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Staff at Berkeley Lab’s X-Ray facility mobilize to support COVID-19-related research

Staff at Berkeley Lab’s X-Ray facility mobilize to support COVID-19-related research

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Advanced Light Source experiments focus on proteins related to virus that has infected about 2 million people worldwide

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Credit: Thor Swift, Marilyn Sargent/Berkeley Lab

X-rays allow researchers to map out the 3D structure of proteins relevant to diseases at the scale of molecules and atoms, and Lawrence Berkeley National Laboratory’s (Berkeley Lab’s) Advanced Light Source (ALS) X-ray facility has been recalled to action to support research related to COVID-19, the coronavirus disease that has already infected about 2 million people around the world.

A small team of staff at the ALS, which produces beams of X-rays and other types of light to support a wide variety of experiments for researchers from around the world, on March 31 launched several experiments for other scientists who controlled the work remotely.

At this time, only approved COVID-19-related experiments are allowed at ALS – most staff and experiments at the ALS and Berkeley Lab have been sidelined because of shelter-in-place orders that are intended to limit the spread of the virus.

A small group of ALS staff who run the accelerator and ensure safe operations have supported on-site work since experiments resumed.

The specially approved ALS experiments – which were authorized by Berkeley Lab leadership – have so far been carried out by individual scientists working at separate experimental sites, known as beamlines, in the ALS facility in order to maintain social distancing. Additionally, on-site workers are taking extra precautions for safety such as regularly sanitizing equipment.

None of the work involves any live samples of the SARS-CoV-2 virus that causes COVID-19. The samples include crystallized viral proteins that cannot cause infection. Additional samples to be analyzed include host-cell proteins required for infection by the virus.

“Everyone I’ve talked to is taking an ‘everything’ approach,” said Jay Nix, a participant in the new experiments who is beamline director for the Molecular Biology Consortium, which supports and operates a beamline at the ALS (Beamline 4.2.2) and is a lab affiliate and partner.

“Every idea is on the table,” Nix said, including explorations of the form and function of the spiky proteins poking out of the COVID-19 virus in the now-ubiquitous colorized images displayed in COVID-19-related websites and news articles.

Structural studies can lead to drugs that target and attack the virus while leaving other vital systems intact, for example, or that can otherwise improve the body’s defenses against the virus.

“There are proteins that are making up the virus structure and a large number of other, non-structural proteins that help in the infection cycle of the virus,” said Marc Allaire, a beamline scientist at the ALS who supports several beamlines operated by the Berkeley Center for Structural Biology. The center receives support from participating members for this work, including from a large group of pharmaceutical companies across the U.S. and internationally.

The center is a part of the Lab’s Molecular Biophysics and Integrated Bioimaging (MBIB) division, which is connected to all of the beamlines and staff participating in the initial batch of approved COVID-19-related experiments.

The earliest experiments since the ALS restarted used three ALS beamlines (beamlines 4.2.2, 5.0.1, and 5.0.2) that all specialize in macromolecular crystallography, a technique for learning the 3D structure of proteins, viruses, and other samples by beaming X-rays at their crystallized forms.

Light from the X-rays striking the crystals produce patterns that computers then process into 3D reconstructions of the samples.

“I’m pleased the ALS is able to contribute to this important work and make its tools available to the biosciences research community,” said ALS Director Steve Kevan. “I personally want to thank our beamline scientists and operations staff for working together to make this happen under very trying circumstances.”

MBIB Director Paul Adams said, “It is a testament to the importance of the ALS for this kind of biomedical research that so many groups have requested access to help in their efforts to address COVID-19. The beamlines being used for the crystallography work developed a ‘rapid response’ capability several years ago, with remote access and automated data collection and analysis, and so were ready to hit the ground running when this crisis occurred.”

Work that has been approved at the ALS includes proprietary experiments by several pharmaceutical companies: Switzerland-based Novartis, which has an office in Emeryville, California; San Francisco-based Vir Biotechnology; and Canada-based IniXium, a drug-discovery contract research organization serving the U.S. biotech industry.

