November 12, 2025

Warren, Lawmakers Urge U.S. Trustee to Investigate Whether Genesis Healthcare Is Abusing the Bankruptcy System to Avoid Paying Victims and Families

“We urge you to press Genesis for answers that would help determine whether company insiders are attempting to exploit the bankruptcy system for their own gain…, while non-insiders like patient victims and vendors ‘may get nothing.’”

Text of Letter (PDF) | Text of Genesis Response (PDF) | Text of ReGen Response (PDF)

Washington, D.C. - U.S. Senator Elizabeth Warren (D-Mass.), a member of the Senate Finance Committee, alongside Senator Richard Blumenthal (D-Conn.) and U.S. Representative Maggie Goodlander (D-N.H.), urged the Acting Director of the Executive Office for U.S. Trustees to investigate whether Genesis Healthcare Inc. (Genesis) is attempting to exploit the bankruptcy system at the expense of victims, workers, and other businesses.

“Genesis [...] may be abusing our bankruptcy system to wipe away Genesis’s debts and claims to victims by selling the company at a discount to insiders,” wrote the lawmakers. “Genesis’s takeover by private equity companies JER Partners and ReGen preceded worse outcomes for patients, while investors reaped the profits and left the company with unsustainable finances.”

On July 9, 2025, Genesis, one of the largest post-acute care providers in the country, filed a petition for Chapter 11 bankruptcy, affecting nearly 200 skilled nursing facilities and senior living centers across 18 states, with more than 15,000 residents and 27,000 employees. At the time of the filing, Genesis owed patients, patients’ families, and other individuals who won lawsuits against them an estimated $259 million, with some experts estimating further debts to victims could reach $344 million. These lawsuits stem from serious allegations of improper care, abuse, inadequate training, unsafe conditions, and wrongful death.

Despite a record of mismanagement, Genesis has proposed to sell itself to some of the same individuals who helmed the company preceding its bankruptcy, raising concerns that Genesis may be abusing the bankruptcy system to wipe away Genesis’s debts and claims to victims by selling the company at a discount to insiders. A joint letter received by the lawmakers from ReGen, the current owner of Genesis, and CPE 88988, the prospective owner, indicates no attempt for a full or substantial recovery of funds for patients and families, small businesses, or employee pension funds.

“We are concerned that Genesis…could be incentivized to pay out debts to current Genesis insiders completely or almost completely, while non-insiders like patient victims and vendors ‘may get nothing,’” the lawmakers concluded. “The parties’ refusal to respond to questions regarding the structure of Genesis and ReGen – despite Genesis’s ‘commit[ment] to maintaining transparency’ – is a red flag that warrants investigation prior to approval of the sale.”

On October 8, 2025, Senators Warren, Richard Blumenthal (D-Conn.), and Peter Welch (D-Vt.), and Representative Maggie Goodlander (D-N.H) launched an investigation into Genesis Healthcare, pushing for information related to Genesis’s private equity-caused bankruptcy and its apparent attempt to use the bankruptcy process to wipe away the company’s debts to victims and businesses by selling the company at a discount to insiders. The U.S. Trustee’s Office is the federal government’s bankruptcy watchdog and is tasked with preventing fraud, dishonesty, and overreaching in the bankruptcy system on behalf of taxpayers.

Senator Warren, one of the nation’s leading bankruptcy experts, has led the fight to expose private equity’s role in raising costs and lowering quality of care for patients in health care facilities, including private equity’s abuse of the bankruptcy system:

  • On October 8, Senator Warren, Senator Blumenthal, Senator Welch, and Representative Goodlander launched an investigation into Genesis Healthcare’s apparent attempt to abuse the bankruptcy to get out of paying patient victims and their families.

  • In February 2025, Senator Warren questioned private equity executive Stephen Feinberg, President of Cerberus Capital Management and nominee for Deputy Secretary of Defense, on his actions to enrich himself and his investors at the expense of Steward Health Care patients and workers.

  • In November 2024, Senator Elizabeth Warren (D-Mass.) and Representative Jake Auchincloss (D-Mass.) sent a letter pushing the Massachusetts Health Policy Commission to hold the Rural Healthcare Group accountable for protecting Steward patients and doctors.

  • In October 2024, Senator Warren led colleagues in reintroducing the Stop Wall Street Looting Act, comprehensive legislation to fundamentally reform the private equity industry and level the playing field by forcing private investment firms to take responsibility for the outcomes of companies they take over, empowering workers and protecting investors. This reintroduction comes after private equity firm Cerberus looted Steward Health Care, leaving hospitals, patients, and workers hanging out to dry.

  • In September 2024, Senator Warren released a statement following Steward CEO Ralph de la Torre’s refusal to comply with a congressional subpoena.

  • In September 2024, Senators Warren and Markey (D-Mass.), alongside Representatives Auchincloss and Lynch, sent a letter to RHG raising concerns over its proposed acquisition of Steward Health Care’s physician group, Stewardship Health.

  • In September 2024, Senator Warren urged the IRS to crack down on Real Estate Investment Trusts (REITs) squeezing the health care industry.

  • In August 2024, Senators Warren and Markey requested information from private equity firm Apollo Global Management (Apollo) on the company’s role in Steward’s bankruptcy and urged Apollo to work in good faith to facilitate the sale of Steward’s Massachusetts hospitals.

  • In July 2024, Senators Warren and Markey wrote to Medical Properties Trust and Macquarie Infrastructure Partners, owners of Steward’s eight Massachusetts hospitals, urging them to offer lease concessions to keep the hospitals open and viable.

  • In June 2024, Senators Warren and Markey introduced the Corporate Crimes Against Health Care Act of 2024 to root out corporate greed and private equity abuse in the health care system, specifically preventing what happened with Steward from happening again.

