Do Nursing Home Chains Provide Poorer Care?

Few families make the decision lightly to move an elderly loved one into an assisted living facility, but often the care demands of older adults is too great for a spouse or other family caregiver, and a move is necessary.  But placing an elderly parent or another family member into a care facility is often a guilt-laden experience and loved-ones worry that care will be insufficient or residents will be neglected or worse, abused.   

With the advent of corporate-run nursing homes, care for aging adults has become big business, and in some cases, owners are making huge profits while the basic needs of residents go unmet.  According to a recent investigative report by Kaiser Health News, corporations frequently use a web of companies with shared interests that provide services, drugs and other supplies to nursing homes rather than outsourcing goods and services.  And while patients many suffer from a shortage of linens, incontinent products or nursing staff; though the books may show a shortage of funding, owners are benefitting hugely from contracts made in their favor.  Nursing homes that bring in supplies and staff from related companies also have higher rates of injuries among patients and more complaints from families than independently-run nursing homes.

Shortages of staffing is a common problem in chain nursing home operations, which often leads to poorer overall health, more injuries and neglect of residents that rely on help with bathing, bathroom use, meals and dressing.  Lack of personal care can result in bedsores, malnutrition, more incidents of falls, depression and cognitive decline.

Because corporate for-profit nursing homes are increasingly common; in 2012 more than half of the nursing homes were operated by corporate chains, it’s important for families of residents to be educated about the warning signs of neglect or abuse.  Frequent, unpredictable visits from family and friends can offer better insight into nursing home care.  Loved ones should try and make a connection with someone on the nursing staff who sees their family member regularly, a good relationship can help ensure good communication about care and well being.

Signs of Neglect

• The elderly adult is more confused, disoriented or sleeping all the time – could be a sign of medication mismanagement.
• Becoming incontinent because they can’t get to the bathroom; skin may break down if not regularly cleaned.
• Unexplained bruises, scratches or broken bones
• Sudden weight loss, signs of dehydration  – dry mouth, cracked lips, swollen tongue
• Greater immobility – due to lack of regular exercise
• Changes in behavior – agitation, becoming withdrawn, fearful, anxious or guilty

If you notice any of these changes in the health and wellbeing of a loved one in nursing care, begin by asking to see the care plan and review it with staff to ensure proper changes are made.   Try to work with staff in a collaborative fashion rather than instigate a confrontation.  Long-term abuse should be reported to a state or provincial agency for adult protective services.