Salt Lake City, Utah — One of the country’s largest nursing home chains says it’s come out of a federal billing investigation with a stronger compliance operation, a clearer growth strategy, and a $100 million bet on technology.
PACS Group, which owns 323 skilled nursing and post-acute facilities across 17 states, went public in 2024 and almost immediately landed under government scrutiny over its billing practices. CEO and co-founder Jason Murray told industry reports this week that the scrutiny was a turning point — not a setback.
“Over the last 18 months, particularly in the area of compliance, we’ve accelerated our maturity as a company, and it’s been very encouraging to see,” Murray said. “It is weaved through our operators. It’s weaved into the culture and into the DNA of who we are as a company.”
That’s not just talk. PACS facilities now average 4.4 stars on Medicare’s 5-star quality rating system, and the company’s “mature” facilities — those owned for three or more years and fully transitioned to the PACS model — are running at 95% occupancy. For an industry that has struggled with census recovery since the pandemic, those numbers stand out.
Higher Acuity, Bigger Bets
Murray said PACS has leaned hard into a shift that’s been reshaping nursing homes across the country: hospitals are increasingly offloading their sickest patients to skilled nursing facilities, partly to cut costs, partly because SNFs can handle more than they used to.
“It was not common for us to see higher acuity patients. Those were reserved for the hospital or for the LTACs,” he said. “Now we’re getting the patient out of the higher cost setting, which is the hospital, and getting them into a lower cost setting, and yet still [achieving] high quality clinical outcomes.”
That shift is driving PACS’s technology investments. The company is spending $100 million on tools, training, and equipment to support staff managing more complex patients — a move that mirrors a broader industry push toward using technology to manage higher-acuity admissions more effectively.
Thinking Beyond the Facility
PACS isn’t just looking to grow its bed count. Murray described a strategy of expanding touchpoints along the entire post-acute journey — before a patient arrives at a facility, during their stay, and after discharge. The goal is to better control outcomes and strengthen referral relationships with hospitals and health systems.
“We really want to have as much touch on the patient as possible,” Murray said, “because it allows us to help control the outcomes.”
That’s a play increasingly associated with value-based care models, where operators get rewarded — or penalized — based on what happens to patients after they leave an acute setting. CMS has been pushing more SNF providers toward these arrangements, and larger chains with the infrastructure to track outcomes have a structural edge.
PACS also emphasizes what Murray calls a “decentralized, locally-led, centrally-supported” model — meaning each facility adapts to its local market while drawing on central compliance, tech, and operational resources. It’s a structure he credits with keeping the company in tune with ground-level realities across 17 states.
“There’s a lot of nuance in every market where we operate,” he said. “It could be in the same state, and it could be the same zip code, but the difference is in the way that we operate that facility.”
Whether that approach is enough to put the investigation fully behind the company remains to be seen. But with its star ratings up, occupancy strong, and a major tech buildout underway, PACS is clearly betting the answer is yes.
