摘要：Objectives . Two thirds of nursing homes are investor owned. This study examined whether investor ownership affects quality. Methods . We analyzed 1998 data from state inspections of 13 693 nursing facilities. We used a multivariate model and controlled for case mix, facility characteristics, and location. Results . Investor-owned facilities averaged 5.89 deficiencies per home, 46.5% higher than nonprofit facilities and 43.0% higher than public facilities. In multivariate analysis, investor ownership predicted 0.679 additional deficiencies per home; chain ownership predicted an additional 0.633 deficiencies. Nurse staffing was lower at investor-owned nursing homes. Conclusions . Investor-owned nursing homes provide worse care and less nursing care than do not-for-profit or public homes. For the 1.6 million Americans who reside in nursing homes, the quality of care largely determines the quality of life. Most patients in acute-care hospitals will return to their homes and families, regaining command of their sleep schedules, food choices, hygiene, and mobility. They can generally change physicians and hospitals if dissatisfied. But most nursing home patients cannot go home again; many are too impaired to exercise meaningful choices or protest poor treatment. They are forever bound to the rhythms, diets, and treatments decreed by their institution's management. Poor-quality care has long plagued the nursing home industry. 1 – 5 Two thirds of the nation's nursing homes are investor owned. 6 Several small studies suggested that for-profit facilities deliver poorer care, compared with nonprofit and public facilities. 7 – 10 We analyzed quality-of-care data derived from government inspections of virtually all US nursing homes that receive Medicare or Medicaid payments.
