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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; the report also detailed staffing cuts and related-party payments at RegalCare facilities.
A Boston Globe Spotlight investigation found that nursing home chains based in New York and New Jersey expanded their Massachusetts holdings from 12 facilities in 2019 to 61 by 2025, while average federal star ratings fell at eight of the nine chains. The findings raise questions about how acquisitions, staffing and spending are monitored in a state with roughly 340 nursing homes.
The Globe’s review found that RegalCare and its chief executive, Eli Mirlis, acquired 12 Massachusetts nursing homes and at least 29 facilities across five states. Some properties had high ratings before the purchases. A Taunton home and a Quincy home each fell from five stars to one within three years, according to the investigation.
At the Taunton facility, overall operating spending fell 19% after the acquisition, the Globe reported. Registered nurse hours dropped by more than half, while licensed practical nurse hours fell by more than a third. Between 2021 and 2025, spending on nursing services decreased by $530,000 as rent paid to a separate company owned by Mirlis rose to $522,000. The facility paid $1.6 million to related companies in 2025, about 16% of its operating expenses, the report said.
The investigation also found that New Jersey permanently revoked Mirlis’ nursing home administrator license in 2018 after determining that he committed fraud involving continuing education requirements. The Globe reported that his revoked license 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. The payment resolves allegations; it is not a finding described here as an admission of wrongdoing.
Staffing and Spending After Acquisitions
The reported changes matter because staffing and facility finances are directly relevant to residents, families and public programs that pay for nursing home care. The Globe’s findings show that, at the Taunton property, lower nursing service spending and reduced nurse hours occurred alongside payments to businesses connected to the owner. The report does not establish that every acquisition caused lower quality, but its findings across the nine chains point to a pattern that state regulators and families may scrutinize.
Federal star ratings offer one way to track facility performance, and the reported declines at eight chains provide a measurable signal after ownership changes. Ratings alone do not explain the cause of a decline or describe every resident’s experience. Taken together with staffing and payment records, however, the findings raise questions about whether oversight and disclosure practices identify risks early enough.
A Larger Ownership Shift
The nine chains identified by the Globe bought at least five Massachusetts nursing homes apiece between 2020 and 2025. Their collective holdings grew to 61 facilities, about one-fifth of the state’s nursing homes. Eight of the nine chains had lower average federal star ratings after acquiring facilities, according to the investigation.
The Globe said it reviewed federal ratings, state and federal records, financial reports, lawsuits and inspection data, and interviewed employees, residents and families. Massachusetts’ Department of Public Health oversees about 340 nursing homes and has authority to reject buyers it considers irresponsible or unsuitable. The Globe found that the agency had not denied an acquisition application or revoked a nursing home license in seven years.
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 ago expanded that authority, he said. The investigation described the acquisitions and their consequences as a trend; it did not establish that every out-of-state buyer or acquired facility experienced the same changes.
“State law historically didn’t authorize regulators to consider an operator’s out-of-state record.”
— Robbie Goldstein, Massachusetts health commissioner, speaking to The Boston Globe
How New Review Powers Will Apply
The investigation does not establish what effect the expanded state authority will have on future acquisitions or whether it will change enforcement. It is also unclear from the reported findings how the state will assess an operator’s out-of-state record in individual applications. The Globe’s data show rating and staffing changes at facilities and chains, but do not by themselves establish why every rating changed or whether the same pattern applies to all new owners.
The $1 million RegalCare payment resolved allegations concerning Medicare and Medicaid claims. The source material does not specify the settlement terms beyond the payment, including whether the company admitted liability. Details of any continuing state or federal review of the acquisitions were not provided.
Regulators Face the Next Applications
Massachusetts regulators can now consider out-of-state records under the law described by Goldstein. Their use of that authority in upcoming ownership applications, and any enforcement action tied to the facilities in the investigation, will show how the change operates in practice. Residents and families may also watch for updates in federal star ratings, inspection findings and staffing disclosures at acquired homes.
The investigation provides a snapshot through 2025 for acquisition figures and through the periods specified in its facility-level financial comparisons. Further reporting or public records would be needed to establish whether the chains’ ownership, staffing and spending patterns have changed since those data were collected.
Key Questions
How many Massachusetts nursing homes did the identified out-of-state chains own?
The nine chains from New York and New Jersey collectively owned 61 facilities by 2025, up from 12 in 2019, according to the Globe investigation.
Did ratings fall at every chain?
No. The Globe reported that eight of the nine chains saw their facilities’ average federal star ratings decline after acquisitions.
What changes did the Globe report at the Taunton facility?
The investigation reported a 19% drop in overall operating spending, a reduction of more than half in registered nurse hours, and payments of $1.6 million to related companies in 2025. It also reported that nursing services spending declined by $530,000 between 2021 and 2025.
Can Massachusetts consider an owner’s record in other states?
Health Commissioner Robbie Goldstein told the Globe that a law enacted two years ago expanded the state’s authority to consider an operator’s out-of-state record. How regulators will apply that authority in specific cases remains unclear from the report.
Source: rss
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