Staffing levels in not-for-profit and for-profit long-term care facilities: Does type of ownership matter?

McGregor, Margaret J.; Cohen, Marcy; McGrail, Kimberlyn; Broemeling, Anne Marie; Adler, Reva N.; Schulzer, Michael; Ronald, Lisa; Cvitkovich, Yuri; Beck, Mary
March 2005
CMAJ: Canadian Medical Association Journal;3/1/2005, Vol. 172 Issue 5, p645
Academic Journal
Background: Currently there is a lot of debate about the advantages and disadvantages of for-profit health care delivery. We examined staffing ratios for direct-care and support staff in publicly funded not-for-profit and for-profit nursing homes in British Columbia. Methods: We obtained staffing data for 167 long-term care facilities and linked these to the type of facility and ownership of the facility. All staff were members of the same bargaining association and received identical wages in both not-for-profit and for-profit facilities. Similar public funding is provided to both types of facilities, although the amounts vary by the level of functional dependence of the residents. We compared the mean number of hours per resident-day provided by direct-care staff (registered nurses, licensed practical nurses and resident care aides) and support staff (housekeeping, dietary and laundry staff) in not-for-profit versus for-profit facilities, after adjusting for facility size (number of beds) and level of care. Results: The nursing homes included in our study comprised 76% of all such facilities in the province. Of the 167 nursing homes examined, 109 (65%) were not-for-profit and 58 (35%) were for-profit; 24% of the for-profit homes were part of a chain, and the remaining homes were owned by a single operator. The mean number of hours per resident-day was higher in the not-for-profit facilities than in the for-profit facilities for both direct-care and support staff and for all facility levels of care. Compared with for-profit ownership, not-for-profit status was associated with an estimated 0.34 more hours per resident-day (95% confidence interval [CI] 0.18-0.49, p < 0.001) provided by direct-care staff and 0.23 more hours per resident-day (95% CI 0.15-0.30, p < 0.001) provided by support staff. Interpretation: Not-for-profit facility ownership is associated with higher staffing levels. This finding suggests that public money used to provide care to frail...


Related Articles

  • WE MUST THINK LONG TERM. Long, Alan // Community Care;9/24/2009, Issue 1788, p6 

    The article presents the author's suggestions that care councils must incentivise home care providers by commissioning services based on improving long-term care outcomes. Excellent commissioning of domiciliary care for older and disabled people will be vital to meet the growing demographic...

  • Ill. hospital cuts: $1 bil.+. Merrion, Paul; Singh, Shruti Daté // Crain's Chicago Business;2/13/2006, Vol. 29 Issue 7, p1 

    The article reports that Illinois hospitals face a billion-dollar hit in the U.S. government's latest attempt to rein in federal spending on health care. The cutbacks could total as much as $2 billion when nursing homes and other health care providers are factored in. By any measure, proposed...

  • Long-term care: A test bed for coming reform. Holthaus, Mark // Geriatrics;Jul2009, Vol. 64 Issue 7, p7 

    The article reports that a closer collaboration is currently being tested among medical professionals in U.S.'s nursing homes. Long-term care (LTC) has always served as a laboratory of sorts for testing government-directed health care, offering a controlled environment for finding ways to use...

  • Medicaid Home And Community-Based Services: National Program Trends. Kitchener, Martin; Ng, Terence; Miller, Nancy; Harrington, Charlene // Health Affairs;Jan/Feb2005, Vol. 24 Issue 1, p206 

    Long-term care (LTC) policymakers face mounting pressures to expand Medicaid home and community-based services while the cost of institutional provision continues to rise and consume the bulk of Medicaid LTC spending. This paper presents the latest program trends in the three Medicaid home and...

  • Nursing Home Care Tops $85,000 A Year In Most Expensive Markets: Survey.  // National Underwriter / Life & Health Financial Services;8/4/2003, Vol. 107 Issue 31, p31 

    Reports on the cost of nursing home care in the U.S. Value of long term care insurance; Form of protection of accumulated asset; Variation of cost based on the types of facilities.

  • Advance Directives Lower Costs In LTC. Moore, Amy Slugg // RN;Jun2000, Vol. 63 Issue 6, p16 

    Reports on the reduction of healthcare costs through advance directives in the United States. Education of hospital staff.

  • Medication return, reuse gaining ground in states. Gebhart, Fred // Drug Topics;6/16/2003, Vol. 147 Issue 12, DRUG TOPICS... p44 

    Presents issues related to the return and dispensing of prescription medications in the U.S. Drug donations made by private long-term care facilities; Potential for cost savings; Concern over the safety of repackaging blisterpacks.

  • Focusing on home care.  // McKnight's Long-Term Care News;Jan2011, Vol. 32 Issue 1, p21 

    The article features the report released by the state appointed advisory committee regarding the future of long-term care costs in Ohio.

  • THE LAISSEZ-FAIRE ELIXIR. Starr, Paul // New Republic;4/18/83, Vol. 188 Issue 15, p19 

    Presents information on the U.S. health care policy faced on free-market basis. Plans of U.S. President Ronald Reagan to reduce the cost of health care in the nation; Need to provide training to medical personnel in the nation; Problems faced by the administration of President Reagan in the...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics