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A recent analysis of 43 peer-reviewed comparative studies of long-term care facilities confirms that not-for-profit facilities have a considerable advantage in almost every dimension of care.

When for-profit corporations deliver long-term residential care, public health care costs and private spending on health care both increase. Patient health is worse, staff turnover increases and patients and families are less satisfied

Not-for-profit For-profit
Better physical plant and environment
Room maintenance
Physical plant maintenance
Patient control of environment
Good staffing practices
Staff/patient ratio
Skill mix
Staff involvement in care plans
Low turnover rates/continuity of staff
Patient care
Use of advanced directives (living wills, do-not-resuscitate orders)
Pain management programs
Specialized hospice programs
Use of anti-psychotic drugs
Low level of citations for deficiencies
Patient health
Fewest admissions to hospitals for:
  • Dehydration
  • Pneumonia
  • Falls
  • Fractures
  • Anemia
  • Urinary tract infections
  • Gangrene
  • Skin ulcers
Least use of restraints
Least incidence of infection
Hospitalization rates samesame
Most physician involvement
Most expenditures
Patient per day
Use of practical nurses
Use of physicians
Wages and benefits
Skilled staff mix
Staff training
Nursing care

Source: Dr. Michael M. Rachlis, “The Hidden Costs of Privatization: An International Comparison of Community and Continuing Care” in Without Foundation, a joint project of the Canadian Center for Policy Alternatives - BC, the British Columbia Government Employees Union, the British Columbia Nurses Union, and CUPEs Hospital Employees Union, November 2000.