scholarly journals Marketization in Long-Term Care: A Cross-Country Comparison of Large For-Profit Nursing Home Chains

2017 ◽  
Vol 10 ◽  
pp. 117863291771053 ◽  
Author(s):  
Charlene Harrington ◽  
Frode F Jacobsen ◽  
Justin Panos ◽  
Allyson Pollock ◽  
Shailen Sutaria ◽  
...  
Keyword(s):  
Nursing Home ◽  
Private Equity ◽  
Public Information ◽  
The United States ◽  
Nursing Home Care ◽  
Private Industry ◽  
Term Care ◽  
For Profit ◽  
Cross Country

This article presents cross-country comparisons of trends in for-profit nursing home chains in Canada, Norway, Sweden, United Kingdom, and the United States. Using public and private industry reports, the study describes ownership, corporate strategies, costs, and quality of the 5 largest for-profit chains in each country. The findings show that large for-profit nursing home chains are increasingly owned by private equity investors, have had many ownership changes over time, and have complex organizational structures. Large for-profit nursing home chains increasingly dominate the market and their strategies include the separation of property from operations, diversification, the expansion to many locations, and the use of tax havens. Generally, the chains have large revenues with high profit margins with some documented quality problems. The lack of adequate public information about the ownership, costs, and quality of services provided by nursing home chains is problematic in all the countries. The marketization of nursing home care poses new challenges to governments in collecting and reporting information to control costs as well as to ensure quality and public accountability.

scholarly journals Purchasing Quality Nursing Home Care in the Veterans Health Administration

2020 ◽  
Vol 4 (6) ◽  
Author(s):  
Orna Intrator ◽  
Edward Alan Miller ◽  
Portia Y Cornell ◽  
Cari Levy ◽  
Christopher W Halladay ◽  
...  
Keyword(s):  
The United States ◽  
Veterans Affairs ◽  
Nursing Home Care ◽  
Veterans Health ◽  
Health Administration ◽  
Star Rating ◽  
For Profit ◽  
Veterans Affairs Medical Centers ◽  
And Performance

Abstract Background and Objectives U.S. Department of Veterans Affairs Medical Centers (VAMCs) contract with nursing homes (NHs) in their community to serve Veterans. This study compares the characteristics and performance of Veterans Affairs (VA)-paid and non-VA-paid NHs both nationally and within local VAMC markets. Research Design and Methods VA-paid NHs were identified, characterized, and linked to VAMC markets using data drawn from VA administrative files. NHs in the United States in December 2015 were eligible for the analysis, including. 1,307 VA-paid NHs and 14,253 non-VA-paid NHs with NH Compare measures in 128 VAMC markets with any VA-paid NHs. Measurements were derived from the Centers for Medicare and Medicaid Services (CMS) five-star rating system, NH Compare. Results VA-paid NHs had more beds, residents per day, and were more likely to be for-profit relative to non-VA-paid NHs. Nationally, the average CMS NH Compare star rating was slightly lower among VA-paid NHs than non-VA-paid NHs (3.05 vs. 3.21, p = .04). This difference was seen in all 3 domains: inspection (3.11 vs. 3.23, p < .001), quality (2.68 vs. 2.83, p < .001), and total nurse staffing (3.36 vs. 3.42, p < .10). There was wide variability across VAMC markets in the ratio of average star rating of VA-paid and non-VA-paid NHs (mean ratio = 0.93, interquartile range = 0.78–1.08). Discussion and Implications With increased community NH use expected following the implementation of the MISSION Act, comparison of the quality of purchased services to other available services becomes critical for ensuring quality, including for NH care. Methods presented in this article can be used to examine the quality of purchased care following the MISSION Act implementation. In particular, dashboards such as that for VA-paid NHs that compare to similar non-VA-paid NHs can provide useful information to quality improvement efforts.

