Nancy Hunt died five days after arriving at a Pennsylvania hospital from a Genesis HealthCare nursing home with severe injuries, including maggot infestation in her foot. Her son alleged in a lawsuit that the conditions amounted to elder abuse. Genesis denied wrongdoing but agreed to pay $3.5 million in an August 2024 settlement. However, court records show most of this amount remains unpaid, and the company may never have to fulfill its obligation.
Genesis HealthCare, once the largest nursing home chain in the United States, has been involved in extensive litigation over resident injuries and deaths. The company reported spending $8 million monthly on legal defenses and settlements before filing for bankruptcy in July 2025. At that time, it estimated liabilities for nearly 1,000 lawsuits at $259 million.
A review by KFF Health News found that Genesis included provisions in many settlement agreements allowing deferred payments—sometimes for more than a year—even as insolvency loomed. As a result, Genesis paid nothing in 85 cases and only partial amounts in another 70; it still owes $41 million of the $58 million promised.
"It just feels like they killed my mom and got away with it," said Vanessa Betancourt, whose mother died following an injury at a Genesis facility in New Mexico. The family settled for $650,000 under terms delaying payment by one year.
Genesis has denied wrongdoing across all lawsuits and settlements. In a written statement, the company said it is "focused on delivering high-quality, compassionate care to our patients and residents without disruption" during bankruptcy proceedings.
Some settlements stemmed from allegations of sexual assault or delayed medical attention resulting in death. For example, one case involving sexual assault at Sandia Ridge Center resulted in a $925,000 settlement that remains unpaid according to bankruptcy claims.
Creditors—including families of deceased residents—are likely to recover only a fraction of what they were promised as unsecured creditors rank behind secured debt holders under bankruptcy law. On December 10th, Genesis’ owners sought court approval to sell assets to its largest investor—a private equity firm—under terms that lawyers say would shield new ownership from further liability claims.
John Anthony, representing hundreds of personal injury claimants against Genesis, commented: "They never had any intention to honor these deals."
Federal oversight data shows persistent quality issues at Genesis homes: the Centers for Medicare & Medicaid Services rated 58% of them below average or much below average using its five-star system; CMS fined Genesis facilities $10 million over three years for violations of federal health standards; Connecticut regulators closed two facilities due to safety concerns between 2022 and 2023.
At its peak in 2016 after aggressive expansion funded through leveraged buyouts and real estate sales-leasebacks with Welltower—a real estate investment trust—Genesis operated more than 500 nursing homes nationwide but became increasingly difficult to manage amid rising labor costs and mounting lawsuits.
Private equity involvement has featured prominently throughout Genesis’ financial troubles as well as other major healthcare bankruptcies such as HCR ManorCare and Steward Health Care.
Bankruptcy filings indicate Genesis cared for about 15,000 residents across facilities concentrated mainly in Pennsylvania, West Virginia, New Mexico, New Hampshire, New Jersey, Maine, Alabama, Maryland, and North Carolina at the time of filing.
The company owed $709 million in secured debt (including IRS obligations) which takes precedence over approximately $1.6 billion owed to unsecured creditors such as pension funds; state governments seeking unpaid provider taxes; contractors; former residents; and their families who sued over injuries or deaths.
In multiple instances detailed by court documents and interviews with attorneys representing affected families—including those of James Sanderson (New Mexico), Margarett Johnson (Maryland), Alma Brown (New Mexico), Nancy Hunt (Pennsylvania), among others—settlements were reached but not fully paid due either to delays built into agreements or because bankruptcy intervened before payments could be completed.
Judges overseeing civil cases expressed frustration over nonpayment or slow responses from Genesis prior to its bankruptcy declaration. In some cases judges imposed fines or threatened additional penalties before proceedings were stayed by bankruptcy court protections.
Legal experts suggest industry-wide pressures—including increasing costs and frequency of class action lawsuits—may drive more senior living companies toward Chapter 11 protection as seen with ten other large operators entering bankruptcy within nine months of 2025 alone.
On December 1st Genesis announced plans to sell assets via auction largely favoring existing investors led by Joel Landau’s private equity group despite higher competing bids elsewhere—a process criticized by attorneys representing personal injury claimants who allege it limits creditor recovery options while allowing current controllers continued influence post-bankruptcy.
Senator Elizabeth Warren (D-Mass.) joined two colleagues last month urging federal intervention out of concern that asset sales would let those responsible escape accountability while erasing debts owed to victims’ families: "individuals who already own or control Genesis are trying to sell it to themselves wiping away legal and other creditor debts."
Families fear repeated use of bankruptcy will allow ongoing avoidance of responsibility for substandard care provided at facilities like those run by Genesis HealthCare.
