Does investor ownership of nursing homes compromise the quality of care?
OBJECTIVE
Two thirds of nursing homes are investor owned. This study examined whether investor ownership affects quality.


METHODS
We analyzed 1998 data from state inspections of 13,693 nursing facilities. We used a multivariate model and controlled for case mix, facility characteristics, and location.


RESULTS
Investor-owned facilities averaged 5.89 deficiencies per home, 46.5% higher than nonprofit facilities and 43.0% higher than public facilities. In multivariate analysis, investor ownership predicted 0.679 additional deficiencies per home; chain ownership predicted an additional 0.633 deficiencies. Nurse staffing was lower at investor-owned nursing homes.


CONCLUSIONS
Investor-owned nursing homes provide worse care and less nursing care than do not-for-profit or public homes.
Harrington
C
C
Department of Social and Behavioral Sciences, University of California at San Francisco School of Nursing, USA.
Woolhandler
S
S
Mullan
J
J
Carrillo
H
H
Himmelstein
D U
DU
D000203:Activities of Daily Living; D000704:Analysis of Variance; D001509:Bed Occupancy / Q000706:statistics & numerical data; D006302:Health Services Research; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage; D007449:Investments / Q000706:statistics & numerical data*; D008484:Medicaid; D006278:Medicare; D015999:Multivariate Analysis; D009735:Nursing Homes / Q000458:organization & administration*; D010067:Ownership / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D017149:Private Sector / Q000458:organization & administration; D017150:Public Sector / Q000458:organization & administration; D011787:Quality of Health Care; D011788:Quality of Life; D014481:United States