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State nursing home ownership laws
What states have enacted or advanced since January 2025 on health care ownership disclosure, transaction review and private-equity or REIT involvement, with a note on whether each reaches nursing homes and the legislature's own record as the citation.
- 14 bills · 11 states
- 12 signed into law
- Updated 16 September 2026
How the tracker is kept
Bills enacted or advanced since January 2025 on health care ownership disclosure, transaction notice or review, and private-equity or REIT involvement, with a note on whether each reaches nursing homes. Seeded from the Private Equity Stakeholder Project's 2025 State Healthcare Policy Review and Stateline's June 2026 report, then checked against each legislature's own record. An entry is added when a bill has passed at least one chamber or been signed. Status, dates and chapter numbers are read from the legislature's bill page or the enrolled act; where that page could not be reached from our network, the entry's note says which official source stood in. We do not characterize a law's effect: each summary restates what the bill page or the act says.
Nursing homes marks whether the act names nursing homes or nursing facilities (Yes), covers health care entities under definitions that can include them (Partly), or is limited to hospitals, physician practices or other providers (No). Every entry names its primary source, usually the legislature's bill page or the enrolled act, and the date we last checked it. Secondary sources (press and trackers such as the Private Equity Stakeholder Project) are listed for context and are not the basis of any status. The file is public and versioned; corrections go through the contact page or a pull request.
By state
| State | Bill | Status | Nursing homes | What it does | Provisions | Sources |
|---|---|---|---|---|---|---|
| California | AB 1415 California Health Care Quality and Affordability Act · 2025-2026 | Signed 11 October 2025 effective 1 January 2026 | Partly | Chapter 641, Statutes of 2025. Updates the Office of Health Care Affordability's definitions, adds definitions including hedge fund, requires the office to research management services organizations and set their data-submission requirements, and extends the pre-transaction written notice to the office to the entities the bill defines. Applies to health care entities and providers under the act's definitions. California statutes chaptered in 2025 take effect January 1, 2026 unless the act says otherwise. | transaction noticePE and hedge fund definitionsMSO reporting | California Legislative Information, AB 1415 (2025-2026), chaptered text checked 16 September 2026 |
| SB 351 Health facilities · 2025-2026 | Signed 6 October 2025 effective 1 January 2026 | No | Chapter 409, Statutes of 2025. Prohibits a private equity group or hedge fund involved with a physician or dental practice from interfering with professional judgment or exercising power over listed decisions, voids contract terms that would allow it, and voids specified non-compete and non-disparagement clauses. Physician and dental practices only. | corporate practice limitsPE and hedge fund contract limits | California Legislative Information, SB 351 (2025-2026), chaptered text checked 16 September 2026 | |
| Connecticut | SB 125 An Act Requiring Nursing Homes to Annually Report Certain Ownership Information Regarding Investment Entities, Acquire, If Feasible, a Surety Bond or Similar Security Equal to Ninety Days of Operating Costs, Maintain Full Governance Control and Authority over Nursing Home Assets and Activities and Annually Attest That No Investment Entity Has Control over Nursing Home Resident Health, Safety or Care · 2026 | Signed 4 June 2026 effective 1 October 2026 | Yes | Public Act 26-103. State-contracted nursing homes serving Medicaid recipients must report annually to the Department of Social Services any investment entity (including a REIT) with at least a 5% beneficial ownership interest; from February 1, 2028 the licensee must hold full control over governance, assets and activities and attest annually to the Department of Public Health that no investment entity controls resident health, safety or care (civil penalty up to $2,000 per violation; one-year waivers possible); homes with a 5% investment-entity owner must carry a surety bond or similar security covering 90 days of operating costs if DSS identifies a feasible instrument by January 1, 2028. Effective October 1, 2026; the DSS study and reporting requirement on passage. | ownership disclosurePE/REIT governance limitsfinancial securityattestation | Connecticut General Assembly, bill status SB 125 (2026) and Public Act 26-103 checked 16 September 2026 |
