QUICK READ: The vast majority of elder care facilities are owned by corporations who usually put profit ahead of our fathers and mothers. COVID-19 has exposed the poor care in these facilities but what’s needed is a new approach in which homes are inspected and wages are paid to hire skilled employees. Spare me the outrage now that the poor care at nursing homes has been exposed. We have chosen to look the other way.

One of the issues being exposed because of COVID-19 is the poor quality of most nursing homes. Extensive research finds that the type of nursing home ownership and sponsorship affects the quality of care that facilities provide to their residents. In fact, a study found that residents in for-profit homes are almost twice as likely to experience adverse health problems as a result of substandard care, which was published recently in the journal Gerontology

There are approximately 15,600 (2016) nursing homes in the US and almost 70% are for-profit ownership.

In 2011, the first-ever analysis of the ten largest for-profit nursing home chains reported that between 2003 and 2008, compared to all other ownership groups, facilities owned by the top ten for-profit chains had:

• The lowest staffing levels;
• The highest number of deficiencies identified by public regulatory agencies; and
• The highest number of deficiencies causing harm or jeopardy to residents.

The Government Accountability Office (GAO) reported in 2011 that nursing facilities acquired between 2004 and 2007 by the top ten private equity firms:

• Had more total deficiencies than not-for-profit facilities;
• Reported lower total nurse staffing ratios; and
• Showed capital-related cost increases and higher profit margins, compared to other facilities.

For nursing assistants, the work is often challenging while offering few extrinsic rewards. Due in part to the repeated lifting and carrying required to assist residents, they are injured 3.5 times more frequently than the typical American worker. Also, wages are low. Nursing assistants earn a median hourly wage of $11.87, and a median annual income of $19,000.

Nursing homes are expected to create an estimated 59,000 new nursing assistant jobs from 2014 to 2024. In the coming years, the rapidly growing population of older adults will drive demand even higher: by 2050, the population of adults over the age of 65, who comprise 85 percent of the nursing home resident population, is projected to double, from 47.8 million to 88 million.

The problem is that corporate owners want to keep costs down. More than 3 million immigrants work in the U.S. health care system, accounting for about 1 in 4 people in that field, said lead researcher Dr. Leah Zallman, an assistant professor of medicine at Harvard Medical School. A lot of them work in nursing homes.

Immigrants also account for about 23% of employees in the long-term care sector. and about 27% of direct care workers — home health and personal care nurses and aides — are immigrants, and immigrants also account for a full 30% of the housekeeping and maintenance workers at nursing homes.

So the question then becomes will corporate owners spend the money to ensure great care or will they spend as little as possible so that the elderly are in constant need?

Changes are needed. First, an inspection of elder care facilities needs to be stepped up and unannounced. Second, and this is a political bomb, we need to rethink euthanasia. Most people don’t want to live if they are confined to a bed and their quality of life has deteriorated significantly. If you had progressive cancer, lost most of your body functions, and were confined to a bed would you want to live?

Finally, when nursing facilities are found to be in violation they need to either be closed or significantly fined. We can’t just slap them on the wrist while they make political donations.

I’m sick of people who are just now realizing that. nursing homes could be a nasty, vile, way to place our parents. Our healthcare system has a lot of flaws but perhaps none is bigger than the way we take care of the elderly.