Rhode Island nursing facility acquisitions face heightened scrutiny

Rhode Island nursing facility acquisitions face heightened scrutiny as Attorney General Peter Neronha urges state health regulators to reject Advinia Care’s purchase of three local homes over high debt concerns and corporate asset separation.

Advinia Care’s footprint in Rhode Island encompasses 11 of the approximately 75 skilled nursing facilities licensed in the state. The Health Services Council recommended that the Rhode Island Department of Health approve the acquisition, despite written objections submitted by the Attorney General’s office.

Attorney General Peter Neronha issued a statement on November 14, 2026, responding to the Health Services Council recommendation. Neronha urged the Rhode Island Department of Health to deny the acquisition or attach conditions to any approval.

“Long-term care centers play a crucial role in our state’s health care system, and we must ensure that our centers remain available and viable for Rhode Islanders, particularly when considering the devastating impacts of for-profit acquisition and ownership of health care facilities this State has experienced,” said Peter Neronha, Rhode Island Attorney General.

The Attorney General previously submitted a public comment letter detailing objections to the transaction. The filing said that Advinia Care uses related entities to divert resources away from patient care. Privately-owned for-profit chains frequently saddle nursing facilities with high debt obligations and separate real estate ownership from daily operations.

Consolidation creates systemic financial risks that directly impact patient care. Advinia Care’s application to purchase three additional homes follows a pattern of ownership changes that channel resources into private investors’ pockets.

If the Rhode Island Department of Health approves the transaction, Neronha recommends attaching six categories of conditions. These requirements cover related-party disclosures, funded escrow accounts, limitations on management fees, enhanced financial reporting, restrictions on debt distributions, and mandatory resident care protections.

The Health Care Capacity Assessment performed by Health Management Associates and published in May 2025 detailed Rhode Island’s history of nursing home closures and higher-than-average composition of for-profit chains.

Officials have not yet announced when the Rhode Island Department of Health will issue a final decision on the acquisition.