President Joe Biden made nursing home history March 1, when he included the sector in his first State of the Union address. Biden pledged a crackdown on private-equity investors and vowed tougher oversight.

“As Wall Street firms take over more nursing homes, the quality in those homes has gone down and costs have gone up,” Biden told Congress. “That ends on my watch. … Medicare is going to set higher standards for nursing homes and make sure your loved ones get the care they deserve and that they inspect and will get looked at closely.”

Providers balked at the president’s portrayal and questioned the timing of a reform package the White House has proposed for the nursing home sector. Among 21 focal points outlined Feb. 28 are a federal staffing minimum, a shift away from shared rooms, higher penalties and methods to increase ownership transparency.