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How Can we Trust FOR PROFIT Assisted Living Centers?
Posted: Friday, December 6, 2019 1:00 AM
Joined: 12/5/2019
Posts: 11

I am not a revolutionary. I just think our sick and elderly deserve better especially when they cannot speak for themselves. 

The Assisted Living reality in the USA is horrible. I am in a care giving group and the horror stories make me shake in fear. 

You may tour a facility that has gorgeous public rooms with lovely landscaping and a wood paneled library with gleaming chandeliers. But you have to remind yourself that every one of these facilities is a FOR PROFIT corporation. They put in lovely posh looking furnishings to make it look like a resort. Yet somehow they need to make a profit. 

So how do they do it? They have the embedded investment of the building and furnishings, the special beds, etc. So where can they save?


So they pay minimum wage to 3rd world people to care for your parents and other loved ones. 

As one member of the group said to me after I praised how beautiful a facility was decorated, "But they still pay minimum wage to untrained workers". 

Isn't America great? FOR PROFIT health care is a growth industry now for corporations now that boomers are entering the higher decades of life. And they can't skimp on the buildings and decor, so where is the one area open to savings? LABOR. 

My brother-in-law was in such a lovely facility.  I went to visit him one time. He had messed the bed so I had to leave his room. The complex was built like a big wheel. In the center was a gorgeous public area with leather chairs and couches in front of a lovely gas-lite fireplace and a huge bigscreen TV.  There was a nurses station across from me, totally empty. I had a view of every single wing branching out from the center. Call lights were going off like crazy in every single wing. It was audio chaos. Here's the punchline: THERE WAS NOT A SINGLE PERSON IN ANY OF THE HALLS RESPONDING TO THE CALLS.  Obviously, this posh place was understaffed to increase shareholder value at the next corporate board meeting. I am so sorry to sound bitter, but this is the reality within FOR PROFIT HEALTH CARE.  I am sure these corporations actually have actuary tables that show how many avoidable deaths and serious injuries are tolerable with a fund set asside in case anyone sues. The facility I described above is in a very posh neighborhood in Scottsdale, Arizona (the Beverly Hills of Phoenix).  So even money can't seem to buy a quick response time for the residents/patients. It was so awful just sitting there like I was in the Twilight Zone watching all these lights over the doors going off in all the wings and not a single employee to be seen anywhere. 

The care of the elderly also illustrates the status of old people in a society obsessed with youth and technological advances. I have had Gen Z "kids" respond to me with "OK Boomer" which is the new put down phrase of the young for the old.  The old are seen as obsolete and their life experience is considered irrelevant.  Other cultures have done better. 

Posted: Friday, December 6, 2019 1:35 AM
Joined: 4/4/2018
Posts: 169

Yes, it is sad to look at the outcomes of the "transaction based society" that we live in.  The answer for me is to do it myself.  

I take some pleasure in recognizing that the final years of my life will continue to be service based trying to help others.  It's now very personal with service to just the 2 people I support, wife and dependent son.   Smaller scale but still important and very personal.  There are others here who seem to find the same small pleasures from "just helping".

Sorry you have to be here, I hope you can find a mind set that helps you survive.  Rick

Posted: Friday, December 6, 2019 4:23 AM
Joined: 3/6/2017
Posts: 2261

I am sorry the people in your group have had terrible experiences in care. I toured a number of facilities before helping mom choose a place for dad. I live in an area that's pretty well served and was cautioned against some of the flashier facilities by members here and to concentrate on training and staff retention. The employee parking lot is a good place to check out; my top two choices paid their staff a little more than average and it showed in the cars staff drove.

That said, about half the staff were immigrants or second generation from India- not sure if that's still a part of the 3rd world or not. They come from a culture that respects elders and considers their care to be important work. I believe this was reflected in the kind and gentle care they gave my dad.
Posted: Friday, December 6, 2019 7:13 AM
Joined: 4/2/2018
Posts: 3057

Hello DylandsDad. Welcome to the forum. Unfortunately,  you can't really trust any facility, whether or not they are for profit. There are bad apples in the not for profit ones too. I think the best thing you can do is ask what the staff/patient ratio are on duty at any given time, and what training they are required to have. Also ask what the turnover rate is, and talk to people who have LOs in the facility. Visual clues have little practical value.

I'm not so sure that caregivers from third world countries are necessarily bad. People like that are required to survive without much help from the government, so they have to make it on their own. Not that we have so much help from government, but at least we do have laws which help. That might not be the norm for many places.

This is a good topic, and has been discussed several times before, but it has value every time it is brought up.

Michael Ellenbogen
Posted: Friday, December 6, 2019 7:24 AM
Joined: 11/30/2011
Posts: 3345

The simple answer is you can not an always  be on guard if you have a love one in them. I call them jails. And people wonder why  we don't want to be placed their.  If you have a lot of money then they probably okay.
Rescue mom
Posted: Friday, December 6, 2019 8:29 AM
Joined: 10/12/2018
Posts: 1523

A “nonprofit” place can still make money. Some of the worst scams and horror stories in my area involved nonprofit facilities. The money was going righ into the director(s) pockets for personal use, not clients. There’s no guarantees either way. No matter which, the LOs in charge must be vigilant.

Much depends on the individual staff, and I also believe some cultures give elders more care and respect than ours does.

It’s been kind of interesting that every caregiver I’ve dealt with, except one,  for DH and for my mother in a facility, has been from another country/culture. 

