HHS expands ownership data set for 15,000 Medicare-certified nursing homes

The Biden administration’s promise to bring more scrutiny on the nursing home industry took another step forward Monday with the release of a new database of facility ownership, the Department of Health and Human Services (HHS) announced.  

The new resource covers roughly 15,000 Medicare-certified nursing homes and builds on a previous data release by showing which nursing homes are under common ownership. This allows researchers, regulators, law enforcement and others to better identify whether certain owners are linked to poor care quality or other impacts on residents, HHS wrote in its announcement.

The updated data set also characterizes each owner, “such as whether it’s a holding company or a consulting firm,” HHS wrote.

The department said it plans to update the information monthly.

“President Biden has made clear that we must improve the quality of care in our nation’s nursing homes—and we are taking unprecedented steps to deliver on his call to action,” HHS Secretary Xavier Becerra said in a statement. “Every family deserves the peace of mind of knowing their loved ones living in nursing homes are receiving the best possible care. We are continuing to make more data publicly available than ever before to improve transparency for researchers, regulators and loved ones.”

President Joe Biden painted a target on the nursing home industry during this year’s State of the Union address, when he highlighted recent trends of private equity ownership and worsening quality of care.

A policy fact sheet released shortly afterward by the White House listed minimum staffing requirements, stronger performance incentives, additional facility inspection funding and greater transparency among several planned reforms for the sector.

The administration also cited reports from the Government Accountability Office and others pointing to widespread infection prevention and control deficiency, hundreds of thousands of pandemic deaths and ballooning investments into the sector.

“Despite the tens of billions of federal taxpayer dollars flowing to nursing homes each year, too many continue to provide poor, sub-standard care that leads to avoidable resident harm,” the administration wrote in its Feb. 28 fact sheet.

The American Health Care Association and the National Center for Assisted Living (AHCA/NCAL), which represents more than 10,000 nursing homes, pushed back on the administration’s claims at the time by attributing pandemic deaths to “a series of horrible public health policy decisions” and widespread staffing shortages. Its rebuttal did not, however, address the subject of private equity ownership.

Monday’s release comes five months after the administration published two data sets on Medicare-enrolled hospitals and skilled nursing facilities’ mergers, acquisitions, consolidations and changes of ownership from 2016 to 2022, a move the administration said would help promote competition and protect patients from increasing healthcare costs.

In response to a request for comment, a representative of the AHCA/NCAL referred to a statement from the April release supporting actions to increase financial transparency in the industry. 

"As we seek to better understand the potential impact of nursing home ownership trends, we must also consider how the chronic underfunding of long term care interplays with the financial decisions nursing home providers may feel pressured to make," the AHCA/NCAL said at the time. "Meanwhile, the industry remains steadfast on improving care by focusing on the metrics that will make a meaningful difference in the lives of our residents. Policymakers and providers should work in tandem on these efforts, so that no matter who owns a nursing home, residents receive the highest quality care.”