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even though the residents’ fees are the same in both public and pri-
vate homes.
It has become harder and harder to track for-profit owner-
ship and its consequences, largely because of the lack of transpar-
ency concerning complex financing structures.21 Complex ownership
structures contribute to the efforts to reduce taxes, litigation actions,
and regulatory oversight.22 As a result, it is not easy to have demo-
cratic control, and residents, families, and staff may find it more dif-
ficult to engage with major corporations than they would with local
government or not-for-profit owners. The attempts to provide alter-
native forms of accountability have resulted in the requirement for
increasing documentation that focuses on counting what can easily
be counted. Staff are required to do a growing amount of reporting
on residents and their care, time that takes them away from applying
their skills to care. More regulations have also been introduced, with
the purported purpose of addressing quality care, that here too have
a paradoxical effect. Research shows that scandals publicized in the
media have resulted in more regulations, and this is particularly the
case in the jurisdictions where for-profit ownership is highest.23 The
regulations, however, tend to focus on the workers rather than on the
owners, ownership, and management.24
For-profit ownership is also harder to track because many non-
profit homes have for-profit services within them, but also because
austerity measures adopted by governments across Canada pro-
moted market methods and for-profit managerial strategies within
all homes.25 Public funding cuts add pressure to keep or reduce the
labour force to a minimum, and to rely both on more part-time and
21. Daly, supra note 14.
22. Charlene Harrington et al, “Ownership, Financing, and Management Strategies
of the Ten Largest For-Profit Nursing Home Chains in the United States” (2011)
41:4 International Journal of Health Services 725; Jordan Rau, “Care Suffers as
More Nursing Homes Feed Money Into Corporate Webs”, The New York Times
(2 January 2018), online: <https://www.nytimes.com/2018/01/02/business/nurs-
ing-homes-care-corporate.html>.
23. Liz Lloyd et al, “It’s a Scandal! Comparing the Causes and Consequences of
Nursing Home Media Scandals in Five Countries” (2014) 34:1/2 International
Journal of Sociology and Social Policy 2.
24. Albert Banerjee & Pat Armstrong, “Centring Care: Explaining Regulatory
Tensions in Residential Care for Older Persons” (2015) 95 Studies in Political
Economy 7.
25. Eleanor D Glor, “Has Canada Adopted the New Public Management?” (2001) 3:1
Public Management Review 121.
VULNERABLE
The Law, Policy and Ethics of COVID-19
- Title
- VULNERABLE
- Subtitle
- The Law, Policy and Ethics of COVID-19
- Authors
- Vanessa MacDonnell
- Jane Philpott
- Sophie Thériault
- Sridhar Venkatapuram
- Publisher
- Ottawa Press
- Date
- 2020
- Language
- English
- License
- CC BY-NC-ND 4.0
- ISBN
- 9780776636429
- Size
- 15.2 x 22.8 cm
- Pages
- 648
- Categories
- Coronavirus
- International