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I would appreciate comments on the topic of profit vs non-profit care facilities.

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I have experienced 2 of one and one of the other. Earlier I might have said not for profit ones but then one of those dropped my mother which broke both her femurs and then allowed a bedsore to get very serious a year ago. She is now in a for profit SN and it is much better than the last not for profit one. As far as AL goes I was happier with the not for profit one but then a serious septic infection occurred during Covid landing her in their not for profit SN which became horrendous. Alot depends on the health of the resident.
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My MIL was in 2 different faith-based non-profit facilities. The first one was very small, run by the local Moravian Church. Even though my MIL was well cared-for there and the admin were very flexible, it became clear that they were struggling with financial pressures.

My MIL's 2nd and current facility is run by Presbyterian Homes, a venerable and exceptional organization. My MIL is neither Moravian nor Presbyterian. PH is a much larger organization and has been around so long that their experience in dealing with economic pressures and just caregiving in general is unmatched in our state, They have several locations. Because the Presbyterian Church in general is a large national one, they are able to make sure their facilities are well-funded, well-subsidized (by the church). They see the care as a mission. I'm imagining that the Catholic Church probably has similar facilities throughout the US, so maybe check them out as well.

Also, be sure to join Nextdoor.com and ask your actual neighbors for their input on local facilities.
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Fawnby Sep 2022
The Methodist church has such places also. Faith-based but open to all.
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After a hospitalization my mother needed physical rehab @ a SNF. The place is a for profit facility & was way understaffed. They just assumed mom had dementia & was incontinent, both were incorrect. The PT staff were great but that's about it
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They're both about the money. You can't stay in business long just breaking even.

For profit is being open about it. It's money first everytime all the time. They'll do what they need to to make a profit and spend as little as necessary to attain and keep said goal.

A good example of a non profit, though really want to make a profit, Cleveland Clinic; many of their suburban locations will try to convince patients who may need services after a hospital discharge, to use their services, thereby trying to lock out the competition.
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Geaton777 Sep 2022
Non-profits still have to make a profit so that they can fund improvements and expansions, increases in wages, attract the best people, etc. A non-profit still must run like a business.

There are efficiencies in keeping services within an organization. The Mayo Clinic has their own labs and other services. This also helps keep the patient's medical information loop as accurate as possible. Going outside of an organization can mean insurance payment confusiion or denial, time-delays and less accountability.

Do you think any "competitiion" isn't profit-motivated as well?
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Rather than look at the IRS status, look closely at what the facility spends its money on.

There may be bocce ball. Big movie rooms. Indoor warm water pool. Personal gym trainers.

What there generally is not are aides to take one to those things.
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Fawnby Sep 2022
And everyone doesn’t use them. So the people who don’t use them are paying for amenities for others.
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I am sure you will get lots of Pro's and Con's about each.
Personal opinion here but I think with ANY care facility, ANY service for that matter a lot depends on the people that are actually there doing the work on a day to day basis.
You can get people that are doing minimal work for the paycheck and show up and do just what they have to do.
Then you get a dedicated person that truly loves what they are doing and will do what they can.
You can have both working for either company or organization.
When you tour facilities go at different times. See what it is like at 8:30 in the morning, see what a dinnertime looks like, see what they do in the afternoon. Look at the monthly calendar, are there activities, do they leave the facility? do they have entertainment come in?
Trust your gut. Trust your nose. Trust your eyes.
Look in the common shower room. Is it clean, are the floors and walls clean?
Look in the bathrooms in the rooms. Are they large enough to get a wheelchair into? Are the toilets ADA height? (believe it or not the rehab facility my Husband was in I could not get the wheelchair into the bathroom and the toilets were low and no riser) If the pipes below the sink are exposed are they covered by padding to insulate against burns?
Peeling paint anywhere?
Peeling counters? Tables? Torn fabric on chairs, couches? None of those areas would be easily cleanable.
Does it smell of urine or fecal matter? (common early in the morning)
If staff members are wearing gloves do they remove them and wash hands before putting on another pair?
This and many other things are just clues.
Also check the Medicare Website they do rate facilities and they do put comments about violations.

Oh..and a simple thing. If you want your loved one treated with respect no matter where you chose YOU treat the staff with the same respect that you want them to treat your loved one.
From the person pushing the broom down the hall, the person sitting at the desk when you sign in, to the staff on the floor (CNA's, Aides, Nurses, even Volunteers if they have them) say "Good morning, good afternoon, good evening" when you arrive. Say "Good bye" when you leave. Bring a treat in once in a while. During holidays a Thank you card and if someone has been particularly helpful, kind a letter to the administration and a copy for the staff person. Many places have regulations about gifts so check first. Gift cards seem to be easiest and most will want to keep the cap at $25.00
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My parents lived in a small, privately owned for profit Assisted Living facility for 7 years in total, and privately paid. Then mom moved into their Memory Care bldg and lived there for nearly 3. They had nothing but good experiences all the way around in this ALF and it was very well run. The AL had 100 residents, the MC had 23.

I don't know that you can say that 'all' non profits stink and 'all' for profits are great. You have to stump the pavement yourself and find ALs that YOU feel are a good fit for your loved one based on what you see and feel yourself, not based on anything else. Google reviews are good, but the best feedback you can get is from staff and residents who live there themselves and can tell you how they like doing so.
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The non-profit skilled nursing home almost killed my mother from neglect. In fact, I noticed recently in their latest money pitch that they no longer have skilled nursing. (Color me shocked.) They still haven't noticed that I was less than thrilled with their caregiving, and the fact that my mother hasn't lived there for three years (and has been dead for one) seems to be lost on them.

I moved her to a for-profit (small chain) memory care that not only fixed the issues she developed in skilled nursing but also gave her many happy days for two years. I paid $2800/month LESS for the memory care's far superior care than I did for the non-profit, too.

Go by the individual place and don't get hung up on the profit or non-profit status. Check into them, read reviews, ask to talk to some of their families for references, and don't hesitate to pull your loved one out if they aren't being cared for properly.
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You'll find many people who will tell you that the non-profit facilities are better but the reality is that you need to at both for-profit and non-profit very carefully. There is a common misconception that a non-profit is not trying to make money but in reality, they are just not legally allowed to make a profit. They can, however, pay their CEO, Financial officers, etc exorbitant salaries and provide benefits far in excess of what many for-profit facilities would. Non-profit doesn't necessarily mean that the money is being spent to provide the staff and residents with better treatment. Always look very carefully at the actual facility, talk to some residents, and not just residents that the managers offer to have you talk to. I was allowed to wander around the facility and participate in activites and meals before I made the decision for my father. That's the kind of openness you need to look for.
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