The vulnerability of nursing home residents to the Covid-19 pandemic

2020 ◽  
Vol 23 (2-3) ◽  
pp. 57-60 ◽  
Author(s):  
Edward H Wagner
Keyword(s):  
Nursing Home ◽  
Long Term Care ◽  
Nursing Home Residents ◽  
Nursing Assistants ◽  
Nursing Home Care ◽  
Term Care ◽  
Staff Members ◽  
Care Facilities

Residents in nursing homes and other long-term care facilities comprise a large percentage of the deaths from Covid 19. Is this inevitable or are there problems with NHs and their care that increase the susceptibility of their residents. The first U.S. cluster of cases involved the residents, staff, and visitors of a Seattle-area nursing home. Study of this cluster suggested that infected staff members were transmitting the disease to residents. The quality of nursing home care has long been a concern and attributed to chronic underfunding and resulting understaffing. Most NH care is delivered by minimally trained nursing assistants whose low pay and limited benefits compel them to work in multiple long-term care settings, increasing their risk of infection, and work while ill. More comparative studies of highly infected long-term care facilities with those organizations that were able to better protect their residents are urgently needed. Early evidence suggests that understaffing of registered nurses may increase the risk of larger outbreaks.

scholarly journals For-Profit Nursing Homes in the Netherlands: What Factors Explain Their Rise?

2020 ◽  
Vol 50 (4) ◽  
pp. 431-443 ◽  
Author(s):  
Aline Bos ◽  
Florien Margareth Kruse ◽  
Patrick Paulus Theodoor Jeurissen
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
The Netherlands ◽  
Nonprofit Organizations ◽  
Private Equity ◽  
Nonprofit Sector ◽  
Nursing Home Care ◽  
Specialist Care ◽  
Labor Costs ◽  
For Profit

This exploratory, mixed-methods study analyzes characteristics of the emerging for-profit nursing home industry in the Netherlands and identifies the interrelated set of factors (context, trends, and sector conditions) that contribute to its growth. Until recently, the Dutch nursing home sector relied almost exclusively on nonprofit providers. Even though profit distribution in nursing home care is still banned, the for-profit nursing home sector is expanding. The study uses economic theory on nonprofit organizations and mixed-form markets to understand this expansion. We find that changes in the regulatory framework have unlocked the potential of the for-profit nursing home sector, enabling for-profit nursing homes to circumvent the for-profit ban. The expansion of the for-profit sector was mainly driven by the low responsiveness of the nonprofit sector to increased and changed demands. For-profit providers took advantage of this void. Moreover, they exploited “cream-skimming” potential in the market and used the wider care system to reduce their labor costs by relying on external specialist care. Another main driver was the access to financial capital from private investors (e.g., private equity firms).

scholarly journals Medicaid Reimbursement and the Quality of Nursing Home Care: A Case Study of Medi-Cal Long-Term Care Reimbursement Act of 2004 in California

2016 ◽  
Vol 8 (3) ◽  
pp. 329-343
Author(s):  
Jingping Xing ◽  
Dana B. Mukamel ◽  
Laurent G. Glance ◽  
Ning Zhang ◽  
Helena Temkin-Greener
Keyword(s):  
Nursing Home ◽  
Home Care ◽  
Long Term Care ◽  
Nursing Home Care ◽  
Term Care ◽  
Medicaid Reimbursement ◽  
Quality Of Nursing

A Comparison between the Veteran Administration's Long-Term Nursing Home Care Program and Three Examples of Similar Care Outside of the V.A.

1981 ◽  
Vol 13 (1) ◽  
pp. 61-69 ◽  
Author(s):  
William M. Epstein
Keyword(s):  
Nursing Home ◽  
Home Care ◽  
Nursing Care ◽  
Long Term Care ◽  
Care Program ◽  
Nursing Home Care ◽  
National Academy Of Sciences ◽  
Term Care

In a study mandated by Congress, the National Academy of Sciences reviewed the quality of medical care in the Veteran's Administrations health care system. The study reported here summarizes the findings of the long-term care portion of the NAS' work as it relates to nursing home care. The quality of the long-term care in the VA's nursing home care units was compared to three quality standards of long-term nursing care outside of the VA. Staffing pattern, quality of services, quality of the environment, and patient needs were measured and compared; overall assessments of nursing home quality were made by site visitors. Generally, the results show VA care to be superior to the care provided in the benchmark institutions, suggesting perhaps that the public sector's direct provision of long-term nursing care may be an acceptable alternative to the support of private sector care.