Also in the first batch are crystallography experiments by a group of researchers from the lab of David Veesler, an associate professor at the University of Washington. That team is focusing on the spiky proteins on the surface of the COVID-19 virus, which the virus uses to bind to and enter host cells, and how to neutralize them.

Another team, led by Daved Fremont, a professor at Washington University in Saint Louis, will be sending crystallized samples to the ALS, as will a team led by James Hurley, the Judy C. Webb chair and professor of biochemistry, biophysics, and structural biology at UC Berkeley.

Hurley said three structural biologists in his lab are working on COVID-19 research: Tom Flower, Cosmo Buffalo, and Snow Ren. The researchers “have an enormous amount of experience with X-ray crystallography and cryo-electron microscopy,” another technique to explore biological samples, he said.

“They have begun working on several projects to characterize structures involved in virus replication, with an emphasis on understanding how viral proteins interact with host proteins and membranes, and on the rapid application of this information to antiviral drug discovery in collaboration with others on campus,” he added.

During the AIDS pandemic of the 1980s, Hurley switched fields from physics to structural biology. “I saw how structural biology helped in a pivotal way in the creation of the HIV antivirals that made AIDS a treatable disease instead of a death sentence. That experience gives me a perspective on how structural biology can help with creating new antivirals,” he said.

A team led by Natalie Strynadka, a biochemistry professor at the University of British Columbia in Canada, is also expected to ship crystal samples for ALS experiments. Strynadka said her lab is collaborating with a team in Vancouver, Canada, to identify small molecular inhibitors that slow down COVID-19’s main viral protease (MPro), an enzyme that breaks down proteins into smaller forms.

In related work, her lab is working with Pennsylvania-based Venatorx Pharmaceuticals and a team led by David Baker at the University of Washington to identify MPro inhibitors. “Understanding where and how these inhibitors bind to MPro using X-ray crystallography will be key in guiding further development,” she said.

Ralf Bartenschlager, a virologist and professor at Heidelberg University in Germany, will be sending samples of COVID-19-infected cells, rendered inactive, for study using a technique known as soft X-ray tomography. In this collaborative effort, the aim is to unravel how infection by the SARS-CoV-2 virus alters the structure and organization of infected cells, with the long-term goal to identify viral and cellular targets perturbed by infection that are suitable for antiviral therapy. The experiment will be overseen by the Lab’s Carolyn Larabell, also a professor at UC San Francisco and director of the National Center for X-ray Tomography, which develops imaging technologies for biological and biomedical research.

The ALS is also asking the research community to submit other proposals for COVID-19-related experiments, Nix said.

ALS and Berkeley Lab leadership are considering whether to open up additional X-ray capabilities, such as small-angle X-ray scattering (SAXS) and wide-angle X-ray scattering, which enables high-speed characterization of biological samples that can be in a more natural form than some other techniques allow.

Greg Hura, an MBIB research scientist and associate adjunct professor at UC Santa Cruz who operates the SIBYLS (Structurally Integrated BiologY for the Life Sciences) Beamline 12.3.1 at the ALS that conducts SAXS experiments, said, “SIBYLS can also play a role in a multi-technique and multi-national lab consortium to visualize the potential weaknesses of the COVID-19 virus, and help develop new diagnostics.”

He added, “Viral genomes (DNA sequences) are small but the large molecules they encode are transformers that can adopt many functions in different contexts. SAXS provides an avenue to study these systems in the many contexts they might be targeted, and can identify the states that are most amenable to viewing them at higher resolution.”

Nix noted that Beamline 4.2.2, which he operates, and some other beamlines at the ALS use robotic sample-delivery systems so that once they are filled with samples, experiments can largely operate via remote control.

“I haven’t had an onsite user in over 5 years,” he said.

