A call for openness as sales of facilities churn

James M. Berklan
James M. Berklan

Nursing home chain executives might have been wincing when they saw news of yet another study apparently finding that they're doing a poor job.

The study unequivocally found that poor nursing homes churned through repeated sales more frequently than good-performing ones. But researchers were NOT pointing fingers at class of owners — for-profits or nonprofits included. Rather, it was the nature of these deals researchers have found unsavory.

“We haven't said chains provide lower quality care,” lead study author David Grabowski of Harvard Medical School emphasized to me. “And we don't want to suggest some chains are doing better or worse. That's not the focus here.”

Grabowski's focus is to get expanded oversight and accountability of deals that involve the churning of poor quality facilities. Period.

You see, Grabowski and his team are not in this for me or even you, dear provider. They're in it for the consumer which, when you think about it, is how it should be. In the end, Grabowski is hoping that more is revealed about the facilities and owners buying and selling them.

“I don't know that the answer is more regulation,” Grabowski said, “but I do know the answer is more transparency. They [owners] might not like that or want to provide the information. But the data are pretty clear that these nursing homes are changing hands quite a bit and have lower quality.”

The researchers found that poor performers would be that way for at least a year before a sale — and then remain poor long after the sale. And then could be sold relatively quickly again.

Why this is happening is not really known. But Grabowski, who has studied long-term care ownership structures extensively, emphasized that he doesn't think there's some secret payoff that sharp investors have decoded and exploited. 

He hopes such deals eventually get noted on Nursing Home Compare so that potential nursing home users can see if a facility has changed hands often. This notice is something high-quality nursing facilities should want.

“As a consumer, I wouldn't rule out a place that's just been sold,” Grabowski said. “I just might scrutinize it more.”

Shining a light on any issue is going to bring more clarity, and that shouldn't be a bad thing for anyone involved.