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“Despite requirements that nursing homes file state and federal cost reports each year, we still really can’t tell where all that taxpayer money going,” said Alison Hirschel, director and managing attorney of the Michigan Elder Justice Initiative, also called MEJI. “We don’t know if it’s being squirreled away in excessive profits or whether it’s actually being used completely appropriately to meet very vulnerable people’s needs.

“The lack of transparency,” she added, “means we aren’t able to be good stewards of billions of dollars of taxpayer funds.”