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A Boston Globe Spotlight investigation found that nine nursing home chains from New York and New Jersey expanded their Massachusetts holdings from 12 facilities in 2019 to 61 by 2025. Eight chains saw average federal star ratings decline after acquisitions, while the report cited staffing and spending cuts at a RegalCare-owned Taunton facility. The findings raise questions about state oversight; the Health Department’s authority to review buyers has recently expanded.
Nine nursing home chains based in New York and New Jersey expanded from 12 Massachusetts facilities in 2019 to 61 by 2025, and eight of the nine saw their facilities’ average federal star ratings fall after acquisition, according to a Boston Globe Spotlight investigation. The findings put scrutiny on ownership changes and state oversight in a sector that serves residents requiring ongoing care.
The Globe reviewed federal ratings, state and federal records, financial reports, lawsuits and inspection information, and interviewed employees, residents and families. Its investigation found that the nine chains bought at least five Massachusetts nursing homes apiece between 2020 and 2025. Together, the chains now own about one-fifth of the state’s nursing homes, the report said.
RegalCare, led by CEO Eli Mirlis, acquired 12 homes in Massachusetts and at least 29 across five states, according to the investigation. Two facilities cited by the Globe changed from five federal stars to one within three years: one in Taunton and another in Quincy. The report also found that overall operating spending at the Taunton facility fell by 19% after the acquisition.
At the Taunton home, registered nurse hours fell by more than half and licensed practical nurse hours by more than a third, the Globe reported. Nursing services spending dropped by $530,000 between 2021 and 2025, while rent paid to a separate company owned by Mirlis rose to $522,000. In 2025, the facility paid $1.6 million to related companies, about 16% of its operating expenses, according to the Globe. These are findings from the investigation; they do not by themselves establish that ownership changes caused every rating or staffing decline.
Ownership Shifts and Care Ratings
The reported expansion means a growing share of Massachusetts nursing homes are controlled by a small group of chains headquartered outside the state. For residents and families, ownership and staffing changes may affect day-to-day care, while star ratings offer one indicator for comparing facilities. The Globe’s findings identify a pattern across most of the chains, but do not establish that every acquired home experienced the same changes.
The spending figures at the Taunton facility also focus attention on where nursing home revenue goes, including payments to related businesses. The report’s data raise questions about how regulators assess staffing, quality and financial arrangements when a facility changes hands. The state oversees about 340 nursing homes, according to the source material.
Separately, Skilled Nursing News reported that RegalCare and two executives agreed to pay $1 million to resolve allegations that the company submitted false claims to Medicare and Medicaid for medically unnecessary rehabilitation therapy. The agreement resolves allegations and should not be described as a finding that the allegations were proven. The Globe said a related therapy company had earlier settled for $315,000.
Massachusetts Review of Buyers
The state Department of Health can reject prospective nursing home buyers it considers irresponsible or unsuitable. But the Globe found that the agency had not denied a nursing home acquisition application or revoked a nursing home license in seven years. That record is part of the investigation’s examination of whether oversight kept pace with the market’s ownership changes.
Health Commissioner Robbie Goldstein told the Globe that state law historically did not allow regulators to consider an operator’s record in other states. A law enacted two years before the report expanded that authority, he said. The change could give the state more information to consider during buyer reviews, though the source material does not say how often the expanded authority has been used.
The Globe also reported that New Jersey permanently revoked Mirlis’ nursing home administrator license in 2018 after finding he committed fraud related to continuing education requirements. According to the investigation, that revocation was not mentioned on applications for Massachusetts nursing homes. The report’s account identifies a potential gap in disclosure and review; it does not detail the outcome of each application.
“State law historically didn’t authorize regulators to consider an operator’s out-of-state record.”
— Massachusetts Health Commissioner Robbie Goldstein, speaking to The Boston Globe
Questions on Oversight and Outcomes
The available report does not establish why each facility’s star rating changed or whether acquisition alone caused declines. It also does not provide facility-by-facility staffing and spending data for all 61 homes owned by the nine chains. The figures for staffing, operating costs and related-company payments cited here concern the Taunton RegalCare facility.
It remains unclear how Massachusetts regulators have applied their expanded authority to consider out-of-state records, or whether it will change future acquisition decisions. The source material also does not describe specific enforcement actions planned in response to the investigation. The Medicare and Medicaid matter involving RegalCare was resolved through an agreement to pay; the supplied account describes the underlying conduct as allegations.
Regulators Face New Buyer Reviews
The Department of Health’s expanded authority gives regulators a broader legal basis to review buyers’ records beyond Massachusetts. The supplied reporting does not identify a pending acquisition decision or a scheduled state response to the Globe’s findings, so the next concrete milestones are not specified.
Residents, families and staff may continue to track federal star ratings, inspection findings and staffing at individual homes as ownership changes. Further reporting or state records could clarify whether the post-acquisition patterns identified by the Globe persist and how the state is using its review powers.
Key Questions
How many Massachusetts nursing homes do the nine out-of-state chains own?
The Boston Globe investigation said the chains owned 61 facilities by 2025, up from 12 in 2019, or about one-fifth of the state’s nursing homes.
Did ratings fall at every acquired facility?
No. The investigation found that eight of the nine chains saw their facilities’ average federal star ratings decline after acquisition. The supplied findings do not say that every home under those chains lost stars.
What did the report find at the Taunton nursing home?
The Globe reported a 19% fall in overall operating spending, sharp reductions in registered nurse and licensed practical nurse hours, and $1.6 million in 2025 payments to related companies—about 16% of operating expenses.
Can Massachusetts reject nursing home buyers?
The state Department of Health can reject buyers it considers irresponsible or unsuitable. Health Commissioner Robbie Goldstein told the Globe that a law enacted two years before the report expanded regulators’ ability to consider an operator’s out-of-state record.
Source: rss
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