Close up image of a caretaker helping older woman walk

The Manor Care Inc. acquisition is still in doubt after one state’s regulators agreed to reconsider an earlier approval of the deal.

The West Virginia Health Care Authority set a Dec. 14 public hearing after staying the certificate of need it had granted The Carlyle Group, an investment firm. Officials said they felt compelled to revisit the transaction after concerns were raised by the Service Employees Union. Seven facilities in West Virginia would be affected by the sale.

Lawmakers in at least one other state are also expressing reservations. The state House Committee in Illinois recently held a related hearing at which opponents to the deal spoke out. Concerns over care quality and possible staffing cutbacks were raised at the hearing. The Carlyle Group has repeatedly denied plans to make such cuts. Manor Care is the nation’s largest nursing home chain.