For-profit nursing home chains provide poorer quality of care, study asserts

Lower levels of nursing staff in large for-profit nursing home chains have resulted in substantially lower quality of care when compared to government-owned or non-profit nursing homes, according to a study released Tuesday.

To compare quality at for-profit chain nursing homes against non-profit facilities, researchers studied staffing levels and facility deficiencies received by the United States’ 10 biggest nursing home chains, versus facilities run by five other types of ownership groups. The University of California at San Francisco research team was led by Charlene Harrington, RN, Ph.D., and backed by the Service Employees International Union.

Between 2003 and 2008, the for-profit facilities had fewer nurse “staffing hours,” researchers said. The 10 largest nursing home chains received 36% more deficiencies from regulators, according to the study. Additionally, the for-profit sites received more deficiencies after being purchased by private equity groups than before the purchases.

“Poor quality of care is endemic in many nursing homes, but we found that the most serious problems occur in the largest for-profit chains,” Harrington said. “The top 10 chains have a strategy of keeping labor costs low to increase profits.”

Similar studies comparing the care at for-profit versus non-profit nursing homes have shown mixed results in the past, but providers have contended that management styles and structures at for-profits vary. Nursing homes should be evaluated on an individual basis, they argue.

The study was published online in Health Services Research.