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Bill

A 4722

Revises reporting requirements for nursing homes concerning financial disclosures and ownership structure.

2026-2027 Regular Session Introduced by Clinton Calabrese and 13 co-sponsors

Strengthens transparency for New Jersey nursing homes by expanding ownership, related-party, and financial disclosures and enhancing state oversight and enforcement.

Introduced, Referred to Assembly Aging and Human Services Committee
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WeVote Research Nonpartisan
Bill Summary · A 4722

Bill A4722 (Session 222) — New Jersey: Revises Nursing Home Financial Disclosures and Ownership Reporting

Purpose and Intent

This bill overhauls and strengthens reporting requirements for nursing homes in New Jersey, focusing on ownership structures, related parties, and financial disclosures. It aims to increase transparency around who owns, controls, and finances nursing homes, including entities that exercise substantial management control or provide services, facilities, or supplies. It also broadens oversight mechanisms by empowering the State Comptroller and health authorities to monitor, audit, and enforce compliance.

Key Provisions and Changes

Ownership Transfers and Applications

  • Before transferring ownership, a prospective new owner must submit a comprehensive DOH application, including:
    • Transfer fee amount.
    • Identification of the facility (name, address, county, licensed beds).
    • Full transaction description, including:
    • 100% current owners and 100% proposed owners (with names/addresses of principals and interested parties).
    • Organizational chart showing parent entities, subsidiaries, related and unrelated parties (with material payments anticipated over $200,000 in the coming year).
    • Copy of sale agreement, leases, and management agreements.
  • Public posting: The DOH must post the transfer application and the organizational chart on its website within 30 days of receipt (redacting proprietary/personal information as needed).
  • Public comment: A comment period of at least 30 days (start after application receipt) with a documented acknowledgment process.
  • Approval conditions: Approval contingent on
    • Review of disciplinary history of the applicant’s other facilities (in NJ and elsewhere) to assess risk to residents.
    • Payment of all Medicaid audit claims, Medicaid overpayments, and state penalties (if under appeal, the applicant or current owner must commit to step-in payment after appeal).
    • If Medicaid overpayments arise after transfer, both prior and new owners must identify responsible parties via affidavit.

Reporting and Financial Disclosure Improvements

  • Annual reports (now due 150 days after fiscal year end, instead of 90 days) must include:
    • Balance sheet with assets, liabilities, and equity (in line with future regulation changes).
    • Detailed statement of operations with itemized expenses (leases, equipment loans/leases > $10,000, contracts > $10,000/year for services).
    • Mortgagee information (name, address, amount, term, interest, fees).
    • Names/addresses of operators, land/building owners, mortgage holders, lessors/lessees, and owners of related parties.
    • Details on owners/principals of related parties, including private equity fund ownership (5%+ in a nursing home).
    • Organizational charts for the nursing home and any related/third-party entities with material relationships.
    • Owner-certified financial statements (to be prepared/audited per GAAP, with specifics on assets, liabilities, equity, revenues by payer, cash flow, etc.).
    • Disclosure of any transactions over $10,000 with named individuals/entities.
    • Copies of leases for land/buildings.

Consolidation and Exemptions

  • If a nursing home is under common ownership with others, a single consolidated owner-certified financial statement may be required, covering all facilities and related parties.
  • Nonprofit nursing homes may satisfy part of the owner-certified requirement by filing IRS Form 990 Public Inspection Copy, subject to regulations.

Oversight, Enforcement, and Effective Date

  • The State Comptroller may monitor/audit owner-certified statements, using existing program integrity authorities.
  • The Commissioner of Health and the State Comptroller may issue rules/regulations, including temporary notices (valid for up to one year) to implement provisions.
  • Penalties: Civil penalties for noncompliance could reach up to $200 per day (discretionary), with possible DOH-adopted actions to curtail admissions until corrective action is approved.
  • Effective date: The act would take effect 90 days after enactment; some regulatory/notice authority provisions take effect immediately or on designated timelines.

Who and What Is Affected

  • Nursing homes operating in New Jersey, as well as entities involved in ownership, management, and related-party arrangements.
  • Prospective purchasers of nursing homes.
  • Third-party management entities and private equity funds with investments in NJ nursing homes.
  • The Department of Health and the State Comptroller (plus the State Auditor) for reporting, oversight, and enforcement.
  • Nonprofit facilities may have streamlined compliance via existing IRS Form 990 disclosures.

Timeline and Process Highlights

  • Public posting and posting of an ownership transfer application within 30 days of receipt.
  • Public comment window opens not less than 30 days after receipt and remains open for at least 30 days.
  • Departmental review target: 120 days from receipt for transfer applications.
  • Annual report timing extended to 150 days post-fiscal year end.
  • Immediate and temporary regulatory actions possible via notices, while full rulemaking proceeds.

This bill substantially increases transparency around ownership, related parties, and financial health of nursing homes, with strengthened oversight and enforceable accountability mechanisms.

Compiled from official sources — confirm details with the bill’s official record.

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