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Low Quality of Care at For-Profit Nursing Homes May Lead to More California Elder Abuse

America’s largest for-profit nursing homes deliver significantly lower quality of care, according to a new study conducted by the University of California San Francisco (UCSF). The UCSF-led analysis of quality of care at nursing homes around the country is the first-ever study focusing solely on staffing and quality at the 10 largest for-profit chains.

The reason for lower quality of care at large for-profit nursing homes, the study reports, is that such facilities usually have fewer staff nurses than non-profit and government-owned nursing homes. Our San Diego nursing home abuse lawyers know that lower staff numbers typically mean less one-on-one care and personalized attention. It can also mean that when such homes are short-staffed, important tasks may be rushed or paperwork may be missed.

The study, which will be published in Health Services Research, found that poor quality of care is prevalent at many nursing homes. However, the worst offenders are the largest for-profit chains because that is where the most serious problems generally occur.

According to one author, Charlene Harrington, RN, PhD, the top 10 nursing home chains employ a strategy that fails to make quality care a priority. They keep labor costs low in order to increase profits. Importantly, low nurse staffing levels are considered the strongest predictor of poor nursing home quality. Poor nursing home care can lead to California elder abuse or neglect, such as lack of supervision, painful bed sores, or infections. Large nursing home chains keep costs low by reducing staff, particularly RN staff.
The top 10 largest for-profit chains control approximately 13% of the nation’s nursing home beds. This is particularly concerning since California’s adult care budget repeatedly has been slashed and more and more families are being forced to institutionalize their elderly loved ones due to a lack of services in the community.

The study reports that the 10 largest for-profit chains in 2008 were HCR Manor Care, Golden Living, Life Care Centers of America, Kindred Healthcare, Genesis HealthCare Corporation, Sun Health Care Group, Inc., SavaSeniorCare LLC, Extendicare Health Services, Inc., National Health Care Corporation, and Skilled HealthCare, LLC.

If you’re wondering why a study such as this one is so important, attorneys practicing in this area know that the 10 largest for-profit chains were cited for higher percentages of deficiencies, as well as higher percentages of serious deficiencies, than the best facilities. Additionally, the 10 largest for-profit chains in 2008 had the sickest residents, yet had total nursing hours that were 30% lower than non-profit and government nursing homes.

The UCSF study recommended “greater accountability and quality oversight mechanisms” because they would “help improve nursing home care, along with effective funding incentives and sanctions for low staffing and poor quality.”


Our San Diego nursing home attorneys at the Walton Firm can help you understand the signs and symptoms of elder abuse and neglect so that you can make the best decision possible about a loved one’s care. Our San Diego elder abuse lawyer is well versed in nursing home abuse law. If you have concerns about the care a family member is receiving, please visit a legal professional to learn about the signs of abuse and neglect and about how to best protect you and your loved ones.

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