On March 16, I stood before the New Jersey Senate Health, Human Services, and Senior Citizens Committee in Trenton and said what I have been saying for more than thirty years: the failures happening inside this state's worst-performing nursing homes are not accidents. They are the predictable result of a system designed to move money out of resident care and into owners' pockets, and the residents paying the price are the most vulnerable people in New Jersey.
That day, the committee was hearing testimony on Senate Bill S-2980, legislation that would require nursing homes to disclose their financial transactions with related companies they own and control. The bill passed out of committee. It now heads to the full Senate for a vote.
I want to tell you what I told them, and what I see every time I open a case file.
"This Is Not COVID. This Has Been Decades."
That is what I said in Trenton, and I meant every word.
For more than thirty years, I have worked inside long-term care: first as a volunteer in facilities, then as a national public policy advocate, and now as an attorney representing families whose loved ones were seriously injured or killed because of care failures at some of New Jersey's worst-performing nursing homes. I have reviewed the cost reports. I have followed the money. I know what I am looking at.
What I told the committee is what I see in every case I handle: money is leaving these buildings. Not through one or two companies, but through six, seven, eight, nine, sometimes ten separate related companies, holding companies, and entities that are completely employee-less on paper. The cost reports show the payments going out. What they do not show is where that money ends up, or how much of it ever reaches a resident.
I have seen facilities spending $2.49 per resident per day on three meals and two snacks. I have documented missing oxygen tanks, broken call bells, absent bed alarms, and pressure-relieving mattresses that simply do not exist. These are not supply chain problems. They are budget decisions made by people who are simultaneously paying themselves millions through the related companies they control.
What we need is not more money for these operators. What we need is audits. Certified financial disclosures. Accountability. S-2980 is a start.
What This Bill Would Actually Change
To understand why this legislation matters, you need to understand how nursing home ownership works in practice, because it looks nothing like what most families assume.
When a private equity firm or investment group buys a nursing home, it rarely operates as a single entity. The ownership group usually sets up several separate companies around the facility. One company owns the real estate and collects rent, another manages operations, and others provide food, staffing, or therapy services. Although these companies appear to be independent vendors on paper, they are often controlled by the same people who own the nursing home. In practice, they are frequently owned by the same people who own the facility itself.
The nursing home pays all those related companies with funds it receives from Medicaid, Medicare, and private payers. And because the owner sits on both sides of every transaction, there is no independent check on whether any of those payments reflect fair market value.
Consider what New Jersey Long Term Care Ombudsman Laurie Facciarossa Brewer told the committee about Trenton Gardens nursing home in Trenton. The previous owners paid $1.2 million per year to lease the property. When new owners took over two years ago, the rent became $3.3 million for the exact same building, with no significant capital improvements. Two million dollars a year more, flowing straight to the new owners' own real estate company.
That is what happens when there is no transparency requirement. That money does not disappear into the abstract. It disappears from staffing budgets, from food service contracts, from maintenance queues, from the elevator that has not worked in three years.
Current law requires nursing homes to report related-party transactions on cost reports, documents certified under penalty of fraud. But those reports show only what the nursing home paid out. They do not show what the receiving company did with the money, or how much actually reached residents. S-2980, sponsored by Senator Joseph Vitale and Senator Angela McKnight, would change that by requiring detailed disclosures that let regulators and policymakers follow the full trail.
The People Who Made the Trip to Trenton
The most powerful thing about this hearing was not the data. It was the people who showed up.
Getting to the state house from a nursing home is not easy. Ray DiFrancesco, a resident at Carnegie Post Acute Care Center in Plainsboro, told the committee upfront: showing up that day would cost him and his fellow residents physically, in pain and exhaustion, for days afterward. They came anyway.
DiFrancesco spent his career at Bank of America. He understands how institutional money flows and vendor oversight. Every vendor that his bank worked with had to disclose ownership structures, subcontractors, and performance metrics, and was monitored constantly. Nursing homes receiving millions in public dollars, he told the committee, face none of that scrutiny. A door to his facility's outdoor courtyard has been broken for two years. The repair estimate is $2,500. The owners have not made it. His windows leak badly enough that he packed material around them himself.
