Some of the most sizable and troubled nursing homes in the state of Vermont have struggled for much of this year to provide sufficient care under new ownership, logging violations that included a death, injuries and neglect of residents.

The slate of investigations and new operators’ previous track records have raised questions about how Vermont vets prospective operators and protects residents, under a longstanding process that was supposed to be only temporary.

Corrective plans and subsequent inspections have recently led the facilities to achieve compliance with state regulations. But advocates say there should be policy changes to improve the state’s review process of new ownership, to preempt and root out the problem of poor care.

Genesis HealthCare, a large-scale nursing home oper

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