Whether a nursing facility provides good care to its residents depends on who owns and manages the facility. Citing research finding that private equity ownership of nursing homes was correlated with a 10% increase in mortality rates for nursing home residents – 20,150 lives lost over a twelve-year period [Atul Gupta, et al, “Does Private Equity Investment in Healthcare Benefit Patients? Evidence from Nursing Homes,” (Feb. 2021)] – among other research documenting the devastating effects of private equity, real estate investment trusts, and certain other private owners on residents, the prior Administration published final rules on November 17, 2023, 88 Fed. Reg. 80141, 80144, that strengthened federal requirements related to disclosure of nursing homes’ ownership, management, and related parties. The final rules implemented §6101 of the Affordable Care Act, which was enacted in 2010.
To implement these new resident protections, the Centers for Medicare & Medicaid Services (CMS) required all skilled nursing facilities (SNFs) to complete an off-cycle revalidation process about ownership between October and December 2024, using revised Form CMS-855A. The deadline for SNFs to report the information has been delayed twice, first, to May 1, 2025 (as announced in MLNConnects, 2024-11-14-MLNC) and now, to August 1, 2025 (as announced in MLNConnects, 2025-04-17-MLNC). As of mid-April, 2025, nursing home associations told McKnight’s Long-Term Care News that only about 20% of nursing facilities had completed the revalidation process.
The nursing home industry has opposed the requirements for off-cycle revalidation since they were first announced. McKnight’s Long-Term Care News reported on November 11, 2024, “After being besieged by concerned skilled nursing providers and their national advocacy groups, the Centers for Medicare & Medicaid Services last week quietly extended a quick-turnaround deadline it had imposed for every US nursing home to revalidate its ownership information.” Kimberly Marselas, “CMS gives nursing homes months more to complete onerous revalidation process,” McKnight’s Long-Term Care News (Nov 11, 2024). Skilled Nursing News reported that nursing homes continued to complain about the revalidation process, even after the deadline for submitting information was delayed to May 1, 2025. Amy Stulick, “Even With Extension, Nursing Homes Concerned CMS Medicare Revalidation Will Be Burdensome, Confusing, Pull Resources Away from the Bedside,” Skilled Nursing News (Nov. 11, 2024).
The nursing home industry does not want the public to know who owns the facilities.