A sweeping new Boston Globe “Spotlight Investigation” reveals how out-of-state owners bought up dozens of Massachusetts nursing homes in recent years and watched quality ratings plunge as they squeezed facilities for profit. Among the most prominent is RegalCare, a New Jersey-based company whose local properties, including a facility in Holyoke, saw sharp drops in federal care ratings amid allegations of severe neglect. NEPM's Carrie Healy talks about the reporting with Boston Globe investigative reporter Kay Lazar.
Carrie Healy, NEPM: Can you set the scene for us? How did a handful of out-of-state owners manage to quietly take over nearly 20% of the nursing homes in the state? And what happened to resident care once they took control?
Kay Lazar, Globe: So, I think we can boil it down very simply, is that a lot of these out-of-state operators came in, and there was very little vetting of their backgrounds by the state agency—the Department of Public Health—that is charged with that responsibility of checking the backgrounds and track records of owners who want to buy nursing home licenses here. So, they just, essentially, kept approving their licenses.
One of the more stark examples examples we found was RegalCare and its owner, Eli Mirlis, who has bought up 12 nursing homes in the last few years, including the one in Holyoke that was was a three-star nursing home, out of the five stars federal regulators award them, and within a short time, it dropped to one star because of the just how poor the quality of care was there.
So resident care took a nosedive. How was Eli Mirlis at RegalCare able to siphon millions of dollars into his own side businesses while drastically cutting nursing staff and basic patient supplies?
Basically, there was nobody minding the store.
Actually, and this may be shocking for people to hear, there is not exactly a law prohibiting it. State regulators don't like to hear that and certainly when we spoke with the state health commissioner, he was shocked to learn that 16% of the nursing home's budget in another nursing home [of RegalCare’s] was siphoned off.
But there is no single law that prohibits that. And they can siphon and siphon away if they want, or redirect it to other companies they own, and we found that was happening with RegalCare.
This reporting included real impacts described for local Western Mass. families, including the daughters of a woman who stayed at RegalCare's Holyoke home. In general, what did these budget cuts look like on the ground for patients and for their loved ones?
In Holyoke, one case was especially chilling. It involved two sisters, Tina and Theresa Walsh, whose mother had been in the Holyoke facility for a rehabilitation stay. During the two weeks she was there, the staff gave their mother two types of antidepressants, though she normally received only one. A physician assistant later discovered that she had been given both medications. Their mother died seven weeks later at one sister's home from what the death certificate lists as serotonin syndrome. Her daughters allege that it was an overdose of those antidepressants, and they are suing RegalCare for that.
Maybe the most stunning part of this reporting is the state's role in all of this. The Department of Public Health hasn't denied a nursing home acquisition or revoked a single license in at least seven years. Why did state regulators keep waving these operators through, even when they lied on applications or ran down facility ratings?
That's a great question, and we did not get a satisfactory answer. What the commissioner told us is that he did not feel that the agency had the authority under state law to look at the backgrounds of out-of-state license owners. A law signed in September 2024 explicitly expanded the agency's authority to do that—to take a broad look. But the agency still has not implemented regulations that would formally put that authority into practice. So, more than two years later, it is still not doing that. However, right after our story was published, the agency called us and said it would vote on implementing the regulations in mid-October.
So, based on your reporting, do you get a sense that these new regulations, which are intended to be implemented soon, are enough to fix the system, or are there still major loopholes?
I think that time will tell. And there still is an open question we're still trying to answer, of whether the agency even has enough staff to conduct the background checks and vetting the law would require. Certainly, I think if they were doing better background checks, we might not end up with such bad nursing home owners?
So, I think we need to see some more honesty about whether staff must be redeployed needed, and if they have the resources to properly vet these people. Some of these organizations have very complex business structures that can obscure who is actually in charge of, or even own, the nursing homes.
