Studies have shown that nonprofit and not-for-profit nursing homes consistently outperform their for-profit counterparts, and the COVID-19 pandemic is providing further evidence. When the State of Maryland published its list of nursing homes with COVID-19 cases, four of the five worst outbreaks were for-profit corporations. In the United States, the federal response to COVID-19 under Trump has done an abysmal job of tracking the impact of COVID-19 on nursing homes, but in Canada, a study found fatality rates of 9% in for-profit homes versus 5.3 percent in non-profits.
The difference often boils down to the organization’s attention to detail, which comes from a top-down focus on quality care. If strict standards for quality care, such as infection controls, were not a priority before COVID-19, it was very unlikely that these for-profit facilities would be able to suddenly handle the dramatically increased challenges of a pandemic. Ultimately, the quality of care in times of stress comes down to the nursing home’s organizational mission and culture.
“If the nursing home is focused on turning a profit or if they are focused on providing quality care, you’ll know it as soon as you walk into the facility,” said Brian Brown, a founding partner with Brown & Barron, a law firm that specializes in nursing home issues. “You’re probably going to see that the nursing homes that fare the worst during COVID-19 had the worst track record before the pandemic.”
Nonprofits have a built-in advantage
Studies have shown that for-profit homes, on average, maintain lower staffing levels than nonprofits, providing the most logical explanation for why for-profits perform worse than nonprofits. With the high cost of long-term care already beyond the means of many families, many for-profit nursing homes have cut supplies (including PPEs) and staffing to the bone to cut overhead and increase profitability, resulting in lower standards of care.
According to list of studies compiled by QP Briefing:
- A 2015 study of 640 long-term care homes in Ontario found that "for-profit facilities have significantly higher rates of both mortality and hospital admissions" than non-profits.
- A 2016 study of international care homes found "considerable evidence" that "public funding of care delivered in for-profit facilities is inferior to care delivered in public or nonprofit facilities."
- A 2009 meta-analysis of long-term care studies found that "on average, not-for-profit nursing homes deliver higher quality care than do for-profit nursing homes."
- British Columbia's seniors advocate found in February that for-profit operations spend 24 per cent less on direct care for residents than non-profits, while underpaying staff and failing to deliver on their contracted standards of care.
When choosing a nursing home, families need to do their research, because there are high performing for-profit facilities and low-performing nonprofits, but the nonprofits appear to have an intrinsic advantage. To no surprise it comes down to money.
“For-profit nursing homes need to allocate a certain percentage of every dollar toward profit for shareholders, and that influences decisions on staffing, PPE, and other life-saving resources,” said Leah Barron, a founding partner with Brown & Barron. “For the nonprofit facility, every penny, in theory, goes toward providing care.”
Our attorneys at Brown & Barron, LLC focus on representing nursing home residents who have been neglected or abused. We know first-hand how these facilities function, and just how vulnerable residents are to injuries. If you believe you or a family member has suffered as a result of nursing home negligence, we invite you to contact our team as soon as possible to learn more about your rights and options.