The Landscape of For-Profit Vs Nonprofit Owned Nursing Homes

An Analysis of Nursing Homes in the United States by the Type of Ownership

State Averages_by_Ownership

Most NHs in the United States are owned by for-profit (Individual, Partnership, LLC, Corporation) entities (10,741, 71%) followed by non-profits (Church-related, Corporation, Other) at (3,467, 23%) and Government (County, City / County, State, Hospital District and Federal) owned and run NHs at (958, 6%) of the total NH count of 15,166

There are a total of 450,547 beds across all these entities with for-profit owned NHs having the majority share (329,032 beds, 73%), followed by non-profits (106,630 beds, 24%) and finally Government owned NHs with (14,885 beds, 3%) beds

There is no significant variability in average bed count (95-111 beds) between the NHs owned by the types across the county, although refer to county data for better differentiation in numbers at the county level

In looking at the performance in quality domain, health inspection star ratings were sourced as the primary criteria and averages of the star ratings across the state were considered in evaluating NHs by ownership type. There were zero (none) states in the country where for-profit owned NHs contributed to the highest average health inspection star rating (represented by the color “Green”) when compared to the averages for government-owned and non-profit entities within the state. It is to be noted that for-profit NHs were far higher in numbers (by count and bed count) compared to the non-profits and government owned NHs across the board

The worst performance is represented by the color “Red” and middle / average by the color “Yellow”. In 38 states (CA, CO, DE, FL, HI, IA, ID, IL, IN, KS, KY, LA, MD, ME, MI, MN, MO, MS, NC, ND, NE, NH, NM, NV, NY, OH, OR, PA, RI, SC, SD, TN, TX, VA, WA, WI, WV, WY), for-profit owned NHs contributed to the worst performance and in 12 states (AK, AL, AR, AZ, CT, GA, MA, MT, NJ, OK, UT, VT) to the middle / average performance when state-wide average health inspection star ratings were evaluated.

In contrast, Government-owned entities contributed to the highest / best performance across the state averages in 22 states (AK, AL, AR, CO, FL, HI, IA, ID, IN, KS, KY, LA, MD, ME, ND, NM, OH, OR, SD, UT, WA, WI) and non-profit entities contributed to the highest / best performance in 28 states (AZ, CA, CT, DE, GA, IL, MA, MI, MN, MO, MS, MT, NC, NE, NH, NJ, NV, NY, OK, PA, RI, SC, TN, TX, VA, VT, WV, WY), represented by the color “Green”


Key Statistics Comparing NHs owned by For-profits, Nonprofits and Government Entities

For-profits own 71% of NHs

Of the approx half a million total beds, 73% are owned by for-profits

There is no significant variability in the Average size of NHs based on the bed counts

There were "Zero" for-profit owned NHs in state averages that out-performed nonprofits and Government owned for health inspection star average ratings

County-based Analysis of Nursing Homes by the Type of Ownership

Government-Owned Nursing Homes (All info below pertains to Govt owned NHs)

Govt-owned NHs
  • There are 958 Government (County, City / County, State, Hospital District and Federal) owned and run nursing homes in 49 states (except RI) and 720 counties across the United States

  • Spanning over 33 states, NHs in 85 counties (12%) have a single health inspection star rating on an average (a single health inspection star rating can fetch the NHs, a maximum overall star rating of 1 or 2 stars) or no health inspection star rating at all

  • NHs in the remaining 635 (88%) counties have an average health inspection rating over 1 star

  • NHs in 144 counties have an average health inspection rating of 2 stars and NHs in 7 counties do not have any rating at all

  • 137 (19%) counties have more than one Govt-owned NH provider Marion County, IN with 15 and Bexar County in TX with 12 have the greatest number of Govt-owned NHs in a single county. The Govt-owned NH provider in Delaware, PA, with 874 beds, is the largest, from a bed count perspective

NonProfit-Owned Nursing Homes (All info below pertains to Nonprofit owned NHs)

Nonprofit-owned NHs
  • There are a total of 3,467 non-profit (Church-related, Corporation, Other) owned NHs in 1363 counties across the United States in all the 50 states.

  • 95 (7%) counties have an average health inspection star rating of 1 or no health inspection star rating at all

  • 1268 (93%) of the counties have an average health inspection rating over 1 star

  • NHs in 254 counties have an average health inspection rating of 2 stars

  • Most of the counties (88 out of a total of 95) having a single average health inspection star rating are also the single non-profit provider in the county, the remaining 7 counties have multiple non-profit owned NHs within the county. Overall, NHs in 726 counties (53%) have a single non-profit provider and 637 counties (47%) have multiple non-profit providers within. Los Angeles county in CA and Cook County in IL tie for the greatest number of non-profit NHs in a county at 42 providers in each. Bronx county in NY has a non-profit owned NH with 843 beds, which is the largest non-profit owned NH in the country

For-Profit Owned Nursing Homes (All info below pertains to For-Profit owned NHs

For-Profit Owned NHs
  • There are 10, 741 NHs in the US that are owned by for-profit (Individual, Partnership, LLC, Corporation) entities in 2,388 counties across all the 50 states

  • NHs in 230 counties (10%) have a single health inspection star rating on an average or no health inspection star rating at all

  • NHs in the remaining 2158 counties (90%) have an average health inspection star rating over 1

  • NHs in 708 counties have an average health inspection rating of 2 stars

  • Of the counties (230) with an average health inspection star rating of 1, 79 (34%) counties have multiple for profit owned NHs and 151 (66%) have a single for-profit owned NH with the county. Overall, for all for profit NHs with all star ratings, 1576 (66%) counties have more than a one for profit owned NH and in 812 (34%) counties, there are multiple (more than 1) for profit NH providers. LA county has the largest number of for-profit NH providers-333 total, followed by Cook County IL with 164 for profit NHs. Bronx county in NY has the largest for-profit NH in the country with a count of 816 beds total

Understanding the strengths and weaknesses of your partners (Homecare, Nursing Care Providers, Long Term Care, Rehabilitation Care) allows you to be better prepared in expecting the clinical and financial outcomes on behalf of the patients or customers served, especially the elderly and the vulnerable populations. Hope this series allowed you to gain some insights. For more on how Numiny can help you meet your population care goals, feel free to drop in a note at suma@numiny.com