For-Profit vs. Non-Profit Nursing Homes: Which Type Offers Better Care?

Deciding to place a loved one in a nursing home is an incredibly difficult task. It is further complicated by the responsibility of choosing the right facility. There are some basic differences between for-profit and non-profit homes, and understanding them can help point you and your family in the right direction.

The Difference Between the Two

For-profit facilities are run by corporations and businesses controlled by shareholders. Like any other money-making business, these nursing homes prioritize shareholders, putting residents' needs second. This conflict of interest often diminishes the quality of resident care because of pressure to keep staffing levels low to save money.

Approximately 68% of all U.S. nursing homes are for-profit, a trend that only continues to grow.

Non-profit facilities, on the other hand, have no responsibility to shareholders and can thus prioritize residents and the quality of care. These facilities tend to have more and higher-quality staff, fewer occurrences of bedsores, lower prevalence of restraints, and fewer government-cited deficiencies.

Overbilling the Government

A significant indicator of quality of care is how much money nursing homes overbill Medicare. In this form of fraud, nursing homes bill the government - Medicare or Medicaid - for inaccurate or medically-unnecessary treatments.

According to a 2012 federal health report, 30% of for-profit nursing home billings were deemed improper, while only 12% of non-profit nursing home billings were accused of the same offense.

Facilities that overbill the government push residents to get unnecessary, and often dangerous, services that benefit only the business owners.

In a South Carolina nursing home, one particular patient of deteriorating health was forced upright in a standing frame even though she couldn't open her eyes or support her head. Needless to say, this was an inappropriate physical therapy exercise for her. The nursing home staff irresponsibly and dangerously pushed this woman past her limit simply to bill Medicare for more money.

Sadly, this is not the most egregious example of a nursing home ignoring a resident's wishes and wellbeing in an effort to make larger profits. Some residents undergo unnecessary, invasive procedures that hurt them more than help them.

How Do I Know What Type of Ownership a Nursing Home Has?

The differences between a for-profit and not-for-profit nursing home are not always apparent at first glance, so simply touring a facility may not give families the information they need to determine what type of ownership a home has.

You have to do your research. One way to discover the true business model of a specific Medicare-certified nursing home is to visit the Medicare website. There, you can search for a nursing home by name or zip code to find information about health and fire-safety inspections, ownership information, and other important data.

Once you click on a specific nursing home, a general information page will appear that has a section on ownership. For-profit nursing homes will have the label "For profit – Corporation" and non-profit nursing homes will have the label "Non-profit – Corporation".

Choosing the Right Home for Your Loved One

It is important that the nursing home you choose is one that you can trust. Whether a nursing home is for-profit or not-for-profit may not give you all the information you need to make a decision. Visit nursing homes to observe the following:

  1. How staff interacts with residents - do they seem attentive and sympathetic to their residents? Or are employees grouped only talking to each other?
  2. The home's cleanliness - does it smell fresh and clean?
  3. The behavior of the residents - do they seem happy and calm?
  4. The sounds you hear – are residents crying out for help or pressing their call buttons to no answer?

Trust your gut with what you see; if something seems off, it probably is.

Give yourself plenty of time to research nursing homes. Don't fall into the trap of choosing a home that only looks good on paper. This crucial research could be the difference between your loved one enjoying his or her time, or suffering.