The nation’s largest for-profit nursing homes have the lowest quality of care, according to researchers at The University of California, San Francisco. 

The UCSF- led analysis of the quality of care at nursing homes is the “first-ever study focusing solely on staffing and quality at the 10 largest for- profit chains,” the university said in a statement released Tuesday.

The study indicates that 70 percent of the nursing homes in the U.S. are for profit compared to 30 percent that are nonprofit or government owned.

“Poor quality of care is endemic in many nursing homes, but we found that the most serious problems occur in the largest for-profit chains,” said first author Charlene Harrington, RN, PhD.

Harrington is a professor emeritus of sociology and nursing at the UCSF School of Nursing. She is also director of the UCSF National Center for Personal Assistance Services.

The study compares staffing and deficiencies for six different ownership groups: Largest for- profit chains, smaller for profit chains, for profit non chains, nonprofit chains, nonprofit non chains, and government facilities. 

The results in the study show that for-profit chains had the lowest staffing as well as most serious and more total deficiencies, whereas nonprofit facilities had the highest staffing and least amount of most serious and total deficiencies. 

“The 10 largest for-profit chains were cited for 36 percent more deficiencies and 41 percent more serious deficiencies than the best facilities. Deficiencies include failure to prevent pressure sores, resident weight loss, falls, infections, resident mistreatment, poor sanitary conditions, and other problems that could seriously harm residents,” the University said.

Harrington said that despite the high percentage of deficiencies in for profit nursing homes, for profit nursing homes are were making a 20 percent profit, whereas nonprofit homes were making only 9.5 percent in profit. 

Harrington says that there is a growing number of for profit chains and that 54 percent of all nursing homes in the U.S. are part of a for-profit chain. 

“For-profit chains are important to look at because they are dominating the market terms of the amount of beds and facilities they own.  They are very successful in making profits, so other companies look up to them,” Harrington said. 

Harrington lists a variety of strategies the top 10 chains use to keep costs low and profits high.  Some of them include lower staffing levels, lower employee wages and benefits, and taking in high acuity patients who receive more Medicare from the government. 

Nursing homes are growing at a considerable rate, and with the aging of the baby boomers, the rate will continue to accelerate.  In order to provide better quality care for the increasing number of elderly and for profit nursing homes in the future, Harrington suggests better government monitoring. 

“Eighty percent of nursing bills are paid for by the government through Medicare, there needs to be more financial accountability for where the money goes,” Harrington said.