Nursing Home Study Finds Quality Lacking at For-Profit Facilities

For-profit nursing homes have fewer staff and provide less quality care than not-for-profit facilities, according to a review of more than 13,000 nursing home inspection records, the Wall Street Journal reports (Wall Street Journal, 9/4). In a study in the September issue of the
American Journal of Public Health, researchers at Harvard University and the University of California-San Francisco found that for-profit homes were cited for problems 46% "more frequently" than not-for-profit homes, and 43% more often than government-run homes (Feder, San Jose Mercury News, 9/1). Deficiencies ranged from poor record keeping to "substandard hygiene and life threatening neglect." Also, the review found that the "hours-per-patient day of licensed nursing staffing at for-profit facilities were, on average, 32% lower than at not-for-profit homes, and 23% lower than at public facilities." Steffie Woolhandler, an associate professor at Harvard Medical School and co-author of the report, said, "The investor-owned facilities are skimping on nursing and other costs in order to make money" (Wall Street Journal, 9/4). Charlene Harrington, the study's co- author and professor at UC-San Francisco, said, "It makes sense: If facilities are trying to make money, sometimes they cut corners."

On average, 65% of a for-profit facility's residents are Medicaid beneficiaries, compared to 45% for not-for-profit facilities. Kelley Queale of the California Association of Health Facilities, said that for-profit homes do not make "huge profits" because Medicaid reimbursement levels are lower than those for Medicare and private insurance. In California, for example, for-profit nursing homes earned an average profit of 2% in 1998. She added that not-for-profit nursing homes are exempt from taxes and have other means of raising funds unavailable to for-profit facilities. Queale said, "States and the federal government are not doing their part to support nursing home care with adequate financial resources" (San Jose Mercury News, 9/1). The American Health Care Association called the figures in the study as "subjective" and "not reliable." Alan DeFend, vice president for public affairs at the association, said the study "reads more like an opinion piece than a research piece" (Wall Street Journal, 9/4). The study is available online.