There are over 15,000 nursing homes (NHs) in the United States caring for 1.2 million people who need inpatient rehabilitation, skilled nursing care, and/or personal assistance services. While most NHs are for-profit and privately owned, they are primarily funded by taxpayer dollars through Medicaid and/or Medicare. Because of the very large public investment in NH care, U.S. policymakers, health care and aging stakeholders, residents, and advocates have all expressed interest in increasing operational transparency — including nursing home ownership, cost, and quality of care.

Following efforts to increase NH transparency through the Affordable Care Act and Centers for Medicare & Medicaid Services’ (CMS) Medicare reporting requirements, the Biden-Harris Administration announced a package of NH reform recommendations in 2022, which called for increased transparency in NH ownership and operations. On November 15, 2023, CMS responded with a final rule requiring increased transparency in NH operations.

This Better Care Playbook blog post, coauthored by CHCS’ Emma Rauscher and Carrie Graham, describes this new rule and explores the potential impact on NH operations. Since states bear a large responsibility for NH oversight, licensure, and certification, this blog post suggests opportunities for states to respond to this rule and further promote transparency.