Nonprofit Nursing Homes Provide Better Care, Says Consumer Reports

But for-profit homes are more prevalent and regulators are not enforcing standards.      

Consumer Reports (Consumers Union EIN 13-1776434 Form 990) publishes a major study of nursing homes in its current issue (web portal here).  The study found that care overall was not great, but nonprofit organizations (and government entities) were much better than for-profit firms, particularly chains. 

The Washington Post is among the many news outlets that picked up the Associated Press report on the study.

One the web site there is an interactive map that tracks state by state the best performers and the worst performers, according to measures taken from the standardized state reports required by Medicare & Medicaid.  An analysis of this data shows how dramatic the difference is between the for-profit and nonprofit providers.

	Ownership	WORST	BEST	Total
Independent	Government	12	59	71
	For profit	124	86	210
	Non profit	29	212	241
Ind Total		165	357	522
Chain	Government	2	4	6
	For profit	237	111	348
	Non profit	29	106	135
Chain Total		268	221	489
Grand Total		433	578	1011

A nursing home in a for-profit chain is more than twice as likely to appear on the list of worst performers than on the list of the best performers.  An independent nonprofit home is more than seven times more likely to appear on the best list than the worst list.

Or to look at it another way, the for-profit homes represent 55% of the two lists, but they are 83% of the worst performers and only 34% of the best performers. 

At first glance it seems odd to one steeped in market-driven economics that the nonprofit providers would perform better.  But the reality is more likely that consumers are not necessarily making the choices.  The for-profit chains may be caring for those who lack the means (mental and physical ability) to shop.   Thus nursing homes seem to be another instance where charities meet the needs of those who are relatively well off already, operating in relatively well off neighborhoods serving those with enough family support to shop for the best care.