REITs Secretly Control Many Treasure Coast Nursing Homes, Data Shows

For the families of seniors living in long-term care facilities across Martin, St. Lucie, and Indian River counties, the name on the front door may not tell the whole story about who truly controls the building — or the budget — behind it.

Real estate investment trusts, known as REITs, now own a fifth of the nation's senior housing and hold investments in one in six nursing homes nationwide, public records and industry analyses show. A sweeping review of court filings and corporate documents reveals that these financial landlords wield far more influence over care decisions than federal regulators — or the facilities themselves — have publicly acknowledged.

REITs are not required to disclose their involvement in facilities' Medicare filings. Under the current federal administration, the Centers for Medicare & Medicaid Services indefinitely suspended a rule — finalized under the previous administration — that would have required nursing homes to disclose REIT ownership arrangements. A CMS spokesperson said the agency focuses on quality of care rather than facilities' corporate or tax structure.

The stakes for Treasure Coast seniors are concrete. Florida's proportion of residents aged 65 and older ranks among the highest of any state, and Martin, St. Lucie, and Indian River counties reflect that reality in their nursing home and assisted living census. Families choosing long-term care in Stuart, Port St. Lucie, or Vero Beach may be unknowingly placing loved ones in facilities where rent obligations to a distant financial trust shape staffing budgets.

Research on the consequences is unsettled but troubling in its direction. One study found REIT acquisitions were associated with nursing homes replacing registered nurses with lower-credentialed aides. A separate analysis found health inspection results worsened following REIT investment. A California jury this past March awarded $92 million in punitive damages against a former REIT tied to the death of a 100-year-old resident with dementia.

Publicly traded health care REITs are collectively worth nearly a quarter of a trillion dollars and distributed more than $7 billion in dividends in 2024, according to Nareit, an industry trade association. Federal tax law bans REITs from directly operating health care facilities — if they do, they forfeit a five-year tax exemption — but court records in multiple cases show REITs routinely selecting management companies, setting occupancy minimums, and tracking monthly spending on nurses and food.

"There were no improvements in clinical outcomes," said Thomas Tsai, an associate professor at the Harvard T.H. Chan School of Public Health, referring specifically to investor-owned hospital chains that sold their buildings to REITs — a dynamic that contributed to the 2024 collapse of Steward Health Care.

Families with relatives in Treasure Coast long-term care facilities can look up a facility's Medicare quality star rating — including staffing scores — at medicare.gov/care-compare. The Florida Agency for Health Care Administration maintains inspection records for licensed nursing homes and assisted living facilities at floridahealthfinder.gov.

This article was generated with AI assistance using publicly available information. It was reviewed and approved by a human editor before publication. TC Sentinel uses AI writing tools in accordance with FTC guidelines.