The corporate spending of three publicly traded nursing home companies are at the center of questioning by legislators, who sent letters to them Sunday demanding more information on executive compensation, stock buybacks and dividends.

In the midst of the industry’s opposition to the federal government’s minimum staffing mandate, the letters signed by the Senators Elizabeth Warren, Bernie Sanders, and Richard Blumenthal and Representatives Jan Schakowsky and Lloyd Doggett, criticized the three largest publicly traded companies in the sector for putting corporate profits ahead of quality of care.

The three companies under legislator scrutiny – National HealthCare Corp. (NYSE: NHC), the Ensign Group (Nasdaq: ENSG), and Brookdale Senior Living (NYSE: BKD) – spent nearly $650 million in executive pay, stock buybacks and dividends since 2018, according to the letters.

“Despite the significant benefits of safe staffing for nursing home residents, the for-profit nursing home industry has fiercely opposed the staffing mandate—and is gearing up to kill the rule now that it has been finalized,” the letter to Ensign’s executives noted.

In highlighting industry efforts to weaken the staffing measure while doling out big payouts to its own executives, senators and representatives pointed to Ensign CEO Barry Port’s comments on “shaping” the staffing mandate during the company’s third quarter earnings call.

The letter to Ensign also noted that the company spent $145.2 million on stock buybacks and dividends and $144.8 million on executive compensation.

“Your executives received more in pay and compensation than executives at the other two nursing home chains combined,” the letter to Ensign states. “These massive expenditures to enrich shareholders and executives undermine the claim that nursing homes cannot afford to pay for enough staff to meet the Biden Administration’s new nursing home staffing standards.”

This view was backed by a review of financial data from the three large providers, the letter to Ensign also stated.

SNN reached out to Ensign, but did not receive a comment at the time of publication.

Specifically, the legislators want to know how these nursing home companies calculate executive pay and bonuses towards the goal of figuring out the impact on quality of care.

The three companies are also being asked to submit the length of retention as well as the salary of registered nurses (RNs) and nurse aides, along with details on complaints or comments submitted by their nurses over staffing levels and compensation.

The legislators also want the companies to share the sum spent on their lobbying or advocacy efforts, including the amount that may have been used to oppose the minimum federal staffing rule.

According to the letter to National HealthCare, elected officials said the company spent more than $210 million on stock buybacks and dividends and $26.5 million on executive compensation.

Meanwhile, the letter to Brookdale Senior Living noted that the senior living provider and owner of continuing care communities (CCRCs) spent $67.7 million on stock buybacks and dividends and $48.9 million on executive compensation.

Legislators blamed the staffing problems at nursing homes on high turnover due to poor working conditions, understaffing of facilities, and low pay, saying that these nursing home giants were well positioned to rectify these problems.

“CMS’ new rule to set a minimum staffing standard would make these jobs more attractive to workers,” one of the letters stated.

The senators and representatives also countered the claims of a staffing shortage at nursing homes by suggesting that nurses passing the nursing licensure exam had steadily grown since 2017.

The federal government’s staffing rule mandates a minimum of 3.48 hours per resident per day (HPRD) of total staffing, with specific allocations for RNs and nurse aides.

The American Health Care Association/National Center for Assisted Living (AHCA), representing more than 14,000 nursing homes and other long term care facilities, as well as LeadingAge, the largest nonprofit trade group for nursing homes, have harshly condemned the rule, criticizing it as untenable given the lack of funding and an ongoing shortage of workers.

In her letter to President Biden, LeadingAge President and CEO Katie Smith Sloan called out the “misleading” characterization of aging services providers and repeated “incendiary” descriptions of nursing home care that marked the White House’s messaging related to the finalized rule.