It took a team effort, from ALS managers and staff to Berkeley Lab leadership, to make the COVID-19-related research happen, Nix noted. “They were working, even before the ‘lights went out,’ at the Lab, to see what we could do.”

He also noted that a variety of sources of research funding are making this work possible. “It’s public, private, and government support all coming together, which is really nice to see,” he said.

###

The broader research community is welcome to apply for remote experiments relating to COVID-19 and SARS-CoV-2 at some beamlines via the National Institutes of Health-supported ALS-ENABLE program and an ALS fast-track proposal process known as RAPIDD (Rapid Access Proposals, Industry, and Director’s Discretion beam time).

The Advanced Light Source is a DOE Office of Science user facility.

Founded in 1931 on the belief that the biggest scientific challenges are best addressed by teams, Lawrence Berkeley National Laboratory and its scientists have been recognized with 13 Nobel Prizes. Today, Berkeley Lab researchers develop sustainable energy and environmental solutions, create useful new materials, advance the frontiers of computing, and probe the mysteries of life, matter, and the universe. Scientists from around the world rely on the Lab’s facilities for their own discovery science. Berkeley Lab is a multiprogram national laboratory, managed by the University of California for the U.S. Department of Energy’s Office of Science.

DOE’s Office of Science is the single largest supporter of basic research in the physical sciences in the United States, and is working to address some of the most pressing challenges of our time. For more information, please visit energy.gov/science.

Media Contact
Glenn Roberts Jr.
geroberts@lbl.gov

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https://newscenter.lbl.gov/2020/04/15/staff-at-berkeley-labs-x-ray-facility-mobilize-to-support-covid-19-related-research/

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Manufacturing and construction vs. the still-inverted yield curve

  – by New Deal democratProf. Menzie Chinn at Econbrowser makes the point that the yield curve is still inverted, and has not yet eclipsed the longest…

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 - by New Deal democrat


Prof. Menzie Chinn at Econbrowser makes the point that the yield curve is still inverted, and has not yet eclipsed the longest previous time between onset of such an inversion and a recession. So he believes the threat of recession is still on the table.


And he’s correct about the yield curve, although it is getting very long in the tooth. In the past half century, the shortest time between a 10 minus 2 year inversion (blue in the graph below) to recession has been 10 months (1980) and the longest 22 months (2007). For the 10 year minus 3 month inversion (red), the shortest time has been 8 months (1980 and 2001) and the longest has been 17 months (2007):



At present the former yield curve has been inverted for 20.5 months, and the latter for 16.5 months. So if there is no recession by May 1, we’re in uncharted territory as far as the yield curve indicator is concerned.

My view for the past half year or so has been much more cautious. While there has been nearly unprecedented Fed tightening (only the 1980-81 tightening was more severe), on the other hand there was massive pandemic stimulus, and what I described on some occasions as a “hurricane force tailwind” of supply chain unkinking. If the two positive forces have abated, does the negative force of the Fed tightening, which is still in place, now take precedence? Or because interest rates have plateaued in the past year, is it too something of a spent force? Since I confess not to know, because the situation is unprecedented in the modern era for which most data is available, I have highlighted turning to the short leading metrics. Do they remain steady or improve? Or do they deteriorate as they have before prior recessions?

First of all, let me show the NY Fed’s Global Supply Chain Index, which attempts to disaggregate supply sided information from demand side information. A positive value shows relative tightening, a negative loosening:



You can see the huge pandemic tightening in 2020 into 2022, followed by a similarly large loosening through 2023. For the past few months, the Index has been close to neutral, or shown very slight tightness.

Typically in the past Fed tightenings have operated through two main channels: housing and manufacturing, especially durable goods manufacturing.

Let’s take the two in reverse order.

Manufacturing has at very least stalled, and by some measures turned down to recessionary levels.  Last week I discussed industrial production (not shown), which peaked in late 2022 and has continued to trend sideways to slightly negative right through February.

