December 16, 2025 – CMS has once again delayed implementation of the nursing home ownership disclosure requirements enacted by Congress in Section 6101 of the Affordable Care Act (ACA). Specifically, it has indefinitely suspended the off-cycle Medicare revalidation process that it established as the primary vehicle for collecting newly required nursing home ownership and control information under its November 17, 2023 final rule. As a result, there is currently no deadline by which facilities must disclose this information as part of off-cycle revalidation.

The requirements include disclosure of:

  • Each member of the facility’s governing body, including name, title, and period of service
  • Each officer, director, member, partner, trustee, or managing employee of the facility
  • Each additional disclosable party (ADP) associated with the facility
  • The organizational structure of each ADP and a description of how those parties relate to the facility and to one another

“These requirements are essential to understanding who truly owns, controls, and profits from nursing homes, particularly in an industry increasingly characterized by complex corporate structures and sophisticated private enterprise investment,” said Richard Mollot, LTCCC’s Executive Director. “This delay is especially troubling given how much the nursing home industry’s financial and operational arrangements have evolved since the ACA was enacted. Now, in the post-COVID environment, opaque ownership structures enable operators to extract profits while residents and workers bear the consequences of understaffing, degraded care, and facility instability.”

Notably, the final rule — which became effective in January 2024 — is modest in both scope and enforcement. It largely builds upon long-standing Medicare disclosure requirements, adds targeted categories of additional disclosable parties, and was accompanied by extensive CMS guidance. Providers have had ample notice and opportunity to prepare for compliance.

Nevertheless, rather than ensuring timely and universal disclosure, CMS has now removed any meaningful compliance deadline for the off-cycle revalidation process. In practice, this means that many nursing homes that have not voluntarily submitted the required information may continue operating without having disclosed the full ownership and control data Congress expressly required.

Transparency alone is not a substitute for effective oversight. However, it is a necessary precondition for those safeguards to function. By indefinitely suspending the primary mechanism for collecting this information, CMS has undercut one of the few tools available to regulators, policymakers, residents, and advocates to understand and respond to the corporatization of nursing home care.