COVID-19 outbreaks more serious in for-profit long-term care homes

The death rate for private, for-profit long-term care homes with COVID-19 outbreaks was over 4 times the rate for publicly owned homes.

Ottawa (04 Aug. 2020) — A study published in the Canadian Medical Association Journal last month has found that COVID-19 outbreaks were more serious in for-profit nursing homes. The death rate for private for-profit long-term care homes with COVID-19 outbreaks was over 4 times the rate for publicly owned homes.

The study looks at COVID-19 outbreaks in Ontario long-term care homes between March 29, 2020, and May 20, 2020. More recent figures for deaths in Ontario long-term care homes show the same pattern.

More people infected, death rate higher in for-profit homes

The study found that both the percentage of residents who were infected and the death rate were higher in for-profit long-term care homes than in publicly owned homes.

Where outbreaks occurred, the median percentage of residents who caught COVID-19 was 4.8% compared to 1.1% in publicly owned homes. The death rate was 23.4 per 1,000 in for-profit homes compared to 5.8 per 1,000 in publicly owned homes.

Non-profit homes had a lower death rate of 18.2 per 1,000 — higher than publicly owned homes, but still lower than for-profit homes. The median percentage of residents in non-profit homes with outbreaks who caught COVID-19 was slightly higher than in for-profit homes at 5.6%.

Outbreaks more serious in homes owned by chains

The study also looked at how for-profit and non-profit long-term care homes that were owned by chains performed compared to homes that weren't part of a chain. The death toll and the percentage of residents who were infected were both higher for homes owned by chains.

However, as the authors of a commentary on the study pointed out, when 85% of private for-profit long-term care facilities are owned by chains, it is difficult to separate chain ownership and for-profit ownership.

For-profit homes less likely to meet current standards

The study also found that for-profit homes are less likely to meet current standards for long-term care homes. Older homes were built with 4 beds to a room, but current standards only permit a maximum of 2 residents per room.

When the authors of the study factor in the design standards and staffing levels of the homes, the performance of for-profit homes and public homes was relatively similar. However, the fact that so many for-profit long-term care homes don’t meet current design standards and have lower staffing levels isn’t a coincidence. It reflects the fact that when long-term care homes are owned by for-profit companies, the first priority is making a profit.

As an investigation by CBC Marketplace pointed out, when higher standards for long-term care homes were introduced in 1998, it was expected that existing homes would be rebuilt to meet those standards at some point. While most non-profit and public homes were upgraded, owners of for-profit homes were reluctant to spend their profits on upgrades.

Lower staffing levels at for-profit homes have an impact

The authors of the commentary also pointed out that lower staff levels in private for-profit homes also has an impact. Because having enough staff makes so much difference in the ability of homes to respond to a crisis like COVID-19, they felt upgrading private homes wouldn’t be enough if they remained in the hands of for-profit companies.

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The National Union of Public and General Employees (NUPGE) is one of Canada's largest labour organizations with over 390,000 members. Our mission is to improve the lives of working families and to build a stronger Canada by ensuring our common wealth is used for the common good. — NUPGE