scholarly journals (UN)EQUAL BURDEN OF CARE: STAFF PERSPECTIVES ON NURSING HOME CARE AND QUALITY OF LIFE FOR RESIDENTS OF COLOR

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S780-S781
Author(s):  
Odichinma C Akosionu ◽  
Tetyana P Shippee ◽  
Heather Davila ◽  
Mai See Thao ◽  
Moses Waiswa ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Quality Care ◽  
Nursing Home Care ◽  
Care Staff ◽  
Burden Of Care ◽  
Structured Interviews ◽  
Term Care ◽  
Color Experience

Abstract Racial disparities in quality of care (QoC) and quality of life (QoL) for nursing home (NH) residents persist even as the proportion of minorities is significantly increasing. Staff of color are a growing part of the long-term care workforce and staffing is a key component for delivering quality care. This study looks at staff (n=60) perspectives on resident QOL through semi-structured interviews, using thematic analysis in six Minnesota high proportion minority NHs. Key findings show that staff of color are concerned about the QoC and QoL residents of color experience, and take extra steps to provide care that goes beyond addressing their clinical needs. This agency of providing extra care is a factor in burnout among staff of color. More research on how this unequal burden of care impacts QoC/QoL is important to address the disproportionate role that staff of color play in reducing disparities in resident QoC and QoL.

scholarly journals Persistent geographic variations in availability and quality of nursing home care in the United States: 1996 to 2016

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yun Wang ◽  
Qiuli Zhang ◽  
Erica S. Spatz ◽  
Yan Gao ◽  
Sheila Eckenrode ◽  
...  
Keyword(s):  
United States ◽  
Nursing Home ◽  
Home Care ◽  
The United States ◽  
Nursing Home Care ◽  
Geographic Variations ◽  
Quality Of Nursing

scholarly journals A Stage Set for Disaster: For-Profit Nursing Homes, Federal Law, and COVID-19

2021 ◽  
Vol 1 (3) ◽  
Author(s):  
David Papke
Keyword(s):  
United States ◽  
Twentieth Century ◽  
Nursing Home ◽  
Nursing Homes ◽  
Home Care ◽  
The United States ◽  
Nursing Home Care ◽  
Federal Law ◽  
For Profit

This article exposes the tragic relationship between for-profit nursing homes and the spread of COVID-19 in those facilities. For-profit nursing homes came to dominate nursing-home care in the United States in the second half of the twentieth century. However, for-profit nursing homes on average provided care which was inferior to the care provided in state-run and nonprofit nursing homes. Congress attempted to address the problems in nursing homes in the final decades of the twentieth century, but massive statutes and abundant regulations served mostly to legitimize for-profit nursing homes. COVID-19 then underscored the flaws in the legally sanctioned, for-profit nursing homes, as thousands died within the problematic institution’s walls.

Nursing Home Reform and the Politics of Long-Term Care

1987 ◽  
Vol 20 (02) ◽  
pp. 232-241
Author(s):  
Catherine Hawes
Keyword(s):  
Nursing Home ◽  
Quality Of Care ◽  
Long Term Care ◽  
Nursing Home Care ◽  
American Health Care System ◽  
Term Care ◽  
State Budgets ◽  
The Face

Nursing home care has been described as the most troubled and troublesome segment of the American health care system. Despite the annual expenditure of billions of dollars, extensive regulation, and the emergence of an increasingly sophisticated and concentrated industry, significant problems persist. Inadequate quality of care continues to be a serious and pervasive problem. Discrimination against patients whose care is paid for by Medicaid and Medicare, as well as against those with “heavy care” or extensive needs, is rampant. Costs have escalated at a phenomenal rate and continue to represent a substantial fiscal burden, causing one state Medicaid director to refer to nursing home payments as “the black hole of state budgets.”These circumstances are neither new nor surprising. They are, in fact, the result of rather startling failures in the public sector that are rooted in the special nature of the politics of long-term care. This article discusses the history of public policy toward nursing homes and the politics of long-term care, emphasizing problems in assuring acceptable quality of care. It also addresses the possibilities for reform during the next two years, particularly in light of new patient advocate and nursing home reform coalitions that promise to change the face of long-term care politics.

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