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Shining a light on PE ownership.

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CO

Covenant Care

healthcare
PE-OWNED

Home health and hospice services provider.

PE-OWNED

Acquired by Bain Capital2017-06-30

View PE Firm Profile

What Made It Great

“

Home-based healthcare services with focus on end-of-life care

What PE Will Likely Do

Predictions

Reduction in skilled nursing staff (RNs) and replacement with lower-cost LPNs or nursing aides, leading to lower-quality in-home care and less time spent with each patient

HIGH LIKELIHOODBased on: Bain Capital's track record of cost-cutting and workforce reduction in acquired companies

Aggressive coding and billing practices to maximize reimbursements, potentially leading to upcoding and patients receiving more intensive services than necessary

HIGH LIKELIHOODBased on: Common private equity tactics in the healthcare industry, such as staffing reductions, real estate sale-leasebacks, and billing upcoding

Closure or scaling back of less profitable service lines like psychiatric care, rural home health, or end-of-life/hospice services

HIGH LIKELIHOODBased on: The critical nature of Covenant Care's services, especially end-of-life care, and the potential for harm to vulnerable patients if these services are reduced or eliminated

Sale-leaseback of Covenant Care's owned real estate to extract equity, which could lead to higher rents and reduced investment in facilities and equipment

HIGH LIKELIHOODBased on: The critical nature of Covenant Care's services, especially end-of-life care, and the potential for harm to vulnerable patients if these services are reduced or eliminated

Expected Timeline

Phases
0-6 monthsCompleted

“0 to 6 months months”

Announcements of 'optimization' and 'efficiency' programs, potential leadership changes

6-12 monthsYOU ARE HERE

“6 to 12 months months”

Initial staffing cuts under the guise of 'right-sizing', service line reviews begin

12-24 months

“12 to 24 months months”

Noticeable decline in quality of care as nursing staff is reduced, wait times for in-home visits increase, and essential services start to be scaled back

24-36 months

“24 to 36 months months”

Major issues emerge, such as facility closures, quality of care scandals, and difficulties for patients accessing necessary services

36+ months

“36+ months months”

Potential bankruptcy, fire sale to another operator, or continued decline in quality and access to Covenant Care's services

Similar Cases

Other companies that followed a similar path after PE acquisition

Operating

Steward Health Care

Cerberus Capital Management·2010

See full case study
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Envision Healthcare

KKR·2018

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US Dermatology Partners

Ares Management·2016

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Operating

Hahnemann University Hospital

Cerberus Capital Management·2018

See full case study
Operating

Sound Physicians

Summit Partners·2019

See full case study

What You Can Do

Take Action

Actions

  • Closely monitor any changes in the quality of care, staffing levels, and availability of services at Covenant Care facilities and in-home care

  • Advocate for maintaining essential services, such as end-of-life care, psychiatric care, and rural home health, to ensure vulnerable patients continue to have access

  • Be vigilant about potential billing issues and seek clarification on any changes to the services being provided or covered by insurance

Alternatives

Non-profit health systemsSAFE

Community-focused healthcare

Kaiser PermanenteSAFE

Integrated managed care consortium

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"Covenant Care is now PE-owned. Here's what that means for you."