Maryland lawmakers are considering a bill that would mandate state inspections after out-of-state owners purchase nursing homes, where the devastation of the coronavirus pandemic has exposed lapses in infection control, patient care and oversight.

Lawmakers said they decided to introduce the measure following a report in The Washington Post about the Portopiccolo Group, a New Jersey-based investment management firm that acquired at least 20 nursing homes across the country even as the pandemic raged through its other facilities.

Employees of Portopiccolo-owned homes in Maryland, North Carolina and Virginia told The Post that quality of care declined because of disruptions to staffing and supplies that followed the takeovers.

The legislation, which was discussed in committees in the House of Delegates and state Senate this month, would require that state inspectors conduct unannounced visits three and six months after the purchases are made.

It is one of several bills lawmakers are weighing this session to improve conditions at long-term care facilities in Maryland, where 31,000 residents and staff members have contracted the coronavirus since March and nearly 3,500 have died.

About 45 percent of the state's covid-19 deaths have occurred at long-term care facilities — a share that is higher than 35 other states, according to federal data analyzed by the New York Times. Despite having fewer than half of the number of long-term care facilities in Virginia, Maryland has reported more cases and fatalities in such facilities.

The legislative proposals would require Maryland to commit $100,000 yearly to programs that help seniors “age-in-place”; mandate adequate protective equipment and hazard pay for employees during an infectious-disease outbreak; and ensure indoor visitation for family members or friends considered “essential caregivers.”

State Sen. Pamela G. Beidle (D-Anne Arundel), who is spearheading the bill requiring inspections after changes in ownership, said the Post story made clear that Portopiccolo’s eight acquisitions of Maryland nursing homes during the course of the pandemic were made with little government oversight.

The state health department said in December that it saw “no reason to change” its typical procedure of vetting such deals, which involves asking prospective owners to affirm that they have not been convicted of a felony within the past 10 years or penalized more than $10 million because of their ownership of nursing homes.

“In a lot of areas, the pandemic has highlighted need for more regulation,” Beidle said. “This is one of them.”

Del. Geraldine Valentino- Smith (D-Prince George’s), who is leading a matching bill in the House, said the increase in private equity and investment firms entering the nursing home industry has created “economic incentives and models that do not always prioritize quality of care over profit.”

The bill, she added, “is a small investment we can make now to put some quality measures in.”

Portopiccolo has frequently described itself as a private equity firm, but it removed that language from its website after inquiries from The Post in December.

A striking new study published in February by the National Bureau of Economic Research found that patients at nursing homes owned by private equity firms had an increased risk of death during their stay and the following 90 days.

The study also found that after private equity takeovers, overall quality-of-care ratings from the Centers for Medicare and Medicaid Services declined, as did staffing hours at nursing homes. The use of antipsychotic drugs increased, as did the amount billed for residents’ care.

Valentino-Smith said lawmakers removed a requirement to inspect facilities one month after they are purchased by out-of-state companies after consultation with the Health Facilities Association of Maryland. The trade group argued that little can be learned about an operator in its first 30 days.

Joseph DeMattos, president of the association, said he is “actively working to support” the inspection bill’s passage, even though he said that in his experience, most new operators invest significant amounts in the facilities they purchase.

Tina Hurley, who testified in support of the bill at a legislative hearing, said her mother, Brenda Middleton, has been “brushed off or ignored” by the overstretched staff at Peak Healthcare at Denton, which was purchased by Portopiccolo in June 2020.

Hurley told The Post her mother contracted the coronavirus last spring while living at another facility owned by Portopiccolo. Later, after being moved to the Denton facility, she was asked to share a room with a resident who was actively infected with the virus, Hurley said.

“I am here today because the big businesses that run my mom’s facilities can do a lot better for my mother,” she told the committee in Annapolis. “Even if covid wasn’t happening. I ask you to please support the legislation.”

The pandemic has stirred new interest in boosting oversight of long-term care facilities nationwide. In a recent letter, five leading nursing home experts urged the Biden administration to increase transparency of nursing home sales and bar operators with a poor track record from accumulating more properties.

Beidle said lawmakers in Annapolis are cautious about making regulations too stringent, fearing such changes could deter interested operators.

“We still want to keep the nursing homes open. We don’t want them closing,” she said.