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Are Large Nursing Homes Compromising on Quality Care? Studies Prove It

User in Chicago, IL
March 14, 2017

Nursing staff is an indispensable component of the healthcare industry. But the increasing gap in the demand and supply of nursing staff even with so many for- profit and non-profit organizations, has raised doubts about the quality of services provided to the patients. Research has found that for-profit ownership nursing facilities offer poor quality care as compared to the non-profit ownerships.

The increasing corporatization of nursing homes and hospitals has seen a major shift in the patient- care industry. Nursing home chains grew significantly during the 1990s and by the mid-2000s, with the increase in medical payments, they became financially stable. With heavy privatization, nursing homes are treated as a huge profit making business. With for-profit ownerships devoting fewer resources to the patient care, the quality of services has seen a considerable decline, when compared to the non-profit organizations.

Parameters of Quality Care Evaluation

The most commonly used parameters of quality care evaluation were first identified by A. Donabedian. The three domains of quality care evaluation are structure, process, and outcome. The structural aspect includes resources for care i.e. the staff, the process includes the action of providing care, and the outcome refers to the end result of the care (the result may be good or bad health condition). These parameters are evaluated time and again for both non-profit and for- profit facilities.

Non-Profit vs For-Profit Facilities Study

According to an analysis done by the USA Today, as per the government's five-star rating, 27% of the for-profit facilities achieved only one star as compared to the 13% of the non-profit facilities. Only 9% for-profit facilities achieved the five-star rating as against the 19% of the non-profit facilities. The data objectively showcased the low staffing numbers compared to the requirement that adversely affected their rating. As per the latest study, 28% of nursing homes dropped one star from their total ratings, including more than 1,200 nursing homes that lost the much desired five-star status.

The study looking at staffing in aggregation with the quality of care offered suggests that large for- profit chains purchased by the private equity companies are always under pressure to improve investor and shareholder values, due to which they tend to overlook the regulatory guidelines. The top-rated nursing home chains witnessed 36 percent higher staffing scarcity than non-profit organizations.

According to a recent study by the association of LeadingAge New York, when compared with for-profit organizations, the non-profit organizations performed better. Non-profit organizations had lower hospitalization rate, more home discharges, and had a better number of nursing staff to cater to the patient needs.

As per the UCSF led analysis, poor staffing is the largest predictor of poor quality nursing care and for-profit organizations including the top 10 of the country's large chains of nursing facilities that control almost 13% of the total nursing beds, scored scantily. The study further found out that privately held facilities recruited less nursing staff particularly to keep the costs down and improve the profit earnings ratio. These private organizations were having fewer nurse staffing hours. When compared with the non-profit facilities, the staffing hours was 30% less which further led to findings such as increased number of sick residents, poor sanitary conditions, weight loss in residents, mistreatments, infections, falls, and other potentially harmful conditions.

The study also amplified the need for in-depth analysis of the prevalent conditions of poor staffing and requirement for better incentives and funding to overcome this situation. Better quality control and greater accountability on quality care need to be administered to ensure patients do not suffer.

The increasing commercialisation of nursing homes and medical treatments have led the focus of privately owned facilities into maximising the profits. The greed for maximum profits results in more heads on beds and fewer nursing staff to take care of them. This lethal formula of maximising profitability has led to a dangerous environment for the patients as many of their basic daily needs go unmonitored and unfulfilled.


Although steps are being taken in improving staffing deficiencies and better patient care, if any of your loved one has suffered due to the negligence of the nursing home, it is advisable to contact a lawyer and claim a lawsuit. For any kind of negligence caused at the nursing home facility, the nursing home must be fully accountable for the suffering of the plaintiff, irrespective of the size of the company.

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