04/30/2026
Senate Oversight Committee hears report critical of nursing home quality
Gongwer 4-29-26 The Michigan Elder Justice Initiative delivered a report examining the quality of nursing homes to the Senate Oversight Committee on Wednesday.
The report focuses on four nursing home chains with documented histories of poor performance, weak financial oversight, chronic understaffing, inadequate care and diminished quality of life for residents.
"There are thousands of people across the state, your constituents, who are living in nursing homes and are not getting the quality of care, quality of life that you would consider acceptable for yourself or you would want for somebody you cared about," said Alison Hirschel, director of the Michigan Elder Justice Initiative.
Salli Pung, the State Long-Term Care Ombudsman, said she has seen many changes to Michigan's nursing homes in the past 35 years. Today, she said, nursing homes operate under conditions that would have caused them to close in the past, and homes that provide excellent care are exceptions, many of them having long waitlists.
"From my time at MDHHS which was over 10 years, I would have estimated that about 10% of the nursing homes fell into a category of concern, and today when I look across our nursing home population I think that's higher to 50%," she said.
Residents are put at risk due to lack of staff, lack of supplies, services and finances. Common concerns related to budget constraints at nursing homes include incontinence care not being attended to for hours, some residents lying in beds saturated with urine and bodily fluids and limiting residents to one shower a month, Pung said.
"Can you imagine not being able to take a shower more often than once a month?" she said.
Their budgets limit the amount of staff as well. Nursing homes do not generally have trouble recruiting workers but retaining them is a different story, Pung said.
Some nursing homes do not have enough money for wipes, medications and linens due to budget constraints, resulting in staff members paying out-of-pocket expenses for these items for residents. Residents also report poor food quality and quantity in homes, she said.
These services and items are covered by Medicare and Medicaid with taxpayer dollars, but residents are struggling to get basic needs met in many homes, Pung said.
Residents of nursing homes submitted testimony talking about how lack of services and lack of enrichment activities significantly diminish their quality of life. One resident said he "felt like a plant in the corner that the staff just had to water to keep alive."
Nursing homes should be transparent about where the money is being allocated, said Ashvin Gandhi, a researcher with the National Bureau of Economics.
He also said there is a discrepancy between the claim nursing homes are not profitable because they are sold for large sums of money by private investors, sometimes at $100,000 per bed, and we need to determine how profitable they really are.
He said there could be profit funneling to the owner of a nursing home through related party supplier transactions. The nursing home could be paying an inflated price for the goods and services, and paying the owner of the home. The related party supplier could be providing the owner of the home with hidden profits.
Detailed reporting of ownership structure and related party payments are necessary for transparency, which can regulate risky financial behavior, Gandhi said.
Sen Dayna Polehanki, D-Livonia, asked why financial transparency is not happening.
Gandhi said reporting requirements are required for the entity licensed as the nursing home, but loopholes exist where they don't have to disclose financial information about other entities involved in the nursing home, where they will then funnel the profits.
Committee chair Sen. Sam Singh, D-East Lansing, said he would be happy to work on resolving these issues.
Richie Farran, executive vice president of government services at the Health Care Association of Michigan, the association of nursing homes, said every Medicaid dollar is reported in a cost report, and there is an auditing process allowed by DHHS that makes sure money is spent appropriately. There are settlements where providers have to pay money back to the state.
Farran commended the attention placed on ensuring quality nursing home care and said HCAM's members are the most committed to that goal.
A key issue at nursing homes when it comes to quality is staffing, he said.
"We're looking at just a demographic challenge as the demand for care will increase. The caregivers are just not there," he said. "So providers are doing everything they can to hire as much staff as they can. Quality staff means quality care. But when you're asked to reach into a pool where the people just aren't there, it makes it more difficult."
