A Major Collaborative Research Initiative funded by the Social Sciences and Humanities Research Council of Canada

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• A Major Collaborative Research Initiative funded
  by the Social Sciences and Humanities Research
  Council of Canada
• OWNERSHIP MATTERS
• Pat Armstrong, PhD,
• Principal Investigator, York University
• Presentation at Toronto City Councils
• Community Development Recreation Committee
• January 11, 2012

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Complaints

• Compared with for-profit chain facilities,
  non-profit, charitable and public facilities had
  significantly lower rates of complaints in
  Ontario.
• Likewise, in British Columbias Fraser Health
  region, non-profit facilities had significantly
  lower rates of complaints compared with
  for-profit facilities.

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Staffing

• The top 10 for-profit U.S. chains had lower RN
  and total nurse staffing hours than government
  facilities, controlling for other factors.
• Other for-profit facilities also had lower
  staffing.
• Canadian data show for-profits have significantly
  lower levels of direct care staff than non-profit
  and government facilities.

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Quality

• A Manitoba study found for profits had higher
• Rates of falls
• Pressure ulcers
• Respiratory infections
• Fluid and electrolyte imbalances
• Excessive medications

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Violations of Regulations

• The top 10 chains received 36 percent higher
  deficiencies (violations of regulations) and 41
  percent higher serious deficiencies than
  government facilities.
• Other for-profits had higher deficiencies than
  government facilities.
• These deficiencies increased after purchase.

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Sustainability

• Southern Cross, the largest for-profit provider
  in the UK, collapsed in 2011
• House of Commons Public Accounts Committee Report
  of December 2011 raises concerns about the trend
  towards fewer, larger providers of residential
  and home care.
• Government had little warning, residents had no
  options

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Sources

• Doupe M. et al. (2006) Using Administrative Data
  to Develop Indicators of Quality Care in Personal
  Care Homes. Winnipeg, MB Manitoba Centre for
  Health Policy.
• Harrington, C. et al. (2011) Nurse Staffing and
  Deficiencies in the Largest For-Profit Chains and
  Chains Owned by Private Equity Companies. Health
  Services Research, August DOI 10.1111/j.1475-6773
  .2011.01311.x

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Sources Continued

• Harrington, C. et al. (2011) Ownership,
  Financing, and Management Strategies of the Ten
  Largest For-Profit Nursing Home Chains in the
  United States. International Journal of Health
  Services, 41(4) 725746.
• McGregor, M.J. et al. (2011) Complaints in
  for-profit, non-profit and public nursing homes
  in two Canadian provinces. Open Medicine,
  5(5)e183e192.

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Sources Continued

• McGregor, M.J. et al (2011) A Survey of Nursing
  Home Organizational Characteristics Associated
  with Potentially Avoidable Hospital Transfers and
  Care Quality in One Large British Columbia Health
  Region. Canadian Journal on Aging, 30(4)551-561.
  
• McGregor, M.J. et al. (2010) Trends in long-term
  care staffing by facility ownership in British
  Columbia, 1996 to 2006 Health Reports 21(4)1-8.