The Government Wants To Know Who Really Owns Nursing Homes, So It Can Hold The Owners Accountable For Neglect

The federal government has proposed a new rule that would make it mandatory for nursing-home owners to fully disclose their ownership details. The new proposal has received widespread support from Massachusetts Attorney General Andrea Joy Campbell, along with several other attorney generals and advocacy groups. This move has also been welcomed by several Albany, GA nursing home neglect attorneys.

The proposal, which was introduced by the U.S. Centers for Medicare and Medicaid Services or CMS, aims to increase transparency regarding ownership, which would make it easier for regulators to do their jobs amidst the rising cases of substandard care and neglect of nursing home residents. However, the proposal has also received some opposition from within the industry. In addition, some reform groups have also opined that the proposal may not be sufficient for ensuring full transparency.

The CMS had invited public comments regarding the proposed rule. A coalition of attorneys general, co-led by Campbell, recently submitted their comments on the proposal to CMS. The proposed rules were later described as “common sense” that would enable the attorneys general and their Medicaid fraud control units (MFCUs) to “hold bad actors accountable for providing substandard care in nursing facilities.”

The proposal, if passed by the Biden administration, will make it mandatory for nursing homes to disclose all details regarding ownership, as well as information of all the decision-makers. The rule will especially target nursing homes owned by private equity and real estate investment trusts.

Several studies have found a connection between the above ownership models and bad outcomes in nursing homes. According to Campbell’s office, a study on the private-equity ownership model highlighted several issues, including “worsening mobility of residents, declines in nurse availability per resident, and elevated use of antipsychotic medications in nursing facilities.”

These problems became especially visible during the pandemic. According to a study cited by Campbell’s office, the ratio of nursing home residents dying due to the virus and residents dying “prematurely of other causes” was 2:1.

One of the major reasons for neglect and poor care in the nursing home is the lack of staff. Nursing home staff are often underpaid, and following the crisis, the industry has demanded more funds this year to pay better wages to their staff. In the last two years, the state has paid over $300 million to nursing homes to cover operating costs.

The advocates of the new rule have opined that the industry shouldn’t receive any further funds until the nursing homes disclose all details regarding expenditure and ownership.

However, others in the industry aren’t very optimistic regarding whether the CMS rule will be able to accomplish what it intends to. Additionally, many are concerned that the rule targets only two ownership models, which together make up a small percentage of the nursing homes operating within the country. According to a study published in November 2021 by researchers at Weill Cornell Medical College, a mere 5% of nursing homes in the US are under private equity ownership. And real-estate-investment trust-owned nursing homes make up around 12% of the facilities, as per a statement by Mark Parkinson, the president and CEO of the American Health Care Association/National Center for Assisted Living.

Parkinson, who terms the rule’s focus on specific ownership models a red herring, stated that it was a “distraction from the real issues that impact the majority of providers, like Medicaid underfunding and workforce shortages.”

On the other hand, while the American Association for Justice has applauded the CMS proposal, they want the agency to go a step further. They want the rule to include provisions that would force nursing home owners to identify their parent companies, as well as provide full transparency on the entire ownership structure.


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