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VULNERABLE - The Law, Policy and Ethics of COVID-19
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VULNERABLE454 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.
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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
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