How for-profit nursing home regulators can use the powers they already have to fix growing problems with poor-quality care

(The Conversation is an independent and nonprofit source of news, analysis and commentary from academic experts.)

Charlene Harrington, University of California, San Francisco

(THE CONVERSATION) Governments at both state and federal levels have yet to fully wield their authority to fight poor-quality care at for-profit nursing homes nationwide, leaving the pressing need for elder care accountability unmet.

Medicare has the power to improve financial accountability at nursing facilities by capping profits while requiring that a percentage of revenues be spent on direct care expenditures. Already, four states – New Jersey, New York, Massachusetts and Pennsylvania – have shown this can be done, passing laws requiring minimum percentages of expenditures on direct care while limiting profits.

I am a behavioral scientist at the University of California, San Francisco who studies the economics of nursing homes and the implications for care. I am also the co-author of an investigative piece in The Conversation about for-profit nursing homes.

States also have the power to suspend and disqualify nursing home owners from the Medicaid program when they provide poor-quality care, commit fraud...