Nursing home ownership data from the Centers for Medicare and Medicaid Services currently captures only a small portion of private equity and real estate investment trust investments in long-term care, new 2015 research reveals became. health problems.
Researchers found that despite calls for greater ownership transparency under the Biden administration, only private companies identified by CMS compared to proprietary data from Irving Levin Associates and S&P Capital IQ. We confirmed that only 33% of equity and 17% of REIT.
The researchers say that in most cases, this data does not identify what percentage of a facility is owned by investors, so whether owners have a small stake in the nursing home or not. , or that it has always been impossible to parse whether they own most of it.
According to co-author Dr. Tamara Konetzka of the University of Chicago, the complexity of the field means that consumers and policymakers struggle to track and understand the impact of the many private transactions and investments in long-term care. It is said that it means
“It’s really difficult to collect data,” Konetzka said. McKnight Long Term Care News Monday. “Data has evolved. [CMS is] much better than [it] That used to be the case…but CMS needs to invest more in collecting accurate and up-to-date information about financial arrangements. ”
The study’s authors recommended that CMS should further strengthen data collection on financial transparency in the future to close the gap.
“Understanding how investors relate to each other and unraveling the hierarchy of organizational control to identify parent companies will help policymakers conduct a more systematic assessment of ownership through shared ownership.” ” they wrote. “To identify wrongdoers when approving changes in ownership or management, CMS also considers past violations, adequacy of financial reserves, and provision of minimum staffing levels and adequate quality. need to do it.
Tracking reimbursement and quality of care
Permitting these steps would require more time and money from CMS and, in theory, facilities that would need to report data ownership beyond what federal regulators currently require, Konetzka said. However, this process could shed valuable light in two important areas.
First, sector leaders argue that Medicaid reimbursements are insufficient to cover the cost of quality care, and private owners hide profits in opaque business structures and related-party transactions. There is probably an ongoing debate among consumer advocates who argue that there are many.
“To track the flow of funds and resolve this debate to say, ‘We need adequate Medicaid reimbursement,’ or ‘We need to block certain ownership arrangements that don’t put enough money into patient care.’ I think we really need accurate data to think about these ownership arrangements,”’ Konetzka said. Mr. McKnight. “We don’t have the data to tell you all that.”
The authors emphasized that private equity and REITs only account for about 12% of the sector, but that number is likely to grow and already account for approximately $8 billion in taxpayer dollars through Medicare and Medicaid. He also pointed out that the amount was equivalent to the amount of funds.
Konetzka said greater ownership transparency is essential to properly value the sector as a whole. More ownership data will also help consumers and policymakers understand the quality of care within chains and among facilities owned by private investors.
“There has been a lot of concern over the years that just reporting on the quality of a particular facility does not provide enough information,” she explained. They should not be allowed to spend more tax money acquiring or building new facilities to improve the quality of care. ”
Beyond regulatory filings, Konetzka said further information about potential bad actors can help residents and their families avoid facilities whose ownership structure may raise red flags of poor quality of care. He said it could be useful.
“Consumers didn’t really have the right tools to look at the impact on these large organizations,” she said.
Recognizing that additional resources and education are needed to collect new data from facilities and compile it for the public, the authors urge CMS to improve the efficiency and complexity of the long-term care sector while making adjustments in oversight. I asked them to keep this in mind. policy.
“It will be important for CMS to improve quality by streamlining the collection of ownership data while ensuring that the data is timely, flexible, and responsive to complex and changing nursing home situations. “Yes,” they wrote.
Long-term care leaders already provide large amounts of financial and ownership data to regulators, and facilities have very limited resources, making additional reporting and investigation requirements overwhelming regulators. We often point out that it can lead to a burden.
