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RESEARCH |
Charlene Harrington, Joseph Mullan, and Helen Carrillo are with the Department of Social and Behavioral Sciences, University of California at San Francisco School of Nursing. Steffie Woolhandler and David U. Himmelstein are with the Center for National Health Program Studies, The Cambridge Hospital/Harvard Medical School, Cambridge, Mass.
Correspondence: Requests for reprints should be sent to David U. Himmelstein, MD, 1493 Cambridge St, Cambridge, MA 02139.
Objectives. 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.
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