Over the past several years, a surge of out-of-state nursing home operators has dramatically reshaped the landscape of elder care in Massachusetts. Since 2019, nine previously small chains based in New York and New Jersey have expanded their presence in the state, collectively acquiring control of 61 nursing homes—approximately one in five facilities statewide. This rapid growth has prompted increased scrutiny from regulators and raised concerns among families and caregivers about the quality of care.
Analysis of federal data indicates that the average quality ratings of these newly acquired nursing homes have declined following each transfer in ownership. Interviews with residents’ relatives and former staff paint a troubling picture involving delayed responses to call bells, prolonged periods of residents left unattended in unsanitary conditions, and other lapses in basic care. One incident documented in inspection reports details a blind man in a wheelchair who suffered a brain hemorrhage after descending an unsecured ramp.
A central figure in this wave of acquisitions is Eli Mirlis, CEO of RegalCare Management Group, who has rapidly built a portfolio of nursing homes across Massachusetts. Mirlis, 38, grew up in modest circumstances and has publicly stated that his business interests are valued in the tens of millions of dollars. However, federal records and whistleblower complaints have linked several of his facilities with declining standards of care. Families affected by the management of RegalCare homes have expressed fears and frustrations, often citing a lack of alternative placement options for their loved ones. Former employees have also spoken out about the challenging conditions they witnessed, with some describing the experience as emotionally distressing.
Financial documentation reveals complex ownership and management structures, involving layered transactions between real estate holdings and operational entities, which obscures transparency. For instance, in one Taunton facility operated by RegalCare, nursing expenditure reportedly decreased by hundreds of thousands of dollars, while rent payments to a company owned by Mirlis dramatically increased. This arrangement raises questions about financial priorities and their potential effects on staffing and direct patient care.
Regulators responsible for approving these ownership changes have largely continued to authorize transactions, even as concerns mounted. Amid the investigation into these developments, a recent federal whistleblower case involving Mirlis concluded with a $1 million settlement. The case alleged that his company engaged in fraudulent billing by requiring frail residents to undergo unnecessary physical therapy, inflating Medicare and Medicaid claims.
The experience of families such as that of Michael Fothergill, a resident at one of RegalCare’s Medford facilities, underscores the human toll behind the corporate maneuvers. Liberation Iannillo, Fothergill’s son, appealed repeatedly to state regulators to investigate conditions at the facility, stressing the urgent need for oversight to protect vulnerable elders.
The rapid expansion of nursing home ownership by out-of-state companies, the opaque management networks behind them, and regulatory leniency have combined to create a complex and concerning picture for Massachusetts’ long-term care sector. As the state continues to reconcile these challenges, questions remain about the capacity of oversight bodies to ensure quality care as corporate interests reshape this critical industry.