Does investor ownership of nursing homes compromise the quality of care?

Am J Public Health. 2001 Sep;91(9):1452-5. doi: 10.2105/ajph.91.9.1452.


Objectives: Two thirds of nursing homes are investor owned. This study examined whether investor ownership affects quality.

Methods: We analyzed 1998 data from state inspections of 13,693 nursing facilities. We used a multivariate model and controlled for case mix, facility characteristics, and location.

Results: Investor-owned facilities averaged 5.89 deficiencies per home, 46.5% higher than nonprofit facilities and 43.0% higher than public facilities. In multivariate analysis, investor ownership predicted 0.679 additional deficiencies per home; chain ownership predicted an additional 0.633 deficiencies. Nurse staffing was lower at investor-owned nursing homes.

Conclusions: Investor-owned nursing homes provide worse care and less nursing care than do not-for-profit or public homes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Analysis of Variance
  • Bed Occupancy / statistics & numerical data
  • Health Services Research
  • Hospital Bed Capacity / statistics & numerical data
  • Humans
  • Insurance Coverage
  • Investments / statistics & numerical data*
  • Medicaid
  • Medicare
  • Multivariate Analysis
  • Nursing Homes / organization & administration*
  • Ownership / statistics & numerical data*
  • Predictive Value of Tests
  • Private Sector / organization & administration
  • Public Sector / organization & administration
  • Quality of Health Care*
  • Quality of Life
  • United States