Ownership Form and Quality of Care in Sheltered Care Facilities: Chain-Affiliated Business vs. Sole Proprietorship.

Abstract

Mental health services are increasingly provided by private-for-profit organizations that are chain-affiliated businesses. The effect of this trend on quality of care is a growing concern. Sheltered care facilities (board and care, family care, and psychosocial rehabilitation facilities) servicing upwards of 400,000 (Goldman, Gattozzi, & Taube, 1981) seriously mental ill nationwide provide the lowest level of 24-hour supervised care to this population. This study explores the quality of care in 145 sheltered care facilities in California. Contrasts were made between 108 sole proprietorships and 37 chain-affiliated business facilities on several quality of care measures. Chain-affiliated businesses had poorer physical characteristics, higher costs, less experienced staff, and were more likely to be located in minority and lower class neighborhoods. Much of the negative stereotypes of chain-affiliated businesses were documented in our sample.