Amanda C. Chen, Harvard University, Cambridge, Massachusetts.
Robert J. Skinner, Vanderbilt University, Nashville, Tennessee.
Health Aff (Millwood). 2024 Mar;43(3):318-326. doi: 10.1377/hlthaff.2023.01110.
Nursing home ownership has become increasingly complicated, partly because of the growth of facilities owned by institutional investors such as private equity (PE) firms and real estate investment trusts (REITs). Although the ownership transparency and accountability of nursing homes have historically been poor, the Biden administration's nursing home reform plans released in 2022 included a series of data releases on ownership. However, our evaluation of the newly released data identified several gaps: One-third of PE and fewer than one-fifth of REIT investments identified in the proprietary Irving Levin Associates and S&P Capital IQ investment data were present in Centers for Medicare and Medicaid Services (CMS) publicly available ownership data. Similarly, we obtained different results when searching for the ten top common owners of nursing homes using CMS data and facility survey reports of chain ownership. Finally, ownership percentages were missing in the CMS data for 82.40 percent of owners in the top ten chains and 55.21 percent of owners across all US facilities. Although the new data represent an important step forward, we highlight additional steps to ensure that the data are timely, accurate, and responsive. Transparent ownership data are fundamental to understanding the adequacy of public payments to provide patient care, enable policy makers to make timely decisions, and evaluate nursing home quality.
养老院的所有权变得越来越复杂，部分原因是机构投资者（如私募股权公司和房地产投资信托基金）拥有的养老院数量不断增加。尽管养老院的所有权透明度和问责制历来不佳，但拜登政府在 2022 年发布的养老院改革计划包括了一系列关于所有权的信息披露。然而，我们对新发布的数据进行评估后发现了几个差距：在艾弗林·莱文协会（Irving Levin Associates）和标普资本智商（S&P Capital IQ）的专有投资数据中，有三分之一的私募股权和不到五分之一的房地产投资信托基金投资在医疗保险和医疗补助服务中心（CMS）的公开所有权数据中都没有出现。同样，我们在使用 CMS 数据和连锁所有权设施调查报告搜索十大养老院共同所有者时，也得到了不同的结果。最后，在 CMS 数据中，十大连锁机构所有者中有 82.40%和全美所有设施所有者中有 55.21%的所有者的数据缺失。尽管新数据代表了向前迈出的重要一步，但我们强调了额外的步骤，以确保数据及时、准确和响应迅速。透明的所有权数据对于了解公共支付提供患者护理的充足性、使政策制定者能够及时做出决策以及评估养老院质量至关重要。
