Experts and advocates worry that private equity firms and other for-profit owners are underfunding care in order to line their pockets. Evidence, common sense, and academic studies link for-profit status to poor quality. Researchers and investigative articles spotlighting poor care and safety lapses at national chains.
Research has repeatedly linked lower staffing levels to substandard care. To date, CMS requires “sufficient” staffing but nursing homes provide only a skeleton crew of round-the-clock nursing coverage and one registered nurse who works at least eight hours each day.
For-profit nursing homes often appear poorer through tricky accounting. Owners shift money to themselves through rent or management fees paid to corporations they also control. These convoluted networks are often impossible to untangle with the information the government collects. Private equity firms have been buying up struggling nursing homes. Research shows that private equity-owned nursing homes have significantly worse outcomes for residents.
“As Wall Street firms take over more nursing homes, quality in those homes has gone down and costs have gone up,” Biden promised. “That ends on my watch.”
Two decades ago, a federally commissioned study of nursing homes recommended setting minimum staff requirements that would mean 4.1. hours per patient day. Every resident must receive a minimum of at least four hours of individualized attention from qualified staffers per day. Studies have found that homes with higher staffing levels have fewer patient injuries.