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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