Quality of Care May Be Higher in Nonprofit Nursing Homes

Janice Simmons, for HealthLeaders Media , August 21, 2009

A statistical review of 82 individual research studies shows that nonprofit nursing homes may be delivering on average higher quality care in several categories than for profit nursing homes, according to researchers writing in a new study of the online version of the British Medical Journal.

The researchers began with a search that initially yielded nearly 9,000 citations from between 1965 and 2003. This was narrowed down through a systematic review to 82 individual studies that compared four quality of care measurements in thousands of nursing homes, mostly in the United States (with some data from Canada and Taiwan).

The four quality categories examined were:

  • Number of staff per resident or level of training of staff

  • Frequency of use of physical restraints

  • Prevalence of pressure ulcers or bedsores

  • Regulatory or government deficiencies

The researchers masked the studies' results before determining eligibility.

In 40 of the 82 studies, the researchers' meta analysis found that nonprofit facilities delivered higher quality care than for profit facilities in two of the four most frequently reported quality measures: more or higher quality staffing and less prevalence of pressure ulcers. The results also suggested somewhat better performance of the nonprofit homes in the other two quality measures.

About 1.5 million people currently reside in nearly 16,000 nursing homes in the United States, and more than 3 million Americans will spend at least some time in a nursing home this year, according to the Centers for Medicare and Medicaid Services. About two thirds of U.S. nursing home residents live in for profit facilities.

The findings have significant patient care implications, the authors said. The results suggest U.S. residents would receive about 500,000 more hours of nursing care per day if nonprofit institutions replaced for profit nursing homes.

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