| SB 196 An Act Concerning Hospital Sale-Leaseback Transactions and Attestations Concerning Lack of a Controlling Interest of a Hospital or of Interference with the Professional Judgment and Clinical Decisions of Certain Health Care Providers of a Hospital by a Private Equity Entity · 2026 | Signed 27 May 2026 effective 27 May 2026 | No | Public Act 26-22. Permits hospitals in financial distress to enter sale-leaseback agreements under set conditions and requires hospitals to attest that no private equity entity holds a controlling interest or interferes with clinical judgment. Hospitals only; listed here because it passed alongside SB 125. | sale-leaseback limitsattestationPE control limits | Connecticut General Assembly, bill status SB 196 (2026) and Public Act 26-22 checked 16 September 2026 | |
| Illinois | HB 5000 Health Facilities Planning: change-of-ownership and Attorney General notice provisions · 104th General Assembly (2026) | Signed 7 August 2026 | Partly | Public Act 104-0782. Makes permanent the Health Care Facilities Planning Act change-of-ownership provisions and the Antitrust Act requirement that health care entities notify the Attorney General 30 days before a merger or affiliation, and extends that notice to covered transactions whose parties own or control health care facilities or provider organizations without being one themselves, expressly including private equity companies (defined as companies that collect capital and take a direct or indirect ownership share of an Illinois health care entity, or an out-of-state entity with $10 million or more in annual revenue from Illinois patients). The Planning Act's health care facilities include long-term care facilities. Effective date not stated on the bill status page; see the public act text. | transaction noticePE definition | Illinois General Assembly, bill status HB 5000 (104th GA) checked 16 September 2026 |
| HB 4728 Developmental disability facilities: asset management company disclosures · 104th General Assembly (2026) | Signed 30 July 2026 | No | Public Act 104-0661. Licensed community living, MC/DD, ID/DD and CILA facilities and child care facilities must disclose at licensure and quarterly whether they, their affiliates or contractors are owned or managed by an asset management company, give written notice of transactions that dispose of or transfer control of material assets, and are barred from transactions that would have the facility issue debt-funded dividends or otherwise cause financial distress; agencies must publish the filings. Developmental-disability and child care facilities, not skilled nursing facilities. The synopsis as introduced is summarized; the House floor amendment replaced the text, so consult the enrolled act for the final scope. | ownership disclosuretransaction noticedebt-funded dividend limits | Illinois General Assembly, bill status HB 4728 (104th GA) checked 16 September 2026 | |
| Indiana | HB 1666 Ownership of health care providers · 2025 | Signed 6 May 2025 | Partly | Public Law 239-2025. Requires hospitals to report ownership information to the Indiana Department of Health, certain health care entities to the Secretary of State, and insurers, third-party administrators and pharmacy benefit managers to the Department of Insurance; the Department of Health must publish an annual ownership report; amends the health care entity definition for merger and acquisition review and expands the Attorney General's role. Applies to the health care entities the act defines. | ownership disclosureannual public reportmerger and acquisition definitions | Indiana General Assembly, HB 1666 (2025) checked 16 September 2026 |
| Maine | LD 985 Moratorium on hospital acquisitions by private equity firms and real estate investment trusts (emergency) · 132nd Legislature, First Special Session (2025) | Enacted 22 June 2025 effective 22 June 2025 | No | Public Law 2025, Chapter 401. Emergency measure imposing a one-year moratorium on hospital acquisitions by private equity firms or real estate investment trusts; became law without the Governor's signature (recorded as 'Emergency Unsigned') on June 22, 2025. Hospitals only. | PE/REIT acquisition moratorium | Maine Legislature, LD 985 (SP 416), 132nd Legislature checked 16 September 2026 |
