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Blurring the Boundaries:

Not-for-Profit Elder Care Agencies and the For-Profit Sector

This project ran from June 1, 2001 thru June 1, 2003 and was funded by the Aspen Foundation.

In 1999, management guru Peter Drucker stated that today’s business/social sector partnerships are as important a social innovation as the rise of organized philanthropy a century ago or the New Deal 60 years ago. Researchers have since argued that these new partnerships are blurring the boundaries between for-profits and not-for-profits. This blurring is not well understood nor is it well delineated.

The FLTC applied for funding from the Aspen Foundation with the goal of answering the following questions:

How are these not-for-profit entities entering into relationships with for-profit entities?

Why are they doing this?

What do respondents perceive to be the results of such changes?

What are the implications of the answers to these questions for respondents, their clients, and their mission and for other not-for-profit agencies?

Data to answer these questions was collected through the use of a survey of NYAHSA members. Major findings included:

• Of the relationships reported, there were six different types of for-profit businesses: management and consulting services, durable medical equipment, real estate holding company, pharmacy, thrift store and home health care services;
  
• On average the operating budget of those eldercare organizations that established for-profit enterprises are almost twice as large as those organizations that did not;
  
• In this study 63% of the not-for profit organizations that formed for-profit enterprises reported that they wholly owned the for-profit enterprise, while less than half of the organizations (37%) reported having partial ownership of the for-profit organization.
  

Accurate Identification and Measurement of Quality of Care Issues for Nursing Home Residents with Alzheimer’s Disease

This project began in 2001 and ran until the end of 2003. Funding was provided by the national Alzheimer's Association.

The goal of the project was to use MDS data to better understand and characterize the Alzheimer Disease (AD) and dementia population in nursing homes and to identify and assess quality of care issues for this population. Specific outcome measures used by CMS in monitoring nursing home care nationwide such as falls, incontinence, and weight loss, which are more prevalent for this population, were evaluated for appropriateness for nursing home residents with AD.

 

This research also identified additional risk factors for AD residents and developed revised measures to ensure that critical quality of care problems are not missed for this population, including undiagnosed pain and functional decline. Using the improved measures for AD residents, nursing homes with superior outcomes (i.e. slower rates of functional/cognitive decline) were identified, and telephone and on-site interviews were conducted to identify interventions and best practices responsible for their success. Findings have been disseminated at state and national conferences.