Nursing Homes Overview

For-profit vs. Not-for-profit Nursing Homes

Be sure to check into past complaints before entering a nursing home.
Be sure to check into past complaints before entering a nursing home.

In order to receive funding from Medicare and Medicaid, nursing homes must be inspected annually by state surveyors. Unfortunately, more than 90 percent of nursing homes were cited for not meeting health and safety standards in 2007 [source: Pear]. And the kind of care you receive might boil down to who owns the nursing home.

Approximately two-thirds of nursing homes in the United States are operated by private, for-profit firms, while another 25 percent are owned by not-for-profits and 10 percent are operated by the government [source: AGS Foundation]. Nursing homes operated for a profit are linked with a decreased quality of care and a greater number of complaints and violations in their inspections [sources: Harrington et al., Pear]. Not-for-profit and governmental homes are by no means perfect; in 2007, not-for-profit nursing homes averaged 5.7 deficiencies per nursing home, while government homes racked up 6.3 per home. However, for-profit nursing homes were reported to have an average of 7.6 deficiencies per home in 2007 [source: Pear]. The deficiencies included instances of infected bedsores, medication mix-ups and the use of physical restraints.

­The thinking goes that in order to make money, the for-profit homes make cuts that affect the quality of care, such as reducing the number of nursing staff or skimping on the meals. As a result, patients suffer, making them more likely to suffer depression or lose skills related to autonomy and independence than residents in other homes [source: Duhigg]. What's more, for-profit nursing homes often have a confusing corporate setup that makes it difficult to tell who's really to blame for poor resident care, which becomes particularly important should the need for a lawsuit or a federal fine arise.

But it's not only for-profit nursing homes that may skimp on care. In fact, because for-profit homes depend upon customer satisfaction in order to get new residents, they may be very well-run. And just because a not-for-profit or governmental group has its name on the letterhead doesn't mean you'll get great care. These groups may lend their name to the nursing home, while actual day-to-day management is done by an outside company.

If you do suspect abuse or neglect in a nursing home, you could address the issue with staff or contact your state's long-term care ombudsman. The ombudsman is required by law to examine complaints and can work with nursing homes or other agencies to solve conflicts.

Festering bedsores, fighting patients -- this isn't the rosy home that we may want for ourselves in our old age. Find out about what's being done to make nursing homes a better place on the next page.