New federal rule adds transparency to nursing home ownership; VUMC-led research informed rule development

A new federal rule published Nov. 15 will require additional transparency and disclosure of ownership and management of nursing homes across the country, and the rule was shaped by research conducted at Vanderbilt University Medical Center.

The rule will help families make more informed decisions about nursing home care, the Centers for Medicare and Medicaid Services said in a news release.

The rule comes at the same time new research led by Professor David Stevenson, PhD, chair of the Department of Health Policy at VUMC, was published finding that private equity firms and real estate investment trusts increased sharply early in the 2013-2022 study period before leveling off as the COVID-19 pandemic became a national public health emergency.  

A key focus of the rule is to make the role of private equity firms and real estate investment trusts (REITs) in the sector more transparent.  Prior studies have identified quality concerns around these investments, with critics suggesting that these entities may chase short-term profits at the expense of quality care. 

The study led by Vanderbilt in collaboration with researchers at Weill Cornell Medical College, sought to further inform policymakers around these issues in advance of issuing the transparency rule.  Funded by the Assistant Secretary for Planning and Evaluation (US Department of Health and Human Services), the Vanderbilt-Cornell study is among the first to examine quality of care among PE and REIT invested facilities.  Stevenson and colleagues found that registered nurse staffing fell and quality of care deficiencies increased following REIT and PE investment. 

“Our study results point to a changing ownership landscape within the nursing home sector over the last decade,” researchers wrote. “The findings contribute to a growing set of studies that assess the influence of these changes on nursing home quality of care, with our findings raising concerns about the impact of PE and REIT investment on nursing home staffing and survey performance.”