A nursing home chain, Genesis HealthCare, is facing scrutiny after filing for bankruptcy while allegedly evading payments related to settlements for injuries and deaths of residents. The company, once the largest nursing home operator in the United States, filed for bankruptcy in Dallas in July 2023, claiming liabilities exceeding $259 million from nearly a thousand lawsuits. This legal maneuvering raises concerns about accountability in the healthcare sector, particularly regarding the treatment of vulnerable populations.
The tragic case of Nancy Hunt exemplifies the issues surrounding Genesis. Hunt was admitted to an emergency room from a Genesis facility in Pennsylvania in an alarming condition, with severe foot gangrene and maggots present, prompting a report to an elder abuse hotline. Despite her son securing a $3.5 million settlement in August 2024, Genesis has reportedly failed to pay most of that amount, leading to further distress for the family. Hunt’s death certificate indicated that her foot injury was a “significant” factor in her passing.
Genesis HealthCare has attributed its financial woes to mounting legal costs, spending approximately $8 million per month on legal defenses and settlements. The bankruptcy filing allows the company to potentially absolve itself of many of these financial obligations. In the wake of its bankruptcy, Genesis is expected to sell its assets to a private equity firm, effectively shielding itself from claims made by families of former residents.
A comprehensive investigation by KFF Health News revealed that during settlement negotiations, Genesis included clauses allowing it to defer payments, delaying financial responsibility often for a year or more. Of the 155 settlement agreements reviewed, the company paid nothing in 85 cases and only a partial amount in the remaining 70. Genesis still owes $41 million of the $58 million it had agreed to pay in those cases.
The situation has prompted outrage from families affected by Genesis’ alleged negligence. Vanessa Betancourt, whose mother suffered a fractured hip at a Genesis facility in Albuquerque, expressed her frustration: “It just feels like they killed my mom and got away with it.” The Betancourt family reached a $650,000 settlement in April under the condition that payments would not commence for another year.
Genesis has consistently denied wrongdoing in all lawsuits and settlements. In a statement, the company emphasized its commitment to providing high-quality care, asserting that the bankruptcy process would not disrupt services for its residents. Despite this assertion, Genesis has faced numerous allegations of misconduct, including a case where a male resident was accused of sexually assaulting a female resident, leading to a settlement of $925,000 that remains unpaid.
In addition to individual settlements, Genesis has faced significant regulatory scrutiny. The Centers for Medicare & Medicaid Services (CMS) rated 58% of its facilities as below average, and the company has incurred $10 million in fines for violations of federal health standards over the past three years. In Connecticut, a Genesis facility was closed by health regulators after two resident deaths and multiple safety violations.
The bankruptcy case is not an isolated incident; it is part of a broader trend within the nursing home industry. More than ten senior living companies with liabilities over $10 million entered Chapter 11 bankruptcy in the first nine months of 2025, according to Gibbins Advisors, highlighting the increasing financial strain on these facilities.
Genesis’ financial struggles can be traced back to a $1.5 billion leveraged buyout in 2007 by private equity firms, which burdened the company with significant debt. As the company expanded, it faced mounting operational inefficiencies and rising labor costs. In recent years, Genesis received $100 million in loans from a private equity firm, but continued to struggle financially, leading to its eventual bankruptcy filing.
The bankruptcy auction held in December 2023 raised concerns among creditors about fairness, with allegations that the process favored the private equity firm poised to acquire Genesis. U.S. Senator Elizabeth Warren, along with other lawmakers, has called for intervention, fearing that the sale may allow existing owners to absolve legal responsibilities while retaining control of the company.
As Genesis navigates its bankruptcy proceedings, families of former residents remain apprehensive about the implications for accountability and care standards in nursing homes. Gabe Betancourt, whose wife passed away after a stay at a Genesis facility, lamented, “They can file bankruptcy again, and we’re the ones that will pay for it, with our memories, our lives.”
The ongoing situation surrounding Genesis HealthCare underscores the urgent need for reforms in the nursing home industry to ensure the safety and well-being of residents, as well as to hold companies accountable for their actions.
