Inequality in golden years

If we truly believe that we’ve transcended race–” as we’ve so often told ourselves since last fall’s historic election of President Barack Obama–”then it’s time nursing home owners put up or shut up.

In this issue’s cover story “Lower Standards,” Jeff Kelly Lowenstein reveals that most of the Chicago nursing homes where a majority of the residents are black received the worst federal rating–”a one on a scale of five. None of the 30 majority-black nursing homes in the city received the highest rating.

However, 29 percent of the 45 majority-white nursing homes in Chicago received the highest rating, and just 11 percent received the worst rating.

With that racial disparity, nursing homes have joined a long list of Chicago institutions mired in deep racial segregation related to quality.

In his research, Kelly Lowenstein turned the nursing home database on its ear to find an answer to the question we always ask when documenting racial disparity: Why?

Why are majority-black nursing homes rated so poorly?

Some sources claimed that the racial disparity was a byproduct of staffing levels, staff qualifications or income. Others, like state Rep. LaShawn K. Ford, called it “blatant racism.”

“A lot of the times, the owners of these nursing homes treat them [just] as a business,” Ford said. “It has to be more of a mission than a business.”

Our statistical analysis strongly suggests that they’re all right–”even Ford. In fact, Ford may have been the most accurate in assessing the reasons behind Chicago’s racial disparities in nursing home ratings.

The Chicago Reporter used statistical analysis software to measure the relationship between nursing home ratings and other variables, such as race, staff qualifications and nursing home size. We analyzed the data for 92 nursing homes in Chicago and for more than 15,000 nursing homes nationwide. For some variables–”specifically those related to the staffing configuration and racial demographics–” the connections were stronger in Chicago than they were nationwide.

In Chicago, as the percentage of care provided by registered nurses increased, so did a nursing home’s rating–” more so than any other variable. On the flip side, as the percentage of care delivered by licensed practical nurses and licensed vocational nurses increased, nursing home ratings decreased. Registered nurses are considered the most-skilled workers in nursing homes.

Sources told Kelly Lowenstein that nursing home owners are no different than other business owners–”they maximize profits by lowering costs. In the nursing home industry, profits are gained by charging more, having more residents, hiring fewer staff or ones that are less skilled.

When we take a closer look at Chicago nursing homes reliant upon Medicaid, we see this business model in action. There are 27 majority-black nursing homes and 25 majority- white nursing homes where more than 75 percent of the residents received Medicaid. Overall, the staffing levels were nearly identical. But the amount of time registered nurses spent with residents at majority-white homes more than doubled the amount of time they spent with residents at majority-black homes.

The end result: The average rating for majority-white nursing homes reliant on Medicaid was nearly double the average rating for their majority-black counterparts.

So the answer is simple. If we are truly to be post-racial and we really want to create a fair, just and equal society, we need to stop making our choices based on race.

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