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Nine nursing home chains based in New York and New Jersey expanded their Massachusetts holdings from 12 facilities in 2019 to 61 by 2025, according to a Boston Globe investigation. Eight chains saw average federal star ratings fall after acquisitions; the reporting also found reduced staffing and operating costs at facilities owned by RegalCare. The findings raise questions about state oversight, though officials say a recent law gives regulators more authority to review operators’ records outside Massachusetts.
Nine nursing home chains based in New York and New Jersey increased their Massachusetts holdings from 12 facilities in 2019 to 61 by 2025, and eight saw average federal star ratings fall after acquisitions, a Boston Globe investigation found. The findings put scrutiny on ownership changes and state oversight in a sector responsible for care of older and disabled residents.
The Globe reviewed federal ratings, state and federal records, financial reports, lawsuits and inspection records, and interviewed employees, residents and families. It found that the nine chains bought at least five Massachusetts nursing homes each between 2020 and 2025. Their 61 facilities accounted for about one-fifth of the state’s nursing homes, according to the report.
RegalCare, led by CEO Eli Mirlis, acquired 12 Massachusetts facilities and at least 29 across five states. Two facilities cited by the Globe, in Taunton and Quincy, each fell from five stars to one star within three years. The Globe also reported that overall operating spending at the Taunton facility dropped 19%; registered nurse hours fell by more than half and licensed practical nurse hours by more than a third.
The report traced financial changes at the Taunton home between 2021 and 2025. Nursing services spending fell by $530,000, while rent paid to a separate Mirlis-owned company rose to $522,000. In 2025, the facility paid $1.6 million to related companies, about 16% of its operating expenses, the Globe said. These figures describe the facility’s spending and payments; they do not, by themselves, establish why care ratings changed.
Ownership Changes and Resident Care
The findings matter because acquisitions can quickly change who controls a nursing home, how it is financed and how many staff hours are available to residents. The reported declines in average ratings at eight chains and staffing reductions at the Taunton home raise questions about whether new owners maintained care standards after taking over. The investigation documents an association between ownership changes and rating declines; it does not establish that every acquisition caused poorer care.
Financial flows to companies related to an owner can also draw attention from residents’ families and regulators, particularly when spending on nursing services falls at the same time. The Globe’s figures show that related-company payments represented a notable share of the Taunton facility’s expenses. The report does not say that those payments alone demonstrate wrongdoing or explain the facility’s staffing and rating changes.
The scale of the expansion increases the stakes for oversight. If state regulators have limited ability to weigh an operator’s track record in other states, they may have less information when assessing a buyer’s suitability. Massachusetts officials told the Globe that a law enacted two years earlier broadened regulators’ authority to consider out-of-state records, but the investigation’s findings leave open how that authority will be applied.
How the Chains Expanded
The acquisitions occurred in Massachusetts’ post-pandemic nursing home market, according to the report. The Globe identified nine chains headquartered in New York and New Jersey that bought facilities in the state from 2020 through 2025. Collectively, their holdings rose from 12 in 2019 to 61, or about one-fifth of Massachusetts nursing homes.
RegalCare’s acquisitions were one part of that wider trend. The Globe reported that Mirlis’ New Jersey nursing home administrator license was permanently revoked in 2018 after state authorities found he had committed fraud involving continuing education requirements. According to the Globe, that revocation was not disclosed on applications for Massachusetts nursing homes.
Separately, 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, Skilled Nursing News reported. The agreement resolves allegations; the supplied reporting does not describe it as an admission of liability. The Globe also reported that a related therapy company had previously settled for $315,000.
“State law historically did not authorize regulators to consider an operator’s out-of-state record.”
— Massachusetts Health Commissioner Robbie Goldstein, speaking to the Boston Globe
The Globe found that the state Department of Health, which oversees about 340 nursing homes, had not denied an acquisition application or revoked a nursing home license in seven years. The department can reject buyers it considers irresponsible or unsuitable, but the reporting does not establish why no applications were denied during that period or how the agency assessed the acquisitions covered in the investigation.
It is not yet clear how the law enacted two years ago will change reviews of buyers with records in other states, or whether the state will use it to reject future applications. The supplied material also does not detail the reasons for each chain’s rating decline, whether staffing changes occurred at all 61 homes, or how the state’s findings compare with the operators’ own explanations.
How Massachusetts Reviews Buyers
The next test is how Massachusetts applies its expanded authority when reviewing nursing home acquisitions. The Department of Health oversees the state’s homes and can assess prospective buyers, while the law described by Goldstein gives regulators a broader basis to consider an operator’s record beyond state lines.
Further reporting or state records may clarify how the nine chains’ facilities have performed since acquisition, whether staffing and spending patterns have changed, and what actions regulators have taken. The material available so far does not identify a specific upcoming review, enforcement decision or deadline.
Key Questions
How many Massachusetts nursing homes did the nine chains own by 2025?
They owned 61 facilities by 2025, up from 12 in 2019, according to the Boston Globe investigation. That was about one-fifth of the state’s nursing homes.
Did ratings fall after the acquisitions?
The Globe found that eight of the nine chains saw their facilities’ average federal star ratings decline after acquisition. Two RegalCare homes named in the report, in Taunton and Quincy, fell from five stars to one within three years.
What did the investigation report about staffing at the Taunton home?
Overall operating spending fell 19%, the Globe reported. Registered nurse hours fell by more than half and licensed practical nurse hours by more than a third. The report also described changes in spending on nursing services and payments to related companies.
What can Massachusetts regulators do when a nursing home is sold?
The state Department of Health oversees about 340 nursing homes and can reject buyers it considers irresponsible or unsuitable. Commissioner Robbie Goldstein told the Globe that a law enacted two years ago expanded the state’s authority to consider operators’ out-of-state records.
Source: rss
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