A very good harbinger with a record going back 75 years has been the ISM manufacturing index. Here’s its historical record through about 10 years ago (when FRED discontinued publishing it):



And here is its record for the past several years:



This index was frankly recessionary for almost all of last year. It is still negative, although not so much as before.

Two other metrics with lengthy records are the average hourly workweek in manufacturing (blue, right scale), which is one of the 10 “official” leading indicators, as well as real spending on durable goods (red, measured YoY for ease of comparison, left scale):



As a general rule, if real spending on durable goods turns negative YoY for more than an isolated month, a recession has started (with the peak in absolute terms coming before). Also, since employers generally cut hours before cutting jobs, a decline of about 0.8% of an hour in the average manufacturing workweek has typically preceded a recession - with the caveat in modern times that it must fall to at least roughly 40.5 hours:



The average manufacturing workweek has met the former criteria for the last 9 months, and the latter since November. By contrast, real spending on durable goods was up 0.7% YoY as of the last report for January, and in December had made an all-time record high.

But if some of the manufacturing data has met the historical criteria for a recession warning, it is important to note that manufacturing is less of US GDP than before the year 2000, and had been down more in 2015-16 without a recession occurring.

Further, housing construction has not meaningfully constricted at all. The below graph shows the leading metric of housing permits (another “official” component of the LEI, right scale), together with housing units under construction (gold, *1.2 for scale, right scale), and also real GDP q/q (red, left scale):



Housing permits declined -30% after the Fed began tightening, which has normally been enough to trigger a recession. *BUT* the actual measure of economic activity, housing units under construction, has barely turned down at all. In comparison to past downturns, where typically it had fallen at least 10%, and more often 20%, before a recession had begun, as of last month it was only 2% off peak!

The only other two occasions where housing permits declined comparably with no recession ensuing - 1966 and 1986 - real gross domestic product increased robustly. This was similarly the case in 2023.

An important reason is the other historical reason proppin up expansions: stimulative government spending. Here’s the historical record comparing fiscal surpluses vs. deficits:



Note the abrupt end of stimulative spending in 1937, normally thought to have been the prime driver of the steep 1938 recession. Note also the big “Great Society” stimulative spending in 1966-68, when a downturn was averted (indeed, although not shown in the first graph above, there was an inverted yield curve then as well). Needless to say, there as been a great deal of stimulative fiscal spending since 2020 as well.

Fed tightening typically works by constricting demand. Both government stimulus and the unkinking of supply chains work to stimulate supply. 

All of which leads to the conclusion that, while manufacturing has reacted to the tightening, the *real* measure of construction activity has not, or not sufficiently to be recessionary.

Tomorrow housing permits, starts, and units under construction will all be updated. Unless there is a sharp decline in units under construction, there is no short term recession signal at all.

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Half Of Downtown Pittsburgh Office Space Could Be Empty In 4 Years

Half Of Downtown Pittsburgh Office Space Could Be Empty In 4 Years

Authored by Mike Shedlock via MishTalk.com,

The CRE implosion is picking…

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Half Of Downtown Pittsburgh Office Space Could Be Empty In 4 Years

Authored by Mike Shedlock via MishTalk.com,

The CRE implosion is picking up steam.

Check out the grim stats on Pittsburgh.

Unions are also a problem in Pittsburgh as they are in Illinois and California.

Downtown Pittsburgh Implosion

The Post Gazette reports nearly half of Downtown Pittsburgh office space could be empty in 4 years.

Confidential real estate information obtained by the Pittsburgh Post-Gazette estimates that 17 buildings are in “significant distress” and another nine are in “pending distress,” meaning they are either approaching foreclosure or at risk of foreclosure. Those properties represent 63% of the Downtown office stock and account for $30.5 million in real estate taxes, according to the data.

It also calculates the current office vacancy rate at 27% when subleases are factored in — one of the highest in the country.

And with an additional three million square feet of unoccupied leased space becoming available over the next five years, the vacancy rate could soar to 46% by 2028, based on the data.