"They take the money, and they steal it from our care," he said.
Tanette Clegg, a resident at Trenton Gardens for more than four years, described a facility that changed overnight when new ownership took over. Before the new owners came, the administrator would meet with residents within days of a complaint, hear them out, and follow up. That administrator treated them with dignity. She said the situation is completely different now.
Gail Smith, a resident at Waterfront in Somerset County, described linens with brown stains and holes, soiled sheets that go unchanged for days, and an hour waiting for a response to a call bell in the middle of the night. Then there is the retaliation, the same pattern every resident who speaks up describes, for having the audacity to complain.
"Those of us who speak up, speak for ourselves and for all the residents who cannot speak up," Smith told the committee. "Besides the fear of retaliation, some are afraid of being kicked out. So they stay quiet."
These residents traveled to Trenton to say: This is what happens when the money leaves and no one is watching. It is the same pattern I document in my cases.
What the Numbers Say
New Jersey's Long Term Care Ombudsman reviewed 2023 data and found that 90 percent of New Jersey nursing homes reported at least one related-party transaction. At some facilities, those transactions consumed 60 percent of all spending. That same year, New Jersey nursing homes received $4 billion in combined Medicaid and Medicare funding, which accounted for three-quarters of their total revenue.
AARP New Jersey reviewed cost reports from 2021 to 2023 and found that nursing home owners directed nearly $2 billion to companies they controlled for rent, management, therapy, and food services. Many of these payments were higher than the cost of the same services if purchased from independent providers.
Retired registered nurse Catherine Hunt made the staffing situation easy to understand. In New Jersey, residents in for-profit nursing homes typically receive about 3.6 hours of nursing care per day, while those in nonprofit homes get an average of 4.67 hours. Having more staff helps prevent falls, infections, hospitalizations, and pressure wounds, making a real difference in residents' lives. If a facility claims it cannot afford enough staff, the real question is not about underfunding, but rather where the money is actually going.
The Industry Did Not Show Up
The nursing home industry was invited to testify at this hearing. They chose not to send a single representative. They submitted written comments instead.
Senator Vitale addressed that directly from the dais. He called it disrespectful and unconscionable, and said he was not surprised.
Families who interact with these facilities are familiar with this lack of response. They experience unanswered call bells and administrators who remain out of reach, staying behind closed office doors. It’s the "we're working on it" that stretches into years. The industry's absence from a hearing about where billions of public dollars are going is entirely consistent with the posture residents and families face inside these buildings every day.
Where This Stands and What You Can Do
S-2980 passed the committee on a largely party-line vote. It now moves to the full Senate, where Senate President Nick Scutari controls whether it gets scheduled for a floor vote. A companion bill, A-4722, has been introduced in the Assembly by Assemblywoman Shanique Speight.
If your family has a loved one in a New Jersey nursing home, assisted living facility, or group home, this legislation is directly relevant to you. Whether there are adequate staff to answer a call bell, whether equipment functions, whether food is safe, all of it connects to whether money is reaching residents or being routed somewhere else first. That is what this bill would reveal.
Contact your state senator and ask them to support S-2980. Contact your assembly representative and ask them to support A-4722. Find your legislators at njleg.state.nj.us.
If your loved one is in a facility, keep a record of what you see each time you visit. Pay attention to the condition of their room, how quickly staff respond to call bells, the quality of the food, and any complaints your family member makes, and whether those concerns are addressed. You can also ask the facility in writing for staffing levels for each shift, as well as for care plans and medical records.
If care has already failed and your loved one was seriously injured, those records often tell exactly what happened and why. That is where accountability begins.
Were you or a loved one a resident of a nursing home, assisted living, or group home and injured due to failures in care?
Better Call Schall® at 856-310-6782 or send a message through our contact form.
Important: Time limits apply. If this happened recently, contact us promptly.
This post is general information, not legal advice.
To read the full article detailing the hearing, click here.
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