but it was not unusual: a hospital filled with clinicians doing everything they can to keep vulnerable patients safe while being starved of resources, as investors walk away with the money. This, experts say, often happens during or in the aftermath of private equity ownership.

A spokesperson for Leonard Green disputed this characterization and said that at the time of their exit, “Prospect was in strong financial condition with access to over $500 million of liquidity available to continue to fund operations, invest in improving hospitals, and provide quality care to its patients, and was at no risk of financial failure.” Prospect Medical Holdings did not respond to a request for comment.

For roughly the past 20 years, private equity firms have been on a buying spree of health care businesses, like hospitals, surgical centers, physician practices, nursing homes, rehabilitation facilities and hospices. According to the nonprofit Private Equity Stakeholder Project, which uses Centers for Medicare........

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