BOSTON (WWLP) – Attorneys General in 18 states are asking federal regulators to support a rule requiring more transparency in the ownership of long-term nursing facilities.

Massachusetts Attorney General Andrea Campbell and New York Attorney General Letitia James and the Inspector General of Washington D.C are co-leading the coalition recommending that the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) require the disclosure of certain ownership, managerial, and other information regarding nursing facilities, particularly from private equity investors and real estate investment trusts.

State Attorneys General oversee consumer protection laws that guarantee the safety and well-being of residents of nursing facilities, including investigating and prosecuting those responsible for committing abuse or neglect of residents, and misappropriation of residents’ funds in these facilities.

“When actors in the nursing home industry put profits first at the expense of people’s health and well-being, the public deserves to know who they are,” said AG Campbell. “I’m proud to join my colleagues from across the country in support of these common-sense rules to improve transparency and accountability.”

Issues that have surrounded nursing home care came to the public’s attention as a result of the COVID-19 pandemic. According to AG Campbell’s office, nationwide, over 200,000 nursing facility residents and staff died due to COVID-19 since the start of the pandemic, accounting for at least 23% of all COVID-19 deaths in the United States. The numbers show that for every two victims of COVID-19 in nursing facilities, there was another resident who died prematurely of other causes. The coalition believes that these results are due to chronic understaffing that results in the failure to provide basic support to residents, including hygiene, wound care, feeding, and hydration.

The coalition sent a letter last week to HHS and CMS highlighting that the quality of care delivered by nursing facilities operated on a for-profit basis, particularly when those for-profit owners and/or operators include private equity investors, is often worse than at non-profit nursing facilities. 

They also expressed concern that corporate owners and operators, especially private equity investors and real estate investment trusts, continue to structure acquisitions of nursing facilities to avoid disclosing to CMS the extent of their ownership or involvement in the facilities’ operations.  This lack of transparency hampers and delays law enforcement efforts from identifying the true decision makers at nursing facilities who may be responsible for the root causes of substandard care.

Campbell pointed out that in 2021 the AG’s office settled with a private equity firm that had billed for mental health care services provided to patients by unlicensed, unqualified, and improperly supervised staff members at clinics across the state.

The other Attorneys General who signed the letter are from Arizona, California, Delaware, Hawaii, Maine, Maryland, Michigan, Minnesota, New Hampshire, New Jersey, New Mexico, Oregon, Pennsylvania, Rhode Island, Vermont, and Washington.