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Elderly Patients In For-Profit Nursing Home Facilities Receive Lower Quality of Care and Have Higher Rates of Mortality

It has been found that states like Maryland have some of the worse for-profit nursing home chains in the nation, ranking lowest in family-reported quality of care ratings.

A recent study explored the relationship between nursing home chain size and profit level, using consumer reports and survey data completed from 2007 to 2010 for every non-government run nursing home in Maryland. The consumer-reported data indicated things like overall quality of care, quality of the facility, staff performance, quality of meals, physical environment and personal rights.

The study found that Maryland’s independently owned nonprofit nursing home facilities possessed the highest overall rating of 8.9, with small nonprofit nursing home chains having the second highest rating of 8.6. Independently owned for-profit nursing home facilities had an overall rating of 8.5.

The results of the data showed that nursing home facilities that were involved in for-profit chains had the three worst ratings among all nursing home types, with small, medium, and large for-profit nursing home chains possessing conusmer ratings of 8.2, 7.9, and 8.0, respectively.

According to the researchers of the study, nursing home facility ratings for more specific factors such as recommendation rate, quality of staff communication and quality of care portrayed similar results, with lower consumer ratings in nursing home facilities that were involved in a for-profit chain.

The authors of the study include researchers from the University of Albany, the University of Michigan, Vanderbilt University School of Medicine, University of Rochester Medical Center, and Harvard Medical School. Medical Care published the results of the study in their January 2016 issue.

There have been a few previous studies that have found a relationship between for-profit long-term care facilities and poorer quality of care than their government run or nonprofit counterparts. A study that was published in October 2015 found that for-profit nursing home facilities had significantly increased rates of mortality among their older adult residents and higher hospital admissions.

The researchers of this study explored admissions at 384 for-profit and 256 nonprofit long-term nursing home facilities in Ontario, Canada, from the year January 2010 to March 2012. The study found that a year after admission, the elderly patients of the for-profit nursing home facilities had an overall mortality rate of 107.5 residents per 1,000 person-years, compared to patients in nonprofit nursing home facilities with a rate of 184. The rate of hospital admissions for the for-profit nursing home facilities after exactly one year was 462.4 per 1,000 person-years, whereas the rate for nonprofit nursing home facilities was 358.0.

According to lead researcher of the study Peter Tanuseputro, M.D., It has been hypothesized that differences in outcomes may be related to reinvestments that not-for-profit facilities make into patient care that otherwise would be consumed as profit in for-profit facilities.” This means that senior residents at these for-profit nursing home facilities are not getting their care needs met due to the facilities using their reinvestments for their own gains, instead of using those funds to enhance quality of care.

According to the study’s researchers, the differences could be due to nonprofit nursing home facilities being more strongly tied with acute care facilities, the level of a facility’s relationship with the community, differences in capital funding, and whether a nursing home facility is linked to a chain.