CARD was founded in 1990 by
Doreen Granpeesheh, a former graduate student of
Ole Ivar Løvaas, the UCLA psychology professor who popularized the use of ABA on autistic children.
Acquisition by Blackstone (2018–2019) In May 2018, the
Blackstone Group acquired CARD in a leveraged buyout valued at approximately US$600–700 million, one of the largest transactions in the behavioral-health sector. Granpeesheh stepped down as CEO in 2019 but remained on the company’s board. Blackstone planned to scale CARD to over 500 clinics using data analytics and centralized management. Former staff later reported that after the acquisition, corporate leadership reduced centralized clinical training and replaced experienced clinicians with managers from outside behavioral health, leading to concerns about quality of care and high employee turnover.
Ethical and clinical concerns The
COVID-19 pandemic disrupted in-person services, and CARD’s telehealth expansion proved unsustainable. Critics and former staff alleged that under private equity ownership, clinical practices were increasingly standardized and profit-driven, reducing individualized care. CARD’s practices under private equity ownership were criticized for: • Inflating treatment hours to maximize billing. • Reducing supervision ratios (1 BCBA per 25–30 clients). • Prioritizing preschool-age clients with higher insurance reimbursement. These trends reflected a broader pattern of “financialization of care” identified by a CEPR report In June 2023, CARD filed for
Chapter 11 bankruptcy protection, reporting US$82 million in losses and US$245 million in debt. The CEPR report concluded that Blackstone’s debt-loading and overexpansion turned CARD from a sustainable clinic network into “a cautionary example of financialized health care.” == Legacy ==