Charles Grassley’s Push for Transparency

“CMS’ thirteen-year delay is slow even by bureaucratic standards and especially egregious given that the number of nursing homes owned by private equity has significantly increased since then”

-US Sen. Charles Grassley wrote (R-IA).

Recently Grassley sent a letter asking CMS to finalize CMS’ “overdue proposed rule that…failed to finalize and implement.” New rules will require transparency at nursing homes. Grassley first noted this issue in 2007 after “high numbers of serious health and safety deficiencies in nursing homes” operated by private equity firms.

The latest CMS recommendation was “generally consistent” with previous recommendations. The agency should collect and report data on nursing facility ownership and related entities to enable better accountability. Most nursing facilities (72%) are now for-profit. By 2020, private equity firms own and operate at least 5% of all nursing facilities. In 2021, REITs held investments in 1,806 nursing facilities.

“Many of the new owners have also put Byzantine corporate structures in place, apparently in an effort to derail those who might pursue legal retribution, or government agencies seeking accountability.”

-McKnights Long-Term Care News reported

Grassley was instrumental in pushing through federal legislation that required facilities to disclose all people and entities with control, offering administrative services, or holding property leases. SNFs need to detail their organizational structures and describe the relationships.

SNFs frequently use related entities to divert funds and provide innocuous support. Transparency is needed so families know “which different companies or firms provide care to their loved ones and how they might be connected to the owners of a nursing home.”