Nursing Home Quality Goes Down When Profits Go Up

What happens when family-owned nursing homes are bought by corporations? With few exceptions, they raise profits at the expense of residents by lowering the standard of living and the standard of care. During a pandemic, the lack of attention to detail translates to tens of thousands of preventable deaths. The nursing home industry is simply a poor fit for a free-market model because the customer base often does not have free choice, due to infirmity or poverty, removing the businesses’ incentive to provide quality services.

“In the 2000s, private equity firms really began buying up all the independent nursing homes, and to make them more profitable they often cut staff levels. Studies have shown that lower the staff levels at nursing homes leads to more preventable deaths. So to make a few extra dollars, they’re endangering lives, and they know it,” said Leah Barron, a founding partner with Brown & Barron, a Baltimore law firm specializing in cases of nursing home abuse and neglect.

Bloomberg Businessweek examined the transformation that occurred at Tennessee facilities acquired by national nursing home corporation CareRight. The effects were immediately noticeable by residents and staff — as well as the nursing home abuse and neglect attorneys in the state. At the once family-owned Trevecca nursing home, acquired by CareRight, employees reported to Bloomberg that the firm “slashed the budget to keep the facility clean, reducing spending on linens, towels, and blankets by more than 50%. Nurse’s aides sometimes had to cut old sheets into pieces to use them as washcloths for residents. Meanwhile, several housekeepers were laid off, often leaving one person to clean 30 rooms on a floor during an eight-hour shift, when before there’d been two.  Workers say the building fell into disrepair. Blankets wore so thin that a staff member recalls holding one up and reading the time off a clock through it. The lobby was adorned with big potted plants and plush upholstered chairs, but the cream-colored carpet accumulated an ever-expanding collection of stains.”

Staff Cuts Kill

The cuts not only affect the comfort level and dignity of elderly residents. They also cost lives. The most expensive aspect of nursing home care is hiring highly trained nursing staff. Many nursing home residents have limited access to actual registered nurses (RNs), who are the only staff trained on medical matters, such as infection control.

The bulk of the work done at nursing homes is by lower trained, lower paid nurses aids. Even this lower echelon of health care provider is stretched too thin, with nursing homes hiring the bare minimum the government will tolerate. As a result, the residents get dangerously low access to both RNs and other staff, as the workers are stretched too thin. This results in abuse and neglect under normal circumstances, and during a pandemic like COVID, it also results in widespread outbreaks.

Only 0.6% of the total U.S. population lives in nursing homes, but they account for 40% of COVID fatalities, according to the Kaiser Family Foundation. One of the main reasons is understaffing. Bloomberg cited the research of Yue Li, a professor at the University of Rochester Medical Center, who compared the rate of nursing home infections in Connecticut to the number of registered nurses they employed. Li found that “among homes with at least one infection, every 20 minutes of additional RN staffing time was associated with a 22% decrease in COVID cases.”

Bloomberg found that CareRight’s four facilities in Tennessee averaged only 22 minutes of RN time per resident each day (about half the national average of 41 minutes). These facilities each had more than 100 infections.

As CareRight expanded into Tennessee it quickly gained the attention of attorneys who were contacted about abuse and neglect incidents at their facilities.

Failing to Meet Already Low Standards

The CMS (The Centers for Medicaid and Medicare), which supervises the nursing home industry, conducts regular inspections of nursing homes to ensure that minimum levels of care and safety are adhered to. Sadly, the government’s minimum standards are pretty low, and the fines are relatively inexpensive, giving many nursing homes little incentive to improve. Only the prospect of losing an expensive lawsuit for nursing home abuse and neglect provides any motivation for the nursing home industry to provide a safe environment.

As corporations acquire more family-owned nursing homes the goal of providing care, safety, and dignified golden years for our elderly neighbors is a concept that is dying with each mistreated resident.

Our attorneys at Brown & Barron, LLC focus on representing the victims of medical malpractice and nursing home abuse/neglect. We know first-hand how these facilities function, and just how vulnerable patients and residents are to injuries. If you believe you or a family member has suffered as a result of medical malpractice or nursing home negligence, we invite you to contact our team as soon as possible to learn more about your rights and options. To contact our team, call (410) 698-1717 today for a consultation.

This site offers legal information, not legal advice. Although we do our best to provide helpful information about your options, your specific needs require specific legal advice, and for that you should consult an attorney. 

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