Monthly Archives: September 2025

The “People’s Data Project:” A Data Ecosystem for Giving the American People Healthcare Information They Rightfully Own & Deserve to Have

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By: Dave Kingsley

The American People Have a Right to Know What They Are Getting for Their Hard-Earned Money – That’s Why We Formed the People’s Data Project (PDP) as a component of the Center for Health Information & Policy (a 501c3 nonprofit organization).

U.S. taxpayers and users of the government-corporate privatized healthcare system are paying 2 to 3 times as much as residents of peer countries such as England, Japan, South Korea, France, Canada, and all of the Scandinavian countries. While all residents of those countries have either free or affordable access to medical care, over 30 million Americans have no insured access to a doctor, clinic, or hospital. The uninsured either forego care or risk bankruptcy.

The ugliest facet of this disgrace is that the uninsured pay taxes for the care they are not getting. Indeed, the poor often pay more disproportionally because the states’ proportion of Medicaid is paid to a large degree with sales and property taxes, both of which are regressive. And yet it is the poor who are targeted for bureaucratic harassment and denial of services. We will be saying much more about this in the months and years ahead.

Ethical and moral issues are crucial in the fight against predatory corporate practices, but effectively opposing bad corporations and their executives requires valid and reliable data. For instance, the nursing home industry claims that pervasive neglectful care by Medicare and Medicaid-funded long-term care is justifiable due to inadequate Medicaid reimbursement. As we will demonstrate with overwhelming evidence, this is false. It is an intentional lie pushed through a powerful lobby (see post today: Nursing Home Industry Financial Propaganda is a Barrier to Decent Medicaid Funded Long-Term Care).

“Effectively opposing bad corporations and their executives requires valid and reliable data.”

The People’s Data Project: A Data Ecosystem for Healthcare Data Accessibility & Transparency

Americans intuitively know that the privatized healthcare system is siphoning off excess amounts of funding for their healthcare into the pockets of private interests. However, the only data available that people need and deserve to prove that their taxes, premiums, deductibles, and co-payments are unduly and excessively channeled from their care to investors and executives are rarely obtainable without the aid of advanced data analytical tools. For instance, hospital and nursing home cost report Public Use Files (PUFs) are available online.

One problem is that the files are too large to open in a commonly used spreadsheet. The data must be merged with other data files and converted into file formats suitable for analysis. Even when the data is analyzable in a typical spreadsheet, considerable assistance from data analysts who have experience with cost reports is necessary. That is the role and purpose of the People’s Data Project. We prepare and analyze data for nonprofit organizations, legislators, and other Americans who want to understand how money flows through nursing homes, hospitals, Medicaid contractors, and other providers of U.S. healthcare nationally, as well by region, state, county, city, and zip code.

Our data ecosystem has been built with an IBM-SPSS statistical core using Python/Pandas programming languages for file transformation, analysis, and data modeling. Steps in the analytics of hospital and nursing home cost reports are depicted in the schematic below.

This schematic displays the originating sources of data, the tools used to format the data for creating needed output, the necessary organizing structure, and the files the with which data are merged to complete the full picture.

The PDP makes data available online usable for the lay public. In addition, we have extensive experience with and knowledge of hospital and nursing home data and other obtainable healthcare data. Our purpose is to assist nonprofit organizations, researchers, and lay people with obtaining and analyzing data within our bailiwick.

The Dangers of Predatory Corporate and Government Data Analytics are Creating a Democratic Crisis.

Without integrity in the collection and use of data by governments and corporations, Democracy as we know it will disappear. Unfortunately, the power of contemporary corporations with sophisticated technology is producing a crisis of citizen powerlessness. It is also unfortunate that too many professionals and politicians are indifferent to glaring conflicts of interest and intentional misinformation for the purpose of manipulating and misleading the public.

“Without integrity in the collection and use of data by governments and corporations, Democracy as we know it will disappear.”

