RICHMOND, Va. — Ten chains own or operate 61% of Virginia nursing homes, according to data from the Department of Medical Assistance Services (DMAS), which manages the state's Medicaid program.
Nearly half of those facilities are rated below average or much below average, according to the data. Some of those chains have an even higher concentration of low-rated homes.
The federal Centers for Medicare and Medicaid Services (CMS) defines chains as nursing homes with common owners or operational control. CMS collects and publishes chain data to help consumers identify trends among these groups and make informed decisions about their care.
Last month, DMAS presented ownership data at a Nursing Home Oversight Advisory Panel meeting without naming the chains. CBS 6 later received the names from DMAS upon request.
For five of the chains, according to DMAS, a majority of their nursing homes had a one or two-star overall rating from CMS. That means they perform below or much below average on a metric that combines the facilities' health inspection results, staffing data, and quality measures.
Of Trio Healthcare's nine facilities, DMAS data showed 100% were rated one or two-star, meaning all of the chain's Virginia nursing homes performed below average.
CBS 6 asked the company about its ratings and what it was doing to improve them. Chief Marketing Officer Alan Cosby said the star ratings rely heavily on health inspection outcomes, which he said reflect "a snapshot in time" and do "not always tell the full story of the care being provided day in and day out."
Cosby added the "best way to understand life at a Trio Healthcare center is to see it firsthand" and that the company continually looks "for ways to better support our residents and their families."
Of Eastern Healthcare Group's 18 Virginia facilities, DMAS data showed 94% were 1 or 2-star. Eastern has not responded to CBS 6's requests for comment.
Of Hill Valley Healthcare's 24 Virginia facilities, DMAS data showed 71% were 1 or 2-star. Hill Valley has not responded to CBS 6's requests for comment.
Of Avardis Health's 11 Virginia facilities, DMAS data showed 64% were 1 or 2-star.
In response, Chief Executive Officer Tiffany Hoback said Avardis "assumed management responsibility for these centers last year, so some current ratings reflect historical performance and legacy conditions from before or during the transition."
"The centers meet all applicable state licensure standards and federal requirements for participation which provide important baseline expectations. Beyond those standards, our dedicated, hard-working staff show up every day committed to maintaining and improving resident safety and care outcomes for those entrusted to their care," Hoback said.
Of Lifeworks Rehab's 34 facilities that are assigned ratings, DMAS data showed 53% were 1 or 2-star. CBS 6 notes that three of those rated facilities recently changed operators, which has not yet been fully updated in the CMS chain database. Lifeworks Rehab has not responded to CBS 6's requests for comment.
CBS 6 also asked DMAS how it's using this data in its oversight role. The agency has not responded.
CMS says states could use chain data to deny acquisitions by chains with poor inspection and staffing records.
But the Virginia Department of Health, which is responsible for licensing nursing homes, has previously said chain ratings are not a part of its change of ownership review process.
Licensing director April Dovel said VDH does not track inspection results by ownership group but is hiring complaint analysts that could begin tracking that data.
"I wanted to focus on regional trends and have one complaint analyst really focusing on that region to see if we could identify any trends, and if there is a potential problematic provider that we would be able to flag that, so we could have some dialog with those provider agencies," Dovel said.
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