Property assessments on 10 buildings, including U.S. Steel Tower, PPG Place, and the Tower at PNC Plaza, have been slashed by $364.4 million for the 2023 tax year, as high vacancies drive down their income.

Another factor has been the steep drop — to 63.5% from 87.5% — in the common level ratio, the number used to compute taxable value in county assessment appeal hearings.

The assessment cuts have the potential to cost the city, the county, and the Pittsburgh schools nearly $8.4 million in tax refunds for that year alone. Downtown represents nearly 25% of the city’s overall tax base.

In response Pittsburgh City Councilman Bobby Wilson wants to remove a $250,000 limit on the amount of tax relief available to a building owner or developer as long as a project creates at least 50 full-time equivalent jobs.

It’s unclear if the proposal will be enough. Annual interest costs to borrow $1 million have soared from $32,500 at the start of the pandemic in 2020 to $85,000 on March 1. Local construction costs have increased by about 30% since 2019.

But the city is doomed if it does nothing. Aaron Stauber, president of Rugby Realty said it will probably empty out Gulf Tower and mothball it once all existing leases expire.

“It’s cheaper to just shut the lights off,” he said. “At some point, we would move on to greener pastures.”

Where’s There’s Smoke There’s Unions

In addition to the commercial real estate woes, the city is also wrestling with union contracts.

Please consider Sounding the alarm: Pittsburgh Controller’s letter should kick off fiscal soul-searching

It’s only March, and Pittsburgh’s 2024 house-of-cards operating budget is already falling down. That’s the clear implication of a letter sent by new City Controller Rachael Heisler to Mayor Ed Gainey and members of City Council on Wednesday afternoon.

The letter is a rare and welcome expression of urgency in a city government that has fallen in complacency — and is close to falling into fiscal disaster.

The approaching crisis was thrown into sharp relief this week, when City Council approved amendments to the operating budget accounting for a pricey new contract with the firefighters union. The Post-Gazette Editorial Board had predicted that this contract — plus two others yet to be announced and approved — would demonstrate the dishonesty of Mayor Ed Gainey’s budget, and that’s exactly what’s happening: The new contract is adding $11 million to the administration’s artificially low 5-year spending projections, bringing expected 2028 reserves to just barely the legal limit.

But there’s still two big contracts to go, with the EMS union and the Pittsburgh Joint Collective Bargaining Committee, which covers Public Works workers. Worse, there are tens — possibly hundreds — of millions in unrealistic revenues still on the books. On this, Ms. Heisler’s letter only scratched the surface.

Similarly, as we have observed, the budget’s real estate tax revenue projections are radically inconsistent with reality. Due to high vacancies and a sharp reduction in the common level ratio, a significant drop in revenues was predictable — but not reflected in the budget. Ms. Heisler’s estimate of a 20% drop in revenues from Downtown property, or $5.3 million a year, may even be optimistic: Other estimates peg the loss at twice that, or more.

Left unmentioned in the letter are massive property tax refunds the city will owe, as well as fanciful projections of interest income that are inconsistent with the dwindling reserves, and drawing-down of federal COVID relief funds, predicted in the budget itself. That’s another unrealistic $80 million over five years.

Pittsburgh exited Act 47 state oversight after nearly 15 years on Feb. 12, 2018, with a clean bill of fiscal health. 

It has already ruined that bill of health.

Act 47 in Pittsburgh

Flashback February 21, 2018Act 47 in Pittsburgh: What Was Accomplished?

Pittsburgh’s tax structure was a much-complained-about topic leading up to the Act 47 declaration. The year following Pittsburgh’s designation as financially distressed under Act 47 it levied taxes on real estate, real estate transfers, parking, earned income, business gross receipts (business privilege and mercantile), occupational privilege and amusements. The General Assembly enacted tax reforms in 2004 giving the city authority to levy a payroll preparation tax in exchange for the immediate elimination of the mercantile tax and the phase out of the business privilege tax. The tax reforms increased the amount of the occupational privilege tax from $10 to $52 (this is today known as the local services tax and all municipalities outside of Philadelphia levy it and could raise it thanks to the change for Pittsburgh).

