Three U.S. senators and two U.S. representatives are scrutinizing the financial practices of three major nursing home operators as the industry resists a new federal regulation introduced by the Biden administration that would set mandatory minimum staffing levels.

On Sunday, Senators Elizabeth Warren, Bernie Sanders, and Richard Blumenthal, along with Representatives Jan Schakowsky and Lloyd Doggett, sent letters to the top executives of three prominent nursing home chains. They raised concerns about substantial expenditures on executive compensation, stock buybacks, and dividends at a time when the industry is contesting the proposed staffing mandate.

The correspondence, endorsed by the four Democratic members and Sanders, who is an independent from Vermont, highlighted that National Healthcare Corp., the Ensign Group Inc., and Brookdale Senior Living Inc. have collectively disbursed nearly $650 million on executive salaries, share repurchases, and dividends since 2018. The legislators argue that such spending challenges the industry's assertions that it lacks the financial resources to meet the staffing requirements stipulated by the new rule.

Industry opposition centers on the federal mandate announced last month by the Biden administration, which stipulates that nursing homes receiving federal funding must ensure minimum daily staffing that includes 0.55 hours of care by a registered nurse and 2.45 hours by a certified nursing aide per resident. This rule, which aims to mitigate neglect and care delays—a concern highlighted during the COVID-19 pandemic when over 200,000 nursing home residents and staff perished—will be gradually implemented over the next two to three years.

However, the nursing home industry, represented by the American Health Care Association (AHCA), has expressed significant reservations. AHCA's president and CEO, Mark Parkinson, described the staffing rule as "an impossible task," citing a critical nationwide shortage of caregivers and the need for hundreds of thousands more staff members.

Nonprofit nursing home representatives, such as Katie Smith Sloan, president and CEO of LeadingAge, also foresee difficulties with implementing the new standards due to workforce shortages and the high costs associated with recruiting, training, and retaining staff. Sloan cautioned that the regulation could lead to restricted admissions, fewer available beds, and potentially, nursing home closures.

Amid these challenges, the five lawmakers are pressing the three companies for details on their corporate spending, particularly how they determine executive remuneration and its correlation to care quality or profits. They are also seeking information on average salaries, tenure of registered nurses and nurse aides, and any employee feedback regarding staffing and compensation. Furthermore, the legislators are inquiring about the companies' expenditures on lobbying activities, especially those aimed at opposing the federal staffing rule.