Senior Care Policy Brief: Growth, Profits, and Resident Harm

The Senior Care Policy Briefing covers important long-term care issues by highlighting policy updates, news reports, and academic research.

Read the full Senior Care Policy Briefing below or download here.

June 15, 2026.

June 15 is World Elder Abuse Awareness Day (WEAAD), a global initiative to raise awareness of the abuse, neglect, and exploitation that affect millions of older adults each year. To learn more about recognizing, preventing, and reporting elder abuse and neglect in nursing homes and assisted living facilities, visit LTCCC’s Abuse, Neglect, and Crime Reporting Center.
Three U.S. senators are urging the Centers for Medicare & Medicaid Services (CMS) to immediately reinstate nursing home ownership disclosure requirements that were suspended indefinitely earlier this year. In a letter to CMS Administrator Oz, Senators Booker, Wyden, and Warren argue that ownership transparency is essential because increasingly complex ownership and related-party arrangements can obscure how billions of taxpayer dollars are spent and whether those funds are supporting resident care.
- The senators point to growing evidence linking ownership structure to resident outcomes, noting that research has associated private equity ownership with more care deficiencies, higher hospitalization rates, and increased mortality. They also highlight data showing that nearly one in every five dollars of nursing home revenue flows to related parties, such as management companies, staffing firms, and real estate entities that share ownership with nursing facilities.

A new investigation by Hunterbrook examines the rapid growth and financial success of The Ensign Group, one of the nation’s largest nursing home chains, alleging that the company’s expansion has coincided with troubling patterns of resident harm and poor-performing facilities. The report argues that Ensign has expanded rapidly by acquiring struggling facilities and highlights allegations involving resident deaths, neglect, staffing concerns, and regulatory violations at some affiliated nursing homes.
- According to LTCCC’s latest provider data report (Feb 2026), Ensign provides 25% lower overall nurse staffing than expected to meet the needs of their residents (on average). Ensign’s registered nurse (RN) staffing shortfalls are even worse, falling 43% below the level expected to meet resident needs (on average).

A new UCLA study finds that nursing home staffing declined less in states that implemented policies to support facilities during the COVID-19 pandemic, suggesting that targeted investments helped stabilize the workforce during a period of unprecedented disruption. Researchers found that states that adopted measures such as enhanced Medicaid payments and workforce support initiatives experienced smaller staffing losses than states that provided less assistance.