California Nursing Home Abuse Lawyer Blog
A recent investigation by KFF Health News sheds light on a troubling trend in long-term care: real estate investors are increasingly purchasing nursing homes and assisted living facilities, sometimes with devastating consequences for residents. As these financial structures grow more complex, families are left wondering who is truly responsible when care fails.
At the center of the reporting is the heartbreaking story of Pearlene Darby, an 81-year-old retired teacher. According to the article by KFF Health News, Darby suffered severe, preventable pressure injuries while living at a Sacramento facility. By the time she was hospitalized in 2020, she had open sores on multiple parts of her body and a large wound on her tailbone. She died just two weeks later from infections linked to those injuries. Her daughter filed a lawsuit alleging neglect, including claims that Darby was repeatedly left sitting in her own waste.
This is not an isolated story. Another family, represented by Leslie Adams, secured a $17 million verdict after his mother, Shirley, died from infected bedsores at a rehabilitation center. Yet even with a substantial judgment, the family has struggled to collect. These cases illustrate a recurring issue in elder care litigation: accountability becomes murky when ownership and operations are split between multiple entities.
The article explains that many long-term care facilities are now owned by real estate investment trusts, or REITs. Under federal law, REITs cannot directly operate healthcare facilities. Instead, they lease properties to management companies that run the day-to-day operations. On paper, this creates a clean separation between landlord and operator. In reality, the lines are far less clear.
In Pearlene Darby’s case, the facility was owned by CareTrust REIT. Court records showed that while the nursing home struggled financially, it still paid over $1 million in rent to the REIT in the year Darby died. Internal documents revealed that the landlord was not entirely hands-off. It selected the management company, required a minimum occupancy rate, and closely tracked spending on staffing and food. It also monitored Medicare ratings and safety inspections.
Despite this level of involvement, the REIT maintained that it was merely a property owner and not responsible for patient care. That defense is common in these cases. However, the reporting by KFF Health News raises an important question: when financial control influences operational decisions, can landlords truly disclaim responsibility?
From a legal and practical standpoint, these ownership structures can create dangerous incentives. Facilities operating under tight financial constraints may cut corners on staffing, training, or supplies. Understaffing, in particular, is one of the leading causes of preventable harm in nursing homes, including pressure ulcers, falls, and infections. When a facility must prioritize rent payments and occupancy targets, resident care can suffer.
For families, this makes pursuing justice more complicated. It is no longer enough to look at the facility itself. A thorough investigation often requires examining the entire ownership chain, including landlords, management companies, and affiliated entities. In some cases, evidence of control or influence by a REIT may open the door to broader liability.
The takeaway is clear: as private investment continues to reshape the long-term care industry, transparency and accountability must keep pace. Families placing loved ones in nursing homes deserve to know not just who is providing care, but who is ultimately calling the shots.
As highlighted by the reporting from KFF Health News, these are not abstract policy concerns. They are real-world issues affecting vulnerable residents and the families who depend on these facilities to provide safe, dignified care.
