Study: Largest for-profit nursing homes provide worse care, lower staffing than nonprofits

The largest for-profit U.S. nursing home chains deliver “significantly lower quality of care” than nonprofit and government-owned nursing homes, according to a new study from the University of California, San Francisco.

In the article, researchers argue that the top 10 nursing home chains employ a “strategy” in which they sacrifice appropriate staffing levels—particularly RN staffing—to increase profits. Low nurse staffing levels are the strongest predictor of poor nursing home quality, the researchers said.

“They are not making quality a priority,” said study author Charlene Harrington, RN, PhD, professor emeritus of sociology and nursing at the UCSF School of Nursing.

Between 2003 and 2008, researchers found the 10 largest for-profit chains to operate about 2,000 nursing homes and 13 percent of the country’s nursing home beds. Researchers then compared staffing levels and facility deficiencies at those for-profit chains to those at homes run by five other ownership groups to measure quality of care during that timeline.

The top 10 for-profit chains combined had 30 percent fewer nurse “staffing hours” than nonprofit and government nursing homes when controlling for other factors, according to the study. The for-profits were also cited for 36 percent more deficiencies and 41 percent more serious deficiencies than the “best” performing facilities they were compared to.

The study also found that the four largest for-profit nursing home chains purchased by private equity companies between 2003 and 2008 had more deficiencies after being acquired.

The authors said that more study is needed on the subject.