John O'Connor, editorial director, McKnight's Long-Term Care News

It was nearly four and a half years ago that The New York Times caused quite a stir in this sector. That’s when the self-proclaimed newspaper of record ran a largely unflattering piece about private equity firms that own nursing homes. 

How these firms operate became a controversial issue inside and outside the field for several months, before eventually fading. And it’s beginning to look like private equity may be revived as a hot topic, thanks to Mitt Romney.

For those of you just arriving from another planet, Romney is the prohibitive Republican favorite in the Oval Office race. But despite his frontrunner status, he is taking a pounding for his private equity bona fides. Much of his wealth — which has been estimated to be in the neighborhood of around $270 million — was generated during his tenure at private equity firm Bain Capital.

Private equity may not grow crops, raise children or promote world peace. But when it works, private equity makes the economy run more efficiently. It also tends to handsomely reward investors. How handsomely? Consider that Carlyle Group’s three founders made $413 million in 2011. Not a bad year at the office.

However, critics remain less enamored with the concept. Their complaint is that many of the resulting efficiencies and profits constitute little more than a pink-slip harvest. Having a reputation as a job killer can have a distinct downside. That’s especially the case during an election year in which job growth has become, well, Job One.

According to the General Accounting Office, private equity firms acquired 1,876 nursing facilities between 1998 and 2008. And you can bet that businesses such as the Carlyle Group, Warburg Pincus, Formation, National Senior Care, Fillmore Capital Partners and others will be closely watching how this presidential campaign plays out as they ponder their next moves.

Under their breath, they may also be cursing Romney’s presence. For unlike the former governor of Massachusetts, these firms might have more to lose than a mere election. One possible casualty could be their special tax breaks — including carried interest  –—which allow them to treat profits like capital gains.

At this point, it’s too early to predict how things will play out. But it is safe to say this: One way or another, Mitt Romney will make this a memorable presidential election.