RegalCare’s Aggressive Cuts in Massachusetts Nursing Homes Trigger Regulatory Scrutiny

Key points

• RegalCare’s Taunton facility dropped from a five-star to a one-star federal rating within three years of Mirlis’s acquisition, with nursing staff hours cut by nearly half.
• Mirlis diverted approximately $1.6 million to affiliated companies in 2025, including quadrupling rent payments to a company he owns, while cutting nursing budgets by over $530,000.
• The Massachusetts Department of Public Health approved Mirlis’s acquisitions despite his revoked New Jersey license and declining quality metrics, with no licenses revoked in the state in seven years.
• Mirlis settled a federal lawsuit alleging unnecessary physical therapy billing schemes, agreeing to pay a $1 million fine and acknowledging his role in the scheme.
• Residents and families reported severe care failures, including unanswered emergency calls, medication errors, and residents left in soiled diapers for extended periods.

Background

This development follows a broader trend of out-of-state chains acquiring Massachusetts nursing homes since the pandemic, with nine such chains now controlling nearly one in five facilities in the state. Recent international incidents, such as a deadly fire at a Chilean care home, have heightened global scrutiny on nursing home safety and regulatory oversight. Additionally, a UK nursing home nurse was recently struck off for dismissive behavior toward dementia patients, underscoring ongoing concerns about staff conduct and quality of care in long-term care facilities.

Why it matters

The collapse in care quality at RegalCare facilities highlights a critical failure in state regulatory mechanisms, as the Massachusetts Department of Public Health approved acquisitions despite clear evidence of declining standards. This raises urgent questions about the protection of vulnerable elderly residents and the integrity of Medicare and Medicaid funding, as diverted revenues and understaffing directly impact patient safety and outcomes.

What to watch

Regulators may face increased pressure to enforce stricter oversight of related-party payments and acquisition approvals in the nursing home sector. Mirlis’s settlement of the fraud lawsuit could set a precedent for future enforcement actions against similar billing schemes. Families and advocacy groups may continue to push for greater transparency and accountability in nursing home ownership and management practices.