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CMS Seeks Greater Transparency of Nursing Home Ownership and Management

A rule proposed last week by the Centers for Medicare and Medicaid Services (CMS) would require nursing homes to disclose additional information regarding owners, operators, and management. This marks the continuation of CMS efforts to make information on ownership status of nursing homes publicly available: in April 2022, CMS released data on mergers, acquisitions, consolidations, and changes of ownership from 2016 to 2022 for hospitals and nursing homes enrolled in Medicare. In September 2022, CMS released additional data publicly on the ownership of approximately 15,000 nursing homes.

The proposal would require nursing homes to disclose individuals or entities that provide administrative services or clinical consulting services to the nursing homes. It would also require additional information about entities that lease or sublease property to nursing homes, to help identify related companies even when facilities and property owners may be set up as different corporate entities. In addition to disclosures, the proposed rule would provide definitions of “private equity company” and “real estate investment trust” to assist nursing homes when reporting this data. CMS believes that these key definitions will lead to the disclosure of whether direct and indirect nursing home owners are private equity companies or real estate investment trusts via an updated nursing home enrollment application expected to be ready for public use in the summer of 2023. Several studies have suggested that private equity ownership can exert a negative impact on quality and outcomes.

Although nursing homes must currently report certain ownership and management data to CMS and the states as part of the Medicare and Medicaid enrollment processes, some of the information is not currently required to be disclosed (e.g., persons who merely furnish cash management services to a nursing home that is enrolling in Medicare). CMS holds that this additional data would give CMS and the states a more complete background on the organizations and individuals that own, oversee, and facilitate the operations of nursing homes.

A fact sheet on the proposed rule is available here, the press release is here, and the rule itself can be accessed here. A great summary by LeadingAge National is available here. CMS will accept comments until April 14th.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841