Unmasked: How California’s Largest Nursing Home Chains Perform

The Sacramento Bee published a groundbreaking series of articles this week on who owns California nursing homes and why it matters to people who need nursing home care. The sweeping three-part series by Marjie Lundstrom and Phillip Reese identifies and examines the performance of California’s 25 largest nursing home chains, exposes some of the people behind them and questions why they are so poorly regulated.

Part 1 is a data-driven examination of how the largest nursing home chains are performing. Using public data, the Sac Bee rated each of the 25 largest chains, giving lowest marks to the following: LifeHouse Health Services, EmpRes Healthcare Management LLC, Genesis HealthCare Corp., Mariner Health Care, and Brius Healthcare Services/Shlomo Rechnitz.
Read Part 1: Unmasked: How California's Nursing Homes Perform

Part 2 examines the great lengths nursing home companies go to disguise what facilities they own and their business relationships. As part of its coverage, The Sac Bee launched a statewide database on California nursing homes that identifies which facilities are owned by chains and the name of the chain for each facility.
Read Part 2: Unmasked: Who Owns California Nursing Homes

Part 3 describes the Department of Public Health’s total failure to measure quality of care throughout a nursing home chain and to give complete and accurate information on nursing home ownership on its consumer information website. A Sac Bee editorial following the series summed up the situation: People who enforce the rules fail on the most basic level – helping people understand which chains operate safe and humane facilities, and which aren’t acceptable.
Read Part 3: California falls short in disclosing nursing-home ownership

Key findings:

• Twenty-five for-profit nursing home chains control about half of the state’s 120,000 licensed nursing home beds;
• Shlomo Rechnitz, California’s largest nursing home operator, has acquired nearly 75 nursing homes since 2004 – and is connected to 130 businesses tied to his nursing home chain –but neither Rechnitz nor his company, Brius Healthcare, appears anywhere in the Department of Public Health’s licensed facility listing report;
• Ten of the largest chains in the state make it hard for consumers to see what facilities they own because they do not have websites or offer websites that lack specific facility information;
• California nursing homes owned by Genesis HealthCare had seven times the state average of complaints of abuse in 2013;
• Among California’s 10 largest chains, nine fell below state averages in three out of five key staffing measures in 2012;
• Five chains control about one-fifth of the state’s nursing home beds: Brius/Rechnitz, Longwood Management, Plum Healthcare Group, Smedra/Winter and Windsor.
• It has been virtually impossible for the public to take a nursing home chain’s performance into account when selecting a nursing home.