As some nursing homes cry poverty, what can be done about increased staffing requirements?

Nursing home operators often have multiple related companies that do business with one another, said Ashvin Gandhi, a professor and faculty associate at the UCLA Center for Health Policy Research, and they sometimes use “tunneling” practices to obscure true profitability.

By way of explanation, he told me a nursing home might sell its building and land to a sister company, and then pay inflated rent to that company. Or it might contract with another sister company for management services and pay inflated rates. The same can be done with food services, say, or laundry services.