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Nursing homes staffing requirements could be hard to meet - PBS NewsHour

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David Grabowski:

I think that's a big part of the story.

Ownership — we don't have a lot of those mom-and-pop-owned nursing homes that we had 20, 30 years ago. There are — these are corporations. They're often very complex corporations with many layers. And it's hard for policymakers to follow the dollars.

And, so, many of those dollars don't end up in direct resident care. They don't end up in the pockets of staff. They unfortunately end up in other parts of the organizations through what are called related party transactions.

So, private equity, real estate investment trusts and lots of other complicated ownership structures have emerged in this industry and really, I think, helped push along the kinds of reforms that we're now thinking about, like a minimum staffing standard, where I think 20, 30 years ago this — we were talking about this policy, but it wasn't as needed as it is today, because we didn't have the same set of owners that we do today.

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