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Distressed nursing homes and financial stress data

WhoOwnsCare scores 5,875 Medicare-certified nursing homes across California, Texas, Florida, Ohio, Illinois, Pennsylvania and New York on four dimensions of stress — operational, regulatory, financial and corporate. 0 sit in the high or severe band.

The financial dimension is built from Medicare cost reports: the average operating margin across scored facilities is -9.2% and average occupancy of certified beds is 76.7%.

CMS ownership and enrollment files 2026-08-19Retrieved 2026-08-20Ownership graph generated 2026-08-20HCRIS fiscal year 2023

Distress by state

StateHigh or severeFacilities scoredAverage scoreDetail
Pennsylvania063830.6Pennsylvania distress
California01,13127.9California distress
Florida067824.3Florida distress
Texas01,15934.1Texas distress
Illinois064635.7Illinois distress
Ohio091729.7Ohio distress
New York054528.9New York distress

What the distress score measures

Four dimensions, weighted: operational 30%, regulatory 30%, financial 20%, corporate 20%. Operational uses staffing hours, turnover and contract labour share. Regulatory uses health citations, severity and civil monetary penalties. Financial uses cost-report operating margin, occupancy and payer mix. Corporate uses ownership churn and the stress profile of the wider corporate family.

A high score is a signal to look, not a conclusion. It does not mean a facility is closing, is for sale, or is providing poor care, and this data must not be used for any purpose covered by the Fair Credit Reporting Act.

Common questions

What makes a nursing home financially distressed?

Sustained negative operating margin, low occupancy against certified beds, heavy reliance on contract labour, and a payer mix weighted to Medicaid. Cost reports make all four measurable.

Are distressed nursing homes for sale?

Not necessarily, and the public record does not say. Distress scoring identifies operating and financial stress, nothing more.