Investor-owned nursing homes deliver lower quality care than nonprofit or public nursing homes, reported these researchers who based their determination on 1998 government inspections of 13,693 nursing facilities.

More than 1.6 million Americans live in nursing homes and probably won't leave the homes until their deaths. They are bound by the practices, the diet, and treatments ordered by the institution management.

Several small studies have suggested that for-profit nursing homes, which make up two-thirds of the nation's nursing homes, offer poor care. These researchers had the same mindset and rated deficiencies involving quality of care and quality of life on an A through L scale with G through L noting harm. Of the homes in this study, 65.8% were investor owned, 27.7% were nonprofits, and 6.5% were public. Two-thirds of the investor-owned homes were a chain. Nurse staffing in all types of nursing occupations was lower at investor-owned homes, which may have something to do with care quality. Investor owned homes were larger than private nursing homes, which may impact quality. Yet public nursing homes were usually larger than investor owned homes and rated higher on care quality.

The most obvious explanation for poor care, the researchers theorized, is that profit seeking takes funds from clinical care. The nation's largest nursing home often make $5.28 per patient each day. These findings do not mean quality of care at nonprofit and private homes is excellent or even adequate, because care at each facility differs. Nevertheless, the message is clear in this study: Those too frail, too sick, too poor, and too powerless to choose or protest care, should steer clear of profits-seeking firms. #782

Harrington, C., Woolhandler, S., Mullan, J., Carrillo, H., & Himmelstein, D. U. (2001, September). Does investor ownership of nursing homes compromise the quality of care? American Journal of Public Health 91(9), 1452-1455.

Keyword: Deinstitutionalization