The coordinators recommended an increase in the deed transfer tax, which occurred in late 2004 (it was just increased again by City Council) and in the real estate tax, which increased in 2015.

Legacy costs, principally debt and underfunded pensions, were the primary focus of the 2009 amended recovery plan. The city’s pension funded ratio has increased significantly from where it stood a decade ago, rising from the mid-30 percent range to over 60 percent at last measurement.

The obvious question? Will the city stick to the steps taken to improve financially and avoid slipping back into distressed status? If Pittsburgh once stood “on the precipice of full-blown crisis,” as described in the first recovery plan, hopefully it won’t return to that position.

The Obvious Question

I could have answered the 2018 obvious question with the obvious answer. Hell no.

No matter how much you raise taxes, it will never be enough because public unions will suck every penny and want more.

On top of union graft, and insanely woke policies in California, we have an additional huge problem.

Hybrid Work Leaves Offices Empty and Building Owners Reeling

Hybrid work has put office building owners in a bind and could pose a risk to banks. Landlords are now confronting the fact that some of their office buildings have become obsolete, if not worthless.

Meanwhile, in Illinois …

Chicago Teachers’ Union Seeks $50 Billion Despite $700 Million City Deficit

Please note the Chicago Teachers’ Union Seeks $50 Billion Despite $700 Million City Deficit

The CTU wants to raise taxes across the board, especially targeting real estate.

My suggestion, get the hell out...

Tyler Durden Mon, 03/18/2024 - 12:10

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Profits over patients: For-profit nursing home chains are draining resources from care while shifting huge sums to owners’ pockets

Owners of midsize nursing home chains harm the elderly and drain huge sums of money from facilities using opaque accounting practices while government…

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The for-profit nursing home sector is growing, and it places a premium on cost cutting and big profits, which has led to low staffing and patient neglect and mistreatment. picture alliance via Getty Images

The care at Landmark of Louisville Rehabilitation and Nursing was abysmal when state inspectors filed their survey report of the Kentucky facility on July 3, 2021.

Residents wandered the halls in a facility that can house up to 250 people, yelling at each other and stealing blankets. One resident beat a roommate with a stick, causing bruising and skin tears. Another was found in bed with a broken finger and a bloody forehead gash. That person was allowed to roam and enter the beds of other residents. In another case, there was sexual touching in the dayroom between residents, according to the report.

Meals were served from filthy meal carts on plastic foam trays, and residents struggled to cut their food with dull plastic cutlery. Broken tiles lined showers, and a mysterious black gunk marred the floors. The director of housekeeping reported that the dining room was unsanitary. Overall, there was a critical lack of training, staff and supervision.

The inspectors tagged Landmark as deficient in 29 areas, including six that put residents in immediate jeopardy of serious harm and three where actual harm was found. The issues were so severe that the government slapped Landmark with a fine of over US$319,000more than 29 times the average for a nursing home in 2021 − and suspended payments to the home from federal Medicaid and Medicare funds.

But problems persisted. Five months later, inspectors levied six additional deficiencies of immediate jeopardy − the highest level.

Landmark is just one of the 58 facilities run by parent company Infinity Healthcare Management across five states. The government issued penalties to the company almost 4½ times the national average, according to bimonthly data that the Centers for Medicare & Medicaid Services first started to make available in late 2022. All told, Infinity paid nearly $10 million in fines since 2021, the highest among nursing home chains with fewer than 100 facilities.

Infinity Healthcare Management and its executives did not respond to multiple requests for comment.

Race to the bottom

Such sanctions are nothing new for Infinity or other for-profit nursing home chains that have dominated an industry long known for cutting corners in pursuit of profits for private owners. But this race to the bottom to extract profits is accelerating, despite demands by government officials, health care experts and advocacy groups to protect the nation’s most vulnerable citizens.

