Intermediate Care Facilities for Individuals With Intellectual Disabilities: Does Ownership Type Affect Quality of Care?
For-profit ICF/IIDs rack up more deficiency citations than other ownership types, but self-reported quality metrics tell the opposite story—demand objective data before contracting.
01Research in Context
What this study did
Morantz et al. (2022) looked at care reports from Intermediate Care Facilities for people with intellectual disabilities.
They compared for-profit, non-profit, and government homes.
The team counted federal deficiency citations and checked each home’s own quality reports.
What they found
For-profit homes earned more violation citations than the other types.
Yet those same homes claimed better staffing ratios and less use of restraints.
The mismatch flags a worry: self-reported data may paint too rosy a picture.
How this fits with other research
Godoy-Giménez et al. (2024) extend the warning. They show residents in any residential facility face twice the risk of caregiver abuse compared with people living elsewhere.
Green et al. (2020) add a time lens. During COVID-19 lockdowns, incident reports first dropped, then aggression reports climbed back up, hinting that paper compliance can hide real-time problems.
C-Pitetti et al. (2007) give an earlier example of objective beats self-report. Adults in specialist psychiatric units improved more than those in generic units, backing the value of hard clinical metrics over facility promises.
Why it matters
When you tour or contract an ICF/IID, bring your own data sheet. Count staff on duty, watch for bruises, and scan medication logs. Pair those live notes with the public citation list before you sign or renew. One extra site visit beats trusting a glossy brochure.
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02At a glance
03Original abstract
Because many large, state-owned Intermediate Care Facilities for Individuals