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Suboptimal RN staffing in large for-profit nursing homes impairs quality of care. A research team comparing the quality of care in the 10 largest U.S. for-profit nursing home chains with care in facilities in five other categories of ownership found that the largest for-profit facilities had lower levels of RN hours and more total and serious deficiencies (violations of regulations), despite having higher patient acuity levels. This is the first study to examine staffing and quality in the top 10 for-profit nursing home chains, according to the authors in the August 30 early online version of Health Services Research. They conclude that several factors necessitate further research: the trends in low RN staffing that may have begun before purchase by the large chains, the growing pressure to increase shareholder and investor returns, and the lack of oversight by regulators.