To uncover the reasons why, The Conversation delved into the nursing home industry, where for-profit facilities make up more than 72% of the nation’s nearly 14,900 facilities. The probe, which paired an academic expert with an investigative reporter, used the most recent government data on ownership, facility information and penalties, combined with CMS data on affiliated entities for nursing homes.

The investigation revealed an industry that places a premium on cost cutting and big profits, with low staffing and poor quality, often to the detriment of patient well-being. Operating under weak and poorly enforced regulations with financially insignificant penalties, the for-profit sector fosters an environment where corners are frequently cut, compromising the quality of care and endangering patient health.

Meanwhile, owners make the facilities look less profitable by siphoning money from the homes through byzantine networks of interconnected corporations. Federal regulators have neglected the problem as each year likely billions of dollars are funneled out of nursing homes through related parties and into owners’ pockets.

More trouble at midsize

Analyzing newly released government data, our investigation found that these problems are most pronounced in nursing homes like Infinity − midsize chains that operate between 11 and 100 facilities. This subsection of the industry has higher average fines per home, lower overall quality ratings, and are more likely to be tagged with resident abuse compared with both the larger and smaller networks. Indeed, while such chains account for about 39% of all facilities, they operate 11 of the 15 most-fined facilities.

With few impediments, private investors who own the midsize chains have swooped in to purchase underperforming homes, expanding their holdings even as larger chains divest and close facilities.

“They are really bad, but the names − we don’t know these names,” said Toby Edelman, senior policy attorney with the Center for Medicare Advocacy, a nonprofit law organization.

In response to The Conversation’s findings on nursing homes and request for an interview, a CMS spokesperson emailed a statement that said the CMS is “unwavering in its commitment to improve safety and quality of care for the more than 1.2 million residents receiving care in Medicare- and Medicaid-certified nursing homes.”

“We support transparency and accountability,” the American Health Care Association/National Center for Assisted Living, a trade organization representing the nursing home industry, wrote in response to The Conversation‘s request for comment. “But neither ownership nor line items on a budget sheet prove whether a nursing home is committed to its residents.”

Ripe for abuse

It often takes years to improve a poor nursing home − or run one into the ground. The analysis of midsize chains shows that most owners have been associated with their current facilities for less than eight years, making it difficult to separate operators who have taken long-term investments in resident care from those who are looking to quickly extract money and resources before closing them down or moving on. These chains control roughly 41% of nursing home beds in the U.S., according to CMS’s provider data, making the lack of transparency especially ripe for abuse.

A churn of nursing home purchases even during the pandemic shows that investors view the sector as highly profitable, especially when staffing costs are kept low and fines for poor care can easily be covered by the money extracted from residents, their families and taxpayers.

A March 2024 study from Lehigh University and the University of California, Los Angeles also shows that costs were inflated when nursing home owners switched to contractors they controlled directly or indirectly. Overall, spending on real estate increased 20.4% and spending on management increased 24.6% when the businesses were affiliated, the research showed.

“This is the model of their care: They come in, they understaff and they make their money,” said Sam Brooks, director of public policy at the Consumer Voice, a national resident advocacy organization. “Then they multiply it over a series of different facilities.”

This is a condensed version of an article from The Conversation’s investigative unit. To find out more about the rise of for-profit nursing homes, financial trickery and what could make the nation’s most vulnerable citizens safer, read the complete version.

Campbell is an adjunct assistant professor at Columbia University and a contributing writer at the Garrison Project, an independent news organization that focuses on mass incarceration and criminal justice.

Harrington is an advisory board member of the nonprofit Veteran's Health Policy Institute and a board member of the nonprofit Center for Health Information and Policy. Harrington served as an expert witness on nursing home litigation cases by residents against facilities owned or operated by Brius and Shlomo Rechnitz in the past and in 2022. She also served as an expert witness in a case against The Citadel Salisbury in North Carolina in 2021.

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