The data crisis we are facing can only worsen with the advent of AI and increasingly sophisticated data analytics tools. It is despicable for industries to misuse technology and statistics to prey on unsuspecting populations needing healthcare. There is no doubt that AI is a powerful tool that can be used against “We the People.” However, The People’s Data Project will empower people to harness the power of AI and data analytics for fighting back against those forces that are using it against them.

Nursing Home Industry Financial Propaganda is a Barrier to Decent Medicaid Funded Long-Term Care

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By: Dave Kingsley

Narratives Make a Huge Difference in Politics: The People’s Data Project (PDP) Will Debunk the Nursing Home Industry’s False Narrative

    The nursing home industry, represented in Washington, D.C. and all 50 states by the American Healthcare Association, has been successful in pushing a simple narrative: “Nursing home companies are operating on a ‘thin margin’ due to inadequate Medicaid reimbursement; therefore, they can’t afford to provide adequate staffing and decent care.”  This hardship plea has been successfully sold to politicians, the media, academics, and the public in general.

   At the People’s Data Project, we have the data and the data analytic tools to debunk AHCA-funded misinformation.  We will begin with the misleading annual report[i] put out by the major accounting firm of Clifton, Larson, & Allen (CLA) on behalf of the industry.  The bar charts below appear in the accounting firm’s latest report. These graphics display the nursing home industry “Median Operating Margin” for 2023.

“From a financial and statistical perspective, the above presentation is highly flawed….”

From a financial and statistical perspective, this presentation is highly flawed and, for a leading accounting firm, disingenuous.  We have the same data as CLA.  We will show briefly in this post why the operating margin as referenced in the above graphic has no relevance to the important concept of “cash flow” – the flow of capital through a network of facilities onto the Income statements, “Cash Flow statements, and “Balance Sheets” of Parent Corporations.  Rarely are nursing home facilities stand alone, independent subsidiaries with meaningful financial statements.  Rather, they are conduits for cash to parent/holding companies.

    The PDP data files include data from cost reports submitted by 14,440 facilities for 2023.  Net operating income in our file – displayed in the table below – is not significantly different than that reported by CLA.

Certainly, accountants at CLA know that foisting these statistics in this manner on an unsuspecting public is unethical.  They are failing to add data and explanations that place them in proper perspective.  The data are extremely skewed in a negative direction, which pulls the average and even the median in a negative direction.  A skew of -38.33 is so extreme that point estimates are of no use when all the data is dumped into a stats package and no adjustment is made for the shape of the data.

    But statistical validity problems such as skew aren’t the only problems with the way nursing home operating net is used in the industry narrative.  Here are the major problems with operating net that CLA accountants most certainly understand:

  • Net operating income (net income from service to patients) is net patient revenue minus expenses.  Expenses include payments to parent and holding companies of the facilities reporting net operating income (see the table below, which indicates $16 billion allocated to related parties and home office allocations).
  • Reimbursement from sources other than Medicaid/Medicare reimbursement and self-pay are not included in operating net income.  However, as the table below indicates, other revenue for state incentive programs, COVID relief, and other sources totaled $18.6 billion in 2023 but is not added to the operating margin by CLA & AHCA.

   Operating expenses of $172.6 billion include payouts to parent/holding companies for management fees of $16 billion.  Also, other revenue from incentive programs, COVID relief, and other sources of $18.6 billion added to the net patient revenue, along with home office allocations and payments to related parties (subsidiaries owned by parent/holding companies) creates a different perspective than operating net.

  When home office allocations, payments to related parties, and nonpatient revenue is added to net operating income, it appears that 12.7% of industry patient revenue is funneled to owners of nursing home chains.  There are other sources of income for chain owners through tax write-downs for interest, taxes, and depreciation.  In future posts, we will discuss other vehicles available to the nursing home industry for adding value to Medicare and Medicaid reimbursement.

[i] See: Clifton, Larson, Allen (2024): The Great Divergence 39th_snf_cost_comparison_report_final.pdf