Newly Released Nursing Home Ownership Data Helps Nurses Avoid Unsafe Working Conditions

• This new data is part of a larger action plan from the Biden-Harris Administration to promote transparency, accountability, safety, and quality of care in skilled nursing facilities.
• The newly released nursing home ownership data provides nurses, families, and residents with additional information on how to choose a nursing home or chain of nursing homes.
• Nursing staff who use this data may be able to avoid unsafe or unethical work environments.

The Biden-Harris Administration released new data detailing the ownership of skilled nursing facilities (SNFs) that receive Medicare funding. The new data supports the goal of providing transparency about who owns nursing homes as explained in President Biden's State of the Union Action Plan for Protecting Seniors.

The data will be available in the ownership details of each nursing home in the Care Compare Tool on medicare.gov. The Care Compare Tool and the new ownership data tell residents, families, and staff about any links between SNF owners and poor quality of care.

A History of Poor Quality of Care

For-profit SNFs typically prioritize profits over quality care. When compared with government-owned and nonprofit SNFs, for-profit SNFs had the lowest average hours spent with each resident each day, according to Health Affairs data from July 2019. Private equity ownership, a type of for-profit ownership, usually costs more and provides poorer care than other types of for-profit ownership.

Private equity-owned nursing homes grew rapidly between 2010-2019. The deals made in those nine years total $750 billion, according to the JAMA Health Forum in November 2021. Private equity-owned nursing homes seek more than 20% in annual returns, often made at the expense of cutting back on staff, services, and supplies, like personal protective equipment.

These cuts directly impact nurses working at these facilities. Private equity-owned nursing homes may have understaffing issues, poor staff-to-patient ratios, poor health ratings, and unsafe working environments. The conviction of nurse Christann Gainey for the death of a patient is evidence of these impacts. Short staffing, high patient-to-nurse ratios, and a lack of administration support are also to blame.

For residents, private equity-owned nursing homes can increase the risk of emergency room visits, hospitalization, and poor quality care.

How Can Nurses Use This Ownership Data?

Residents, nursing staff, and the families of residents can all use this new ownership data to hold nursing homes accountable for patterns of poor and unsafe resident care.

Nursing staff can choose not to work for nursing homes with poor patient outcomes, unsafe work environments, and understaffing. Families can choose not to send their older family members to live in SNFs owned by chains with patterns of poor patient outcomes.

For example, The Alden Network was sued in September 2022 for alleged understaffing that led to injuries and illness. Someone looking into The Alden Network nursing homes will find that though the overall rating of one of their nursing homes might be average or above average, the staffing and hours spent per resident each day tends to be below average or much below average.

Nurses looking for jobs in an SNF can use the data in similar ways to screen their potential employers. Using the Care Compare Tool and the new ownership data, nurses can find out if their potential employers have patterns, such as:

• Creating unsafe work environments
• Asking employees to work with unsafe staff-to-patient ratios
• Understaffing shifts
• Holding poor health and infectious control ratings

This new data provides more information to hold nursing home owners accountable and help staff, families, and residents make informed decisions about where they want to spend their time and resources.