Not-for-profit nursing homes do better than their for-profit counterparts on a key measure of quality, according to data compiled by a trade group representing the nation's not-for-profit long-term-care industry.
But critics dispute whether the data, which track the number of deficiencies per home, are really a useful measure of quality.
The numbers are part of a statistical yearbook released last month by the American Association of Homes and Services for the Aging. The yearbook draws from HCFA data from all 17,259 Medicaid- or Medicare-certified nursing facilities in the country.
For-profit nursing homes averaged 5.45 deficiencies, compared with an average 3.72 citations for not-for-profit homes.
Government-owned homes averaged 4.21 deficiencies.
The findings were surprisingly consistent across states, with for-profits doing worse than not-for-profits in every state but South Dakota and South Carolina.
"It's a startling statistic," Robert Greenwood, association spokesman, said of the discrepancy between deficiencies in not-for-profit and for-profit homes.
However, the number of deficiencies is not a very precise measure of quality of care, Greenwood conceded. Deficiencies range from minor, isolated problems to serious ones that harm residents. But when the association looked at only the more-serious citations in three states where the data were readily available, not-for-profits still fared better, Greenwood said.
Nationwide, 28% of facilities are not-for-profit; 65% are for-profit companies.
HCFA has said it will start collecting outcomes-based quality indicators in the next year. Until then, deficiencies are the only available quantitative measure of quality, Greenwood said.
State officials who oversee the inspections expressed surprise at the finding. Surveyors use the same criteria for all facilities, explained Rosemary Patterson, public information officer for long-term-care at the Texas Department of Human Services.
"It's the care that we care about, not who the owners are," she said.
Tom Burke, senior director of public relations for the mostly for-profit American Health Care Association, dismissed the idea that not-for-profits might provide better-quality care than for-profits.
"You can make data say pretty much what you want," he said.
The release of the study comes as the association strengthens its ties with other healthcare groups that represent the for-profit and not-for-profit sectors.
The AAHSA has joined the American Hospital Association and the AHCA, among others, to lobby lawmakers to change Medicare's prospective payment system for skilled-nursing facilities.
The AAHSA and the AHCA recently held a series of workshops to familiarize member facilities with HCFA's new quality initiatives for nursing homes.
The statistical yearbook is part of the AAHSA's attempt to inform and shape long-term-care policy and services through the establishment of a new policy research institute.