Op-Ed: 16 Nursing Homes, One Bankruptcy, a threat to our seniors

I published this piece in the Conway Daily Sun on Monday. You can read it on their website.

If you have a parent, a grandparent, or a partner 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 last year. And, unfortunately, too many of the people who write the rules in Washington have spent the past year making the problem worse instead of better.

Genesis HealthCare, the Pennsylvania-based chain that operates 16 skilled nursing facilities in NH, 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 promised that no facilities would close and that daily operations would continue "uninterrupted."

That claim deserves scrutiny. "No closures" is not the same as "no harm." 

Research by Harvard Business Schoolʼs 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 cause is clear. Bankruptcy drives staff turnover and can lead to short staffing. For an 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. A KFF Health News investigation found that the federal Centers for Medicare and Medicaid Services already rate 58% of Genesis-affiliated nursing homes as "below average" or "much below average." After the private-equity firm ReGen took 93% control, the share of Genesis facilities rated above average fell from 38% to 15%. The KFF 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. These are settlements the company already agreed to. Before filing, Genesis was reportedly spending roughly $8 million a month defending and resolving injury and wrongful-death claims.

So a chain with a concerning quality-of-care record, operating a sixth of New Hampshire's nursing home beds, is 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. Researchers at the University of Pennsylvania had estimated the repealed rule would save approximately 13,000 lives every year. Now, the required 3.48 hours of total nursing care per resident per day — including specific minimums for registered nurses and nurse aides — is gone. And the old standard that an RN be on site for only eight consecutive hours a day is back.

The repeal didn't happen in isolation. The One Big Beautiful Bill Act, which was signed into law last July, locked in a moratorium on the staffing rule through 2034 and made the margins that Medicare and Medicaid that nursing homes rely on to operate even worse. Industry analysts warn the combined effect of 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 limited number of facilities, that's a problem.

By median age, New Hampshire is the second-oldest state in the country. 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 or a company is taken over and stripped for parts by private equity. 

Voters in New Hampshire should be asking every candidate and elected official the same questions. What is your plan to keep our nursing homes operating and safely staffed? 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 facilities are our family members and our neighbors. They built this state and deserve better care in their golden years from the people in Concord and Washington.