New Study Shows Quality Care is Declining at Largest Nursing Home Chains

December 15, 2011

A recent online study by the University of California, San Francisco shows that the nation's largest for-profit nursing home chains provide decidedly lower quality care than their non-profit and government-owned counterparts. This study was made available in advance of print publication in Health Services Research, and states that the primary cause of the reduced quality of care is due to nursing staff cuts.

The reduction of nurses at major nursing home chains comes as no surprise to Chicago nursing home attorneys at Pintas & Mullins Law Firm, who have seen a steady increase in Illinois nursing home abuse and neglect cases in the past decade. The surge in nursing home neglect cases is due in part to a significant expansion in nursing facilities in recent decades. A large number of nursing home chains were publicly traded until the early 2000's, when five of the largest chains filed for bankruptcy. After a period of reorganization, and substantial increases in Medicare payments, many of the largest nursing home chains became more financially stable, and were taken over by private equity firms.

The top 10 nursing home chains have found that by keeping operation costs low, and reducing the amount of nurse "staffing hours" per facility, they could increase profits. From 2003-2008, the largest for-profit chains had 30% fewer nursing staff hours than non-profit or government-owned facilities. These 10 chains provided care for the sickest patients, yet had considerably lower nursing power to attend to these patients.

In addition to reduced staffing hours, the top 10 chains were 36% more likely to be cited for deficiencies, and 41% more likely to be cited for serious deficiencies than their counterparts. Deficiencies were cited as failure to prevent bedsores, failure to prevent infections, failure to prevent falls, and failure to keep adequate sanitary conditions.

The top 10 largest chains operate approximately 2,000 facilities nationwide, which represents about 13% of the country's nursing homes. In 2008, the top 10 for-profit chains were: HCR Manor Care, Kindred Healthcare, Genesis Healthcare Sun Health Care Group, National Health Care, Skilled Healthcare, Golden Living, Life Care Centers of America, Extendicare Health Services and Sava Senior Care.

Looking forward, it does not appear that the top 10 nursing home chains in the nation plan to make any significant changes to their current business model. The business model, which derives the largest profits for nursing home chains, will most likely continue to keep labor costs down by reducing staffing, in particular nurse staffing hours. Moreover, recent Medicare reductions in payment rates for residents may further threaten the health and wellbeing of patients. In October, 2011, Medicare cut approximately 11% of its payment rates per patient to nursing homes nationwide. This substantial reduction could lead to further nursing home cutbacks in both staffing and staff wages.

All nursing homes have the legal duty to provide their patients with satisfactory care. Our Illinois nursing home lawyers have assisted countless victims of nursing home abuse recover for both pain and suffering at the hands of negligent facilities. Serious falls, untreated infections and uncared-for pressure sores are the result of untrained and understaffed facilities. These facilities need to be held accountable when their inadequate care leads to preventable medical problems.