Nursing Home Chains Provide Worse Care

Because of our experience in representing victims of abuse and neglect in Georgia and South Carolina nursing homes, we are often asked which facilities provide better care. Our response has been that locally owned and operated nursing homes seem to provide better care for their residents. Our opinion has been based primarily upon the fact that we receive fewer calls from families complaining about locally owned and operated nursing homes than we receive from families complaining about facilities which are owned and operated by large corporations. Our opinion about the difference in quality of care can be traced back to the late 1990s. Beginning around 1998, there was a movement by corporations to purchase locally owned and operated nursing homes (so-called “mom and pop facilities”) in an effort to increase corporate profits. This resulted in the formation of several large nursing home chains that owned and operated approximately two thousand nursing homes across the United States. Around the same time, Congress reduced the level of benefits paid to nursing homes for some services, which cut into corporate profits. Rather than cutting back on administrative expenses and corporate perks, these large nursing home chains began to cut staff in an effort to boost profits. Consequently, we observed a corresponding decrease in the quality of care being rendered to nursing home residents.

Until recently, there were no significant studies to substantiate our opinion that locally owned and operating nursing homes provided better care than that provided by larger corporate chains. Now, an important study by the University of California San Francisco (UCSF) has confirmed what we observed and suspected all along. The largest for-profit chains provide worse care in their nursing homes than that which is provided by non-profit and government-owned nursing homes. The fact that reduced staffing was cited by the study as the reason for the decreased quality of care came as no surprise to those of us who have been fighting nursing homes on behalf of victims of abuse and neglect. According to the author of the report, Charlene Harrington, a Professor at the UCSF School of Nursing, the ten largest nursing home chains strategically attempt to boost profits by reducing labor costs (i.e. staffing).

There are Federal and State regulations which govern the provision of services in nursing homes. When facilities fail to follow these regulations, they are cited for deficiencies. The UCSF study found that the largest nursing home chains received citations for up to 41% more deficiencies than the best non-profit and government-owned facilities. The cited deficiencies included failure to prevent pressure sores, falls, weight loss, infections, and other conditions that can result in serious harm to nursing home residents. Regrettably, until these large nursing home chains stop putting profits ahead of people, the lower quality of care will likely continue.


Harrington, C., “Low Staffing and Poor Quality of Care at Nation’s For-Profit Nursing Homes.” UCSF Today, November 29, 2011.

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