16 Nursing Homes, One Bankruptcy, a threat to our seniors

If you have a parent, a grandparent, or a spouse in a New Hampshire nursing home, there's roughly a one-in-five chance their care is in the hands of a company that filed for bankruptcy this year — and the people who write the rules in Washington have spent the past year making the problem worse, not better.

Genesis HealthCare, the Pennsylvania-based chain that operates 16 of New Hampshire's 74 skilled nursing facilities, filed for Chapter 11 bankruptcy on July 9, 2025, in a federal court in Texas. Genesis runs homes in Bedford, Claremont, Concord, Exeter, Franklin, Hampton, Laconia, Lebanon, Keene, Manchester, Milford, Peterborough, Rochester, and Winchester. The company's spokesperson promises that no facilities will close and that daily operations will continue "uninterrupted."

That reassurance deserves scrutiny. "No closures" is not the same as "no harm" — and the harm is documented.

Research by Harvard Business School Assistant Professor Samuel Antill shows that residents in nursing homes operating under bankruptcy protection are more likely to be hospitalized and spend more days in the hospital than residents in stable facilities. The reason isn't mysterious. Bankruptcy drives staff turnover. Nurses and aides leave when paychecks feel uncertain, and the ones who stay get stretched across more residents. For a frail 85-year-old, the cost of that turnover is measured in missed medications, untreated infections, falls that didn't have to happen, and avoidable trips to the emergency room.

This is not a hypothetical concern about Genesis. A KFF Health News investigation found that the federal Centers for Medicare and Medicaid Services already rate 58 percent of Genesis-affiliated nursing homes as "below average" or "much below average." The same reporting documented Genesis using its bankruptcy filing to delay or avoid paying out settlements to families whose loved ones were injured or died in its facilities — settlements the company had already agreed to. Before filing, Genesis was reportedly spending roughly $8 million a month defending and resolving injury and wrongful-death claims.

So this is a chain with a problematic quality-of-care track record, operating a sixth of New Hampshire's nursing home beds, now seeking the protection of a bankruptcy court that is staying payments to grieving families. And the federal government has chosen this moment to weaken the rules that exist to protect residents.

On December 2, 2025, the Centers for Medicare and Medicaid Services published an interim final rule rescinding the minimum staffing standards finalized in 2024. Effective February 2, 2026, nursing homes are no longer required to have a registered nurse on site 24 hours a day, seven days a week. The requirement for 3.48 hours of total nursing care per resident per day — including specific minimums for registered nurses and nurse aides — is gone. The standard reverts to requiring an RN on site for just eight consecutive hours a day. Researchers at the University of Pennsylvania had estimated the repealed rule would save approximately 13,000 lives every year.

The repeal didn't happen in isolation. The One Big Beautiful Bill Act, signed into law in July, locked in a moratorium on the staffing rule through 2034 and tightened the Medicare and Medicaid screws that nursing homes rely on to operate. Industry analysts warn the combined effect — weaker staffing rules and shrinking federal payments — puts hundreds of US nursing homes at higher risk of closure over the next several years. In a rural state with a thin margin of facilities, that's a population-level risk.

New Hampshire is the second-oldest state in the country by median age. Our rural counties communities already operate close to the bone. Brendan Williams of the New Hampshire Health Care Association put it plainly: if a Genesis facility in Claremont were to close, where would those residents go? There isn't a bigger facility down the road. There often isn't a facility down the road at all.

The Genesis bankruptcy is a story about one company's finances. But the larger story is about a system that depends on adequate staffing, predictable federal funding, and meaningful accountability when things go wrong — and all three of those legs are getting shorter at once.

Voters in New Hampshire should be asking every candidate, every official, every regulator the same questions. What is your plan to keep these nursing homes safely staffed? What is your plan to keep them open in towns where there is no alternative? And if a national chain with a documented record of substandard care can use bankruptcy court to wipe out its obligations to the families it harmed, who exactly is the system protecting?

The people in these 16 facilities are our neighbors. They built this state. They deserve better than a wait-and-see posture from the people they sent to Concord and Washington.