Western Massachusetts is home to several nursing homes run by Vantage Care, a for-profit company known for flipping properties and capitalizing on the shortcomings of other business rivals. While the care they provide to residents is essential, it often falls short of regulators’ standards. Investigations into these facilities have raised concerns about staffing and care quality and oversight. Kay Lazar who reports on health care, policy and research for the Boston Globe recently covered this for the newspaper.
Carrie Healy, NEPM: Massachusetts Center for Health Information and Analysis (CHIA) characterizes the overall financial status of the nursing home industry as struggling due to low Medicaid reimbursement rates, a growing population that needs care, rising operating costs, and more. So, can you connect the dots for me? You report that now is a time of hot buying and selling of these facilities. Why?
Kay Lazar, Boston Globe: So, there are several reasons. One is, CHIA is correct that many nursing homes are struggling, but there are several others that are not.
It's a hot commodity because there are a lot of people who are older, who have nursing needs that, you know, exceed what they can get at home. There are fewer nursing homes now because many have closed, and so the demand is there. It's a seller's market.
Also, the state over the last several years has invested hundreds of millions of dollars of Medicaid money in increases in supplemental budgets, with very few strings attached about how it should be used. And advocates say that too often companies are coming in, squeezing the profits out of there by cutting corners, taking the profits, and then turning around and selling the nursing homes.
What did you hear from regulators and advocates about this situation?
State regulators declined an interview. So, I'm not really sure what they're saying. They did say that they are reviewing Vantage's request to take over the eight nursing homes that are now in receivership that were owned by Bear Mountain. Advocates, and I talked to a number of different advocates, say they are concerned that Massachusetts needs to take a closer look at the details of who wants to buy these nursing homes, what their background is, what their track record is, and also they're asking the state if they're going to increase funding to nursing homes to tie it to specific reforms, such as requiring a higher ratio of quality of care, of staffing to how many residents are in the home.
Vantage Care has been rapidly flipping nursing homes, buying four in Massachusetts and reselling them quickly, including a South Hadley facility that fetched $2.7 million more than its purchase price after just a year. Did you get the impression from your reporting that other nursing homes are being bought and sold, just like the Bear Mountain/ Vantage Care deals that you covered?
Yes, yes we did. We were looking at some data on a change of ownership. And you could see that the numbers of these changing of hands have increased in recent years. You can definitely see that the pace of this is going on at the same time that nursing homes [a number of them] I believe it was just under 20, are in receivership. Um, eight of which were Bear Mountain, meaning that they weren't able to pay their bills; utility bills, pay their workers.
Many say that they are struggling. I think there is no doubt that some really are. But I think there needs to be a closer look at how they may be taking the money and giving it to related companies, sister companies that may be managing the nursing homes that are really owned by the same people.
Does this speak in a way to a broader implication for the future of nursing home care in Massachusetts, in terms of quality and oversight?
Absolutely. I think this should be a warning tale for all of us to to ask our state legislators and regulators how closely they're actually watching these facilities and the tens of thousands of people who call these facilities home.
