Of the two Maryland nursing homes that federal officials placed on a national watch list this year, both are owned by private equity groups: ManorCare-Rossville by the Carlyle Group and the Waldorf Center by Formation Capital, which last year acquired Genesis HealthCare. Genesis operates 22 nursing homes in Maryland. Manor Care-Rossville and the Waldorf Center will be inspected twice a year instead of once and face possible penalties.
Kronmiller stressed that problems at the two nursing homes were detected over three years and began before the acquisitions.
But SEIU officials warn that private equity groups hold companies in their portfolios "accountable to profits, but not quality of health care or how they treat their workers."
"Private equity is corporate greed on steroids; how that melds with patient care is hard for us to figure out," said Stephen Lerner, director of SEIU's private equity campaign.
HCR ManorCare, in a written statement, said Carlyle expects to make a profit by selling its investment.
"That's how Carlyle will make money ... not by cutting costs or staffing or anything else, but by helping make HCR ManorCare a stronger care provider," the statement said.
Advocates for nursing home residents in Maryland said they have not documented a link between ownership type and poor care, noting that the number of violations of federal and state regulations discovered during inspections varies within large corporate chains and that some nursing homes owned by nonprofits have fared poorly in recent state inspections.
"Each nursing home is a separate entity, and there are quite wide variations in care," said Bob Bronaugh, vice chairman of Voices for Quality Care, a nonprofit group based in Leonardtown.
Charlene Harrington, a professor in the School of Nursing at the University of California-San Francisco, said studies she has helped conduct since 2000 have found that for-profit nursing homes across the nation operate with lower costs and smaller staffs than nonprofits, which provide more staff and higher quality care.
"I am not sure they need to do another study," said Harrington, referring to Maryland officials.
Private equity firms began to buy nursing homes in 2000, according to David G. Stevenson, an assistant professor at Harvard Medical School in Boston.
Stevenson said a study he recently completed did not find that nursing home quality "worsens markedly" after purchase by private equity firms, but he said more research was needed.
