US Government continues to increase the transparency of nursing home ownership

rhoden on February 13, 2023

US Government continues to increase the transparency of nursing home ownership

Published on: February 13, 2023

Proposed rule would require disclosure of additional ownership and management information to shine a light on private equity ownership Administration seeking to implement Section 6101(a) of the Affordable Care Act
Proposed rule would require disclosure of additional ownership and management information to shine a light on private equity ownership

Administration seeking to implement Section 6101(a) of the Affordable Care Act

As President Biden made clear in his second State of the Union address, the Biden-Harris Administration is unwavering in its commitment to improve the safety and quality of care in the nation’s nursing homes. Over the past year, the U.S. Department of Health and Human Services (HHS) has taken historic actions to deliver on the President’s call to action and ensure seniors and people with disabilities get the reliable, high-quality care they deserve.

Today, in a continued effort to deliver on the President’s commitment, HHS announced additional action to increase the transparency of nursing home ownership and management. The Department issued a proposed rule to require nursing homes to disclose to CMS and states additional ownership and management information. The rule also includes private equity and real estate investment trust definitions, setting the stage for the disclosure of whether nursing home owners are private equity investors or real estate investment trusts. The proposal marks an important step in continuing to implement President Biden’s initiative to improve the quality and care available at nursing homes. By making facility ownership and oversight more transparent, nursing home residents and their families will be more empowered to make informed decisions about care.

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Private equity ownership of nursing homes results in reduced staff, amenities, and poor care …

rhoden on August 25, 2022

Private equity ownership of nursing homes results in reduced staff, amenities, and poor care …

Published on: August 25, 2022

When St. Joseph’s Home for the Aged, a brown-brick nursing home in Richmond, Virginia, was put up for sale, in October 2019, the waiting list for a room was three years long. “People were literally dying to get in there,” Debbie Davidson, the nursing home’s administrator, said. The owners, the Little Sisters of the Poor, were the reason. For a hundred and forty-seven years, the nuns had lived at St. Joseph’s with their residents, embodying a philosophy that defined their service: treat older people as family, in facilities that feel like a home.

St. Joseph’s itself was pristine. The grounds were concealed behind a thicket of tall oaks and flowering magnolias; residents strolled in manicured gardens, past wooden archways and leafy vines. Inside the bright, two-story building, the common areas were graceful and warm—a china cabinet here, an upright piano there. An aviary held chirping brown finches; an aquarium housed shimmering fish. The gift shop, created in 2005, to fund-raise for tsunami relief in the aftermath of the Indian Ocean earthquake, sold residents’ handmade aprons and dish towels. People gathered everywhere: in line for the home’s hair salon, over soup in the dining rooms, against handrails in the hallway, where the floors were polished to a shine. “Take a deep breath,” a resident, Ross Girardi, told me, during a visit in May of 2021. He reclined in a plush armchair. “Deeper! What don’t you smell? A nursing home.”

The home fostered unexpected relationships. Girardi, a former U.S. Army combat medic, first discovered St. Joseph’s as a volunteer, in the early nineteen-eighties; thirty years later, he and his wife, Rae, decided to grow old there. Jennifer Schoening, a floor technician, was unhoused before she started at St. Joseph’s. A social worker from the nursing home had approached her on a street corner in Richmond, where Schoening was panhandling, and told her that the Little Sisters had an opening. She began working in the pantry, serving meals and brewing fresh coffee and found an apartment nearby. Ramon Davila, the home’s maintenance technician at the time, worked in a shop next door to Schoening’s supply room. The two got married on the terrace in front of St. Joseph’s last year. “It got to be that the building wasn’t just my safe spot,” Schoening said. “He was my safe spot.”

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For profit nursing home chain fails to meet staffing standards

rhoden on July 20, 2018

For profit nursing home chain fails to meet staffing standards

Published on: July 20, 2018

Large for-profit nursing home chains in the United States have generally reported low nurse staffing levels. This historical case study examined a class action litigation case regarding staffing levels, resident rights, and quality outcomes in 12 Arkansas nursing homes owned by a large for-profit chain. 

The questions were as follows:

  1. How did the residents’ care needs compare with actual nurse staffing levels?
  2. How did the staffing levels compare with federal and state nurse staffing requirements and professional staffing standards?
  3. Did the facilities comply with state and federal residents’ rights and quality of care requirements?

The findings showed staffing levels marginally above state minimum standards, staffing shortages that violated state standards, staffing levels not adjusted for resident acuity, and shortages that resulted in omitted care. Staffing levels were lower than needed according to nursing directors, lower than average facilities in the state, and lower than professional standards. The findings showed many resident grievances regarding basic care and residents’ rights, clinical measures of poor quality, and state deficiencies. A large settlement was agreed on to compensate the residents. The case shows that chain’s management, as well as the regulatory system, failed to ensure adequate staffing levels that took into account regulatory requirements and professional standards and resulted in violations of residents’ rights, health, safety, and well-being.

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