| Massachusetts | H.5159 An Act enhancing the health care market review process · 193rd General Court (2024) | Signed 8 January 2025 effective 8 April 2025 | Partly | Chapter 343 of the Acts of 2024. Extends the state's material-change notice and post-transaction monitoring to transactions involving private equity sponsors, significant equity investors, health care REITs and management services organizations, adds annual ownership and financial reporting to the Health Policy Commission and the Center for Health Information and Analysis, sets penalties for missed filings, and bars new sale-leasebacks of acute-care hospital real estate. Applies to health care entities and their investors as the act defines them. The legislature's site could not be reached from our network on the verification date; signing date, chapter and effective date are taken from the law-firm summaries of the act listed as secondary sources. | ownership disclosuretransaction noticefinancial reportingsale-leaseback limits | Massachusetts General Court, H.5159 (193rd) / Acts of 2024, Chapter 343 checked 16 September 2026 |
| New Mexico | HB 586 Review of Certain Healthcare Transactions · 2025 Regular Session | Signed 7 April 2025 | Partly | Laws 2025, Chapter 50. Extends the state's health care transaction notice and review framework (built on the 2024 Health Care Consolidation Oversight Act) to additional provider types and makes it permanent, with review by the Health Care Authority. Applies to the provider types the act lists. | transaction noticetransaction review | New Mexico Legislature, HB 586 (2025) checked 16 September 2026 |
| Oregon | SB 951 Relating to the practice of health care; and declaring an emergency · 2025 Regular Session | Enacted | No | Oregon Laws 2025, Chapter 295. Prohibits a management services organization, or its shareholders, directors, officers or employees, from owning or controlling shares in, serving as an officer or director of, or managing a professional medical entity it has a management contract with, and voids related restrictive covenants. Physician practices, not long-term care facilities. The OLIS overview records the chapter number; the signing date is in the measure history. | corporate practice limitsMSO ownership limits | Oregon Legislative Information System, SB 951 (2025) checked 16 September 2026 |
| Pennsylvania | HB 1460 Health System Protection Act · 2025-2026 Regular Session | Passed one chamber 10 June 2025 | Partly | Would ban sale-leaseback transactions by health care facilities, let the Attorney General review mergers and acquisitions involving private equity and other for-profit entities and block those against the public interest, and, per the Governor's office, protect hospitals, nursing homes and other care facilities. Passed the House 121-82 on June 10, 2025; in the Senate as of the last check. The General Assembly's site could not be reached from our network on the verification date; the House vote and date are from the Governor's office and press coverage. Senate action after June 2025 not confirmed. | sale-leaseback bantransaction reviewAttorney General authority | Pennsylvania General Assembly, HB 1460 (2025-2026) checked 16 September 2026 |
| Virginia | SB 808 Nursing facilities; related party rent disclosures, incentive payment reduction, penalty · 2026 Regular Session | Pending 5 February 2026 | Yes | Would require any Medicaid-enrolled nursing facility that pays rent or lease payments to publicly disclose them, including whether the payments go to a related party and the related party rent expense; the Department of Medical Assistance Services would deduct part of any incentive payment where related-party rent exceeds a fair rental value benchmark; a knowingly false disclosure would be a Class 3 misdemeanor. Continued to the 2027 session in the Senate Education and Health committee on February 5, 2026 (14-Y 1-N). | related-party rent disclosureMedicaid incentive payment reduction | Virginia Legislative Information System, SB 808 (2026) checked 16 September 2026 |
| Washington | HB 1686 Creating a health care entity registry · 2025-26 | Signed 22 April 2025 effective 27 July 2025 | Partly | Chapter 142, Laws of 2025. Creates a statewide registry of health care entities and their ownership and affiliations, maintained by the state, so consolidation and investor ownership can be mapped. Applies to health care entities as the act defines them. | ownership registryaffiliation disclosure | Washington State Legislature, HB 1686 (2025-26) bill summary checked 16 September 2026 |
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