The Henry J. Kaiser Family Foundation put out a report in May 2015 that offered an interesting fact about nursing home care in the United States. According to the report, smaller nursing homes score higher than larger nursing homes when it comes to independent measures of patient care by a margin of nearly two to one. That means that according to health inspection records and personal family reviews, smaller nursing homes do a better job of taking care of patients than larger for-profit ones.
This little fact may seem obvious to many people, but it points out a problem that has been on the rise in nursing homes for some time. Smaller facilities are able to afford the staff needed to care for their patients, and that tends to be the contributing factor to the higher level of care. But as facilities get larger, staffing issues emerge that degrade the quality of care. Families with elderly loved ones in nursing homes are wondering why care seems to diminish as the facility gets larger.
For-Profit Facilities Could Be To Blame
The University of California San Francisco released a report in 2011 that bluntly asserted that for-profit nursing homes offer a lower quality of care than non-profits or facilities run by the government. The study indicated that large
for-profit nursing home chains control 13 percent of the nursing home populations in approximately 2,000 facilities. When you do the math, it gets easy to see where the problem lies.
There are approximately 15,500 nursing homes in the United States that are currently approved to accept funds from Medicaid and Medicare. This number represents nearly all of the nursing homes in the United States. There are approximately 1,400,000 patients in long-term care situations in these nursing homes. This means that 2,000 for-profit facilities are caring for 182,000 patients, or an average of 91 patients per facility. Since a small facility is considered one with 60 beds or less, the average for-profit nursing home is a large facility.
Could Profit Be A Priority Over Care?
The for-profit facilities received 41 percent more serious violations than the better public facilities in 2011. With these facilities having to answer to shareholders and turn a profit, there seems to be a correlation between poor care and the quest for higher profits. For-profit facilities are not hiring enough RNs, and they are short-staffing themselves on qualified personnel to care for their patients.
Without evidence, much of this could be dismissed as coincidence. That is why the UCSF report also indicated that between 2003 and 2008, the largest for-profit chains saw drastic drops in service quality immediately after being purchased by private equity and investment firms. It can now be established that for-profit nursing homes that are Medicare-certified are making profits a priority over care.
What Can You Do?
In recent years, lawsuits from families have caused most of the states to start doing more regular inspections of for-profit, non-profit and government nursing homes. Long-term care facilities are now being held accountable for their actions, and there is also a comprehensive rating network in place to help warn families about the facilities that offer poor care.
Despite the advances, nearly 40 percent of all nursing homes in the United States only achieve a maximum rating of one or two out of five. There is still work to be done, but the spotlight is on nursing homes to offer quality care. Before you decide which facility will care for your loved one, do your research and find out if it is a facility that offers quality care, or if it is a facility that tends to put profit before patients.