Texas Nursing Home Residents Were Already at Risk. Then COVID-19 Hit.

WHEN GARY BLAKE LAUNCHED Creative Solutions in Healthcare in 2000, he started small, opening a single modest nursing home in Granbury. Now Blake runs a nursing home empire. He owns or operates 64 nursing facilities across Texas, from big cities to rural cow towns; Creative Solutions pulls in a reported $282 million annually. But the Fort Worth-based company and other for-profit facilities throughout the state have been dogged by deaths of residents and serious rule violations for years, the Observer and Type Investigations found. And, advocates say, federal and state regulators have done little to hold them accountable.

Then COVID-19 hit. Just weeks after the coronavirus was first detected in Texas, nursing homes statewide quickly became the main breeding grounds for the virus as officials