An increase in investor-owned regional and national chains has led to complex organizational structures. Growth In Complex Nursing-Home Ownership ArrangementsĪbout 70 percent of nursing homes are operated by for-profit corporations, 24 percent are not-for-profit, and 7 percent are government-owned, while 58 percent are operated by corporate chains. We recommend specific policy changes to make ownership, management, and financing more transparent and accountable to improve US nursing home care. The growth in complex nursing-home ownership structures has limited financial transparency by allowing nursing homes to hide public payments and stint on direct resident care. Quality issues persist as policy makers are unable to oversee how nursing homes spend Medicare and Medicaid payments. Infection control violations have also been found repeatedly in a majority of nursing homes. The harm to frail older adults can be quite severe-abuse and sexual assault, infections, overuse of psychotropic medications, pressure ulcers, falls with injuries, weight loss, dehydration, pain, and medication errors. Prior to the pandemic, persistent problems with nursing home care had been documented for years, often because of too few and inadequately trained frontline staff. President Joe Biden has many options for addressing these failures, but one important proposal he has put forth is to require audits of nursing home cost reports and ownership data. As of January 17, 2021, at least 570,626 residents and 490,635 staff members were infected and 112,383 residents and 1,385 staff had died. The COVID-19 pandemic has exposed a failure to protect nursing home residents and staff.
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