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New York AG leads 17 others backing HHS rule to expose nursing home ownership and improve resident care

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  • Staff Report 

A coalition of 18 attorneys general, led by New York Attorney General Letitia James, is supporting a proposed rule by the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) that aims to increase transparency in nursing facility ownership. The rule would require nursing homes, particularly those with private equity and real estate investment trust involvement, to disclose information regarding ownership, management, and other operational details.


The attorneys general argue that this transparency is crucial to holding those responsible for substandard care in nursing facilities accountable. Their Medicaid Fraud Control Units (MFCUs) are tasked with investigating and prosecuting cases of abuse, neglect, and misappropriation of funds in these facilities.

The COVID-19 pandemic has highlighted the ongoing issue of substandard care in nursing facilities, with more than 200,000 residents and staff dying from the virus. The coalition contends that these tragedies often result from understaffing, leading to failures in providing basic support such as hygiene, wound care, feeding, and hydration.

A recent study found that for-profit nursing facilities, especially those owned by private equity firms, tend to provide lower quality care compared to non-profit facilities. The study discovered a 10% increase in short-term mortality, declining nurse availability per resident, and higher use of antipsychotic medications in private equity-owned nursing homes.

The attorneys general’s letter emphasizes that corporate owners and operators often structure acquisitions to avoid disclosing their involvement in nursing facility operations. This lack of transparency hinders law enforcement efforts to identify the true decision makers who may be responsible for substandard care.