Several Massachusetts nursing homes fell under financial pressure in the years after the COVID-19 pandemic, leading to many being sold to out-of-state companies in the ensuing years. The Boston Globe’s Spotlight team found that with ownership change came a disturbing drop in facility ratings. An investigation uncovered that nursing home complaints included dangerous falls, medication mix-ups and other extreme health hazards for residents. Globe reporters dove into these issues along with the details of the owners’ profit off of patient care. GBH’s All Things Considered host Arun Rath unpacks the findings with Kay Lazar, a journalist behind the investigation, as the story unfolds. What follows is a lightly edited transcript of their conversation.
You can read the full story at bostonglobe.com.
Arun Rath: Before we talk in detail about these particular companies, and this one company in particular, set the stage for us more about what was happening with private companies buying Massachusetts nursing homes.
Kay Lazar: Sure, so what we saw is that the buying and selling of nursing homes, the pace of it, really picked up in the first few years after COVID. So 2022, 2023, just a lot of nursing homes changing hands. And when we compare that to the following years — '24, '25, into '26 — the pace of nursing homes being bought and sold had doubled, and nearly doubled in Massachusetts. And I think this is something that studies have also shown has gone on around the country because the pandemic was really hard on nursing homes. As you can imagine, a lot of residents died. A lot of nursing home owners just really got beat down by the bad coverage, by the expense, and wanted to get out of the business. So that’s really setting the stage for what we saw when we dug in a little further.
Rath: Yeah, having reported all through the pandemic and seeing what was going on with nursing homes, it kind of makes sense that that would happen. Now, with this company in particular that you spend some time with in this piece, Eli Mirlis [CEO of RegalCare]. This is a New Jersey company. Tell us about them and the nursing homes that they bought in Massachusetts.
Lazar: Sure, so Mr. Mirlis is relatively young. He’s only about 38 years old now. He came out of New Jersey. He bought his first nursing homes that we can see in Connecticut, and they did not do well. So by the time that he got to Massachusetts in 2020, he already had left quite a bit of a track record. I think seven nursing homes at least in Connecticut, some of them really doing poorly. And he got here to Massachusetts and started buying up nursing homes rather quickly in 2022, '23, '24, to the point he’s now at 12 nursing homes. And some of these nursing homes were really a five-star — meaning the highest rated that federal regulators could give them — and within a couple years were one-star, or even a three-star was down to a one-star. So the quality of care went down rather quickly in a number of his nursing homes.
Rath: And before we talk about the details about how these care facilities went down from five stars to, in some cases, one star, tell us about how the finances changed because this is something that you go through in the article — how much was actually spent on care at these facilities.
Lazar: So that was very striking when we looked. When the team looked at RegalCare facilities. We really dug deeper into a couple of them that really dropped — plummeted — the quality of the care to look at where the finances were going. And so, we looked very closely at one, Taunton, which had dropped from a five-star to a one-star. And what was striking is the amount spent on nursing care and the amount of nursing hours, which are really — nurses are the heart. They go to the heart of nursing homes, right? That’s the care. And what we found is that the care, the number of hours, nearly were cut in half for all the nurses there within a few years. And it was striking because when you looked at the finances, Mr. Mirlis had spent about half a million less in nursing care than the previous owner. But there was about half a million dollars going to one of his many related companies, meaning he starts companies that will then manage the facility or own the real estate or ... give the therapy. And what we looked at is that he’d been giving about $500,000 to his real estate company, and that was about four times more than the previous owner was paying for rent, if you will. So what it really looked pretty clearly to us is that he was spending a lot less on nursing and nursing hours and a lot more being moved over to other companies he owned that were also affiliated with the nursing home, known as related parties.
Rath: So am I understanding this right, that he’s paying rent to himself essentially, or to companies that he also owns?
Lazar: Exactly. Yes, that’s true. And this is not unusual in nursing homes in the industry. It’s been growing and growing in recent years. And so what a nursing home owner would do is start a company called, you know, the rental company and another one called the management company, etc. And you’re essentially taking the money from your left pocket and putting it in your right pocket. But yes, paying to yourself.
Rath: And we can stay with this nursing home in Taunton. Talk about what happened with the care.
Lazar: The care was not good. People, residents, families telling us that residents sat for hours in soiled diapers. That often, and this we spoke with someone who has worked in maintenance there for years and years and years, including his last several under RegalCare, where they would literally run out of supplies. That their supplies would be cut short even when they ordered and they would run out of basic housekeeping supplies. Sometimes the staff would run short on milk or bread, and they would run to the store to be able to get basic food supplies. There were medication mix-ups, there were some dangerous falls. There were just a host of real quality care problems that residents faced. And so, yes, it was not good, and for families, terrifying.
Rath: Reading this, you know, we think that things like this shouldn’t happen in Massachusetts. We tend to think that things are well regulated here. But also, running through the article is the worst of these things are being tracked and they’re just paying fines.
Lazar: Correct and that’s, I think, what a lot of the readers responded to. That there was quite a track record of — even leaving aside the out-of-state problems ... they’ve been here for six years, and it’s quite a track record. And yet, they’ll be fined or penalized or even found to be in what they call immediate jeopardy, which means the regulators don’t allow them to take any more patients and residents in until they correct problems. And a couple of weeks later, they’re back open again. And there is a lot of outrage, frankly, that state regulators haven’t done more to stop this gentleman and others who have shown to have very, very poor care from buying more nursing homes. But our State Department of Public Health has essentially just kept letting them in and buying more nursing homes. They have found them to be quote-unquote “suitable” to buy more nursing homes here.
