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For-profit adult day service centers (ADSCs) provide fewer staffing hours per participant than nonprofit centers. This study highlights potential disparities in care quality within the long-term care sector.

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Area of Science:

  • Gerontology and Long-Term Care
  • Health Services Research
  • Organizational Studies

Background:

  • Adult day service centers (ADSCs) are crucial for long-term care, serving diverse populations including older adults and individuals with disabilities.
  • Despite their importance, the quality of ADSCs, particularly staffing levels, remains under-researched.
  • Staffing levels are a recognized indicator of quality in long-term care settings like nursing homes.

Purpose of the Study:

  • To investigate and compare staffing levels between for-profit and nonprofit/government-operated ADSCs.
  • To examine staffing as a key organizational factor influencing ADSC quality.
  • To identify potential differences in care delivery based on ADSC ownership type.

Main Methods:

  • Utilized cross-sectional secondary data from a nationally representative survey of ADSCs (n=573).
  • Employed bivariate comparisons and multivariate linear regression to analyze staffing data.
  • Measured staffing as hours per participant per day, controlling for center characteristics.

Main Results:

  • Nonprofit/government-operated ADSCs constituted approximately 60% of the sample.
  • Nonprofit/government-operated ADSCs averaged 1.9 hours per participant day, versus 1.5 for for-profit centers.
  • For-profit ADSCs demonstrated 15.8% lower staffing hours per participant day, even after controlling for key variables (P=.047).

Conclusions:

  • For-profit ADSCs exhibit significantly lower staffing levels compared to their nonprofit/government counterparts.
  • Further research is essential to link staffing variations to actual care quality in ADSCs.
  • Investigating how these staffing differences impact care for diverse participant groups (income, race, acuity) is critical.