  • In June 2024, Senator Warren wrote to the DOJ, FTC, and HHS calling out high health care costs due to vertically integrated insurers, private equity companies, and pharmaceutical companies that are driving health care consolidation.

  • In June 2024, Senators Warren, Brown (D-Ohio), and Markey wrote to the Director of the U.S. Trustee Program (USTP), calling for USTP to move to appoint a Chapter 11 trustee to run the company in place of Steward’s current management and to monitor the hospitals’ bankruptcy proceedings to protect patients and local communities.

  • In May 2024, Senator Warren sent a letter to the U.S. Department of Health and Human Services and the U.S. Centers for Medicare & Medicaid Services, urging them to support communities and health care providers affected by the crisis caused by Steward’s financial mismanagement.

  • In May 2024, at a hearing of the Senate Committee on Finance, Senator Warren questioned Michael Topchik, M.A., executive director for the Chartis Center for Rural Health, on the impact of the Centers for Medicare & Medicaid Services (CMS) newly finalized minimum staffing rule on quality of care and called out private insurers in Medicare Advantage (MA) for their greedy – and often unlawful – payment practices that threaten to shut down rural hospitals nationwide, blocking seniors from getting the care they need.

  • In April 2024, Senators Warren and Markey (D-Mass.) sent a letter to six private credit funds that are holders of Steward’s debt, asking them a series of questions about their loans and calling on them to offer loan modifications that could potentially help keep the hospitals afloat.

  • In April 2024, Senators Warren and Markey called out Medical Properties Trust and Macquarie Infrastructure Partners for exploiting Steward Hospitals and urged them to help keep the hospitals open.

  • In April 2024, Senators Warren, Markey, and the rest of the MA delegation urged the FTC and DOJ to closely scrutinize UnitedHealth Group’s proposed acquisition of Steward Health Care’s physician group, Stewardship Health.

  • In April 2024, Senator Warren delivered remarks at a Senate hearing in Boston titled, “When Health Care Becomes Wealth Care: How Corporate Greed Puts Patient Care and Health Workers at Risk,” which centered on Steward Health Care’s Massachusetts hospitals.

  • In April 2024, Senators Warren and Ed Markey (D-Mass.) called out private equity firm Cerberus Capital Management (Cerberus) for its role in creating Steward Health Care’s financial challenges, following Cerberus’s reply to the Massachusetts congressional delegation’s February 2024 probe.

  • In March 2024, Senator Warren released a statement about Steward’s plan to sell its physician group, Stewardship Health, to UnitedHealth Group’s subsidiary Optum.

  • In March 2024, Senators Warren and Markey sent a letter to Steward CEO and Chairman Dr. Ralph de la Torre, calling on him to testify at a congressional hearing in Boston.

  • In March 2024, Senators Warren and Markey sent a letter to Dr. de la Torre, blasting him for years of financial mismanagement, private equity schemes, and executive profiteering that have led to Steward Health Care’s financial crisis.

  • In February 2024, Senators Warren and Markey, along with all nine members of the Massachusetts congressional delegation, sent a letter to Cerberus seeking answers from the private equity firm for its role in creating the current financial challenges at Steward hospitals.

  • In February 2024, Senator Warren sent a letter to the DOJ, raising concerns about the abuse of the bankruptcy system by Corizon Health, Inc.

  • In January 2024, Senator Warren released a statement about Steward’s financial situation and allegations of patient neglect at Steward facilities.

  • In January 2024, Senator Warren led the Massachusetts congressional delegation in a letter to the CEO of Steward Health Care pressing the company to brief them on Steward’s financial position, the status of their Massachusetts facilities, and their plans to ensure the communities they serve are not abandoned.

  • In October 2023, Senator Warren and other lawmakers sent a letter to Corizon Health, Inc.-affiliated companies Tehum Care Services, Inc. and YesCare Corporation (together, “Corizon”), expressing concern about poor-quality health services provided to incarcerated people in jails and prisons around the country.

  • In May 2023, at a hearing of the Senate Special Committee on Aging, Senator Warren called out corporate owners of nursing homes, including private equity firms and Real Estate Investment Trusts (REITs), for their failures to protect patient safety and use of complex legal arrangements to avoid regulatory scrutiny.

  • In May 2022, Senator Warren and lawmakers sent a letter to private equity giant KKR for the grossly substandard care and unsafe living conditions in group homes it owned for people with intellectual and developmental disabilities.

  • In February 2022, testifying before the Senate Budget Committee, Senator Warren called out private equity firms’ predatory practices of buying up distressed companies, stripping workers of benefits, fair pay, and safe working conditions, and reaping billions in profits. She noted that research shows that private equity ownership of nursing homes led to a 10% jump in short-term mortality rates.

  • In August 2021, Senator Warren and lawmakers launched an investigation into private equity ownership of for-profit hospice companies and subsequent reductions in the quality of care.

  • In March 2021, Senator Warren released Genesis’s response to her January 2021 letter and sent a letter to the company, revealing new information that the company CEO - who left the company in near bankruptcy in January 2021 - has been awarded $8 million in salary and bonuses since the start of the pandemic. Senator Warren raised new questions about why the company lavishly rewarded its CEO after more than 2,800 of its residents died of COVID-19 and despite the fact that he left the company in dire financial condition.

  • In November 2019, Senators Warren and Sherrod Brown (D-Ohio) and Representative Mark Pocan (D-Wisc.) wrote to four private equity firms that invested in companies providing nursing home care and other long-term care services, citing reports that show private equity investment has played a role in the declining quality of care in nursing homes and requesting information about each firm's management of this sector.

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