Staffing in Ontario's Long-Term Care Homes: Differences by Profit Status and Chain Ownership

Can J Aging. 2016 Jun;35(2):175-89. doi: 10.1017/S0714980816000192.


Ontario has the highest proportion of for-profit nursing homes in Canada. These facilities, which are known in Ontario as long-term care (LTC) homes, offer 24-hour custodial as well as nursing care to individuals who cannot live independently. Increasingly, they are also operating as members of multi-facility chains. Using longitudinal data (1996-2011) from the Residential Care Facilities Survey (n = 627), our analysis revealed discernible differences in staffing levels by profit status and chain affiliation. We found for-profit LTC homes - especially those owned by a chain organization - provided significantly fewer hours of care, after adjusting for variation in the residents' care needs. Findings from this study offer new information on the impact of organizational structure on staffing levels in Ontario's LTC homes and have implications for other jurisdictions where a growing presence of private, chain-affiliated operators has been observed.

Keywords: aging; chain organizations; for-profit ownership; long-term care; maisons de soins infirmiers; nursing homes; organisations de chaîne; personnel; propriété à but lucratif; soins à longue durée; staffing; vieillissment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Health Facilities, Proprietary / statistics & numerical data*
  • Humans
  • Long-Term Care / statistics & numerical data*
  • Longitudinal Studies
  • Nursing Homes / statistics & numerical data*
  • Ontario
  • Ownership
  • Personnel Staffing and Scheduling / statistics & numerical data*
  • Quality of Health Care
  • Workforce