Most of the best ones were from what many would call “third world” country, yet they gave the residents /clients some of the best care and attention. 

Posted: Friday, December 6, 2019 9:28 AM
Joined: 10/27/2019
Posts: 35

Agreed, nonprofits do make money.  If they didn't, they would go out of business.  Nonprofit basically means all of the profits are held internally and not distributed to shareholders, etc.

Most of the assumed 3rd world caregivers (many of them come from industrialized nations) I have come in contact with have been trained early on in life by their families to take care of other humans beings when needed.  Many of these people revere their elders for their wisdom and experience which is not always the case here at home.

I too worry about placing my DH someday and believe I can care for him at home for as long as I can which, as you all know, is not an easy task.  I just asked my DH to change the shirt he has refused to change for several days which generated a 5-minute discussion about his inaccurate belief that I gave away his boat, his guns, his truck, and do nothing but complain all of the time.  My son bought the boat that DH never used, his shotgun and my rifle are in my daughters gun safe, and the truck was a leased vehicle which should not have been driven by someone who can no longer tie his shoes or work a TV remote.  Hence, this I why I came to this forum this morning.

I will be starting to visit various facilities to get an idea of what is out there in case the time comes for placement. I am fortunate to have children and grandchildren who unselfishly help me with DH. In addition, my granddaughter's friend recently offered to sit with 'grandpa' when I need some extended time away to do things I need to do.  She is in college and wants to take care of people suffering from these brain diseases.  Her parents adopted a toddler (her cousin) who was born addicted to narcotics and legally blind. She helped her parents raise that little girl and is devoted to help the needy. She has always called me grandma, and I am blessed to know her.

Best wishes to DylansDad.

Posted: Friday, December 6, 2019 10:32 AM
Joined: 12/4/2011
Posts: 18709

How can you trust not for profit?  They answer to no one and how are they not for profit? Who gets the "profit". Owners?

There is no assurance that the profit is going into care.

We, the consumers, are in controll. If we but into style over substance we have no one to blame but ourselves. 

The very first question to be answered is "what is the training program". Then "staff turnover, salary and benefits". Follow by reading the contract.

After that visit tour the facility and witness the interaction between staff and resident.

If we continue to go for the frosting instead of the cake nothing will change. 

Posted: Sunday, December 8, 2019 4:05 PM
Joined: 10/21/2016
Posts: 2564

There are plenty of problems in non-profit facilities.  Just look at the VA.  And there are some wonderful for-profit facilities, my husband is in one.  Just be vigilant with any facility that you choose.
Posted: Monday, December 9, 2019 2:24 AM
Joined: 2/2/2014
Posts: 5772

Primer on making money out of a non profit

You create both a "non profit" and a "for profit".

The non profit buys critical goods and services from the for profit.  

 "Voila"   the money is now in the "for profit" but hidden from the consumer.

eg. You have a non profit cemetery that buys land and burial services from your for profit company.  etc.

More commonly non profit "surpluses" are used to fund other activities. 

Assisted living centers are exactly as good as government regulation and potential liability makes them.   

I've taught government regulation since 1975.  Corporations have always funded anti-regulatory political groups who are happy to cut consumers' throats by campaigning against effective regulation.   When they succeed people die.  I am in Germany this week speaking on the Boeing 737 MAX.  I am comparing it to the TITANIC and showing how corporations over time have gotten more effective at creating "ceremonial regulation" that looks good but does not work.  One recent article surveyed the nominal regulatory environment.

I disagree with the research approach taken but it s not a bad article


Jo C.
Posted: Monday, December 9, 2019 8:29 AM
Joined: 12/9/2011
Posts: 10979

While there can be good and deficient care in both categories, look up the information.

I just used a simple phrase and found much information just by Googling, "not for profit nursing homes do they benefit patients," and other such search words.

The information from multiple sources including advocacy focused groups indicated the overall better standards of care and staffing as well as far less fraudulent billing and much more in the not for profit facilities.  Staffing, quality of care and less complications were overall better at the not for profits.

It was also mentioned that overall, the for profit facilities earned significantly more profit on each patient than did the not for profits; more than double.

If on the stock market  as some large multiple facility group ownerships are, then profit must be made to plow back to the share holders; this is most often done through less staffing.  It is interesting that these NHs are often the ones most often fancily appointed with dripping crystal chandeliers, upper end furniture in the lobby, "wine" social hours in the afternoon and very, very one on one marketing; BUT that comes at a hidden price.   The savings for making increased profit often comes on  less staffing and core dynamics.  They appeal to the eye and even vanity for those who want the fancy appointments. but are not seeing the actual care.  Fraudulent billings were also higher at the for profits.

In most of the U.S., not for profits are not always easy to find; these facilities are often full with no empty beds for new patient residents.  The for profits are by far the most common type of facility.


Rescue mom
Posted: Monday, December 9, 2019 8:37 AM
Joined: 10/12/2018
Posts: 1523

Crushed, when I worked in government, there was so much of what you talk about, along with “feel good” bills. They made politicians look like they were doing something about a problem, when they were doing very little—or one little “tweak” that would help one (business) party involved in the situation, not the customer/consumer. The media never seems to get into the details, just that somebody passed a bill to “make airlines/cars/drugs/nursing homes etc etc safer.” 

 Few people see how prevalent all that is (and the fake advocacy groups). Two things you never want to see made: sausage and law.

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