Image of Haider Warraich, M.D.; Photo credit: Shawn Rocco/Duke Health
Haider Warraich, M.D.; Photo credit: Shawn Rocco/Duke Health

For-profit nursing homes have put residents at higher risk of death during the pandemic and are a poor deal for elders overall, according to a cardiologist and researcher.

“Private equity investment fundamentally changes nursing homes,” contends Haider Warraich, M.D., in an opinion piece that appeared Tuesday in medical news outlet STAT. Lack of oversight has resulted in reduced quality of care even though costs rise for Medicare and for residents in this ownership model, he wrote.

Warraich referred to a review of six studies conducted during the pandemic, which shows that residing in a for-profit nursing home increases the risk of COVID-19 infection or death. That’s on top of residents’ already high-risk profile due to frailty, comorbidities and advanced age, the doctor wrote. Hospice care has been similarly affected by private equity ownership, he added.

This and other evidence suggests that tens of thousands of individuals, many of them people of color, died during the COVID-19 pandemic because they happened to be in facilities that prized profits, concluded Warraich, who is affiliated with the VA Boston Healthcare System and Brigham and Women’s Hospital in Boston.

In another, long-term study cited by the piece, researchers found that private equity ownership increases short-term mortality by 10%. This increase led to the loss of approximately 21,000 lives over a two-decade study period, they estimated. Factors that may account for those results include declines in resident health measures such as worsening mobility and increased use of antipsychotic medications; declines in nurse availability per patient; and declines in adherence to federal and state standards of care, according to the authors.

“When I care for patients in the hospital, even my most diligent work can mean nothing if they receive poor care at the nursing facility to which they are discharged,” said Warraich.

The doctor recommended more scrutiny by lawmakers, and possibly eliminating immunity provisions to help increase transparency and accountability in for-profit facilities.

More details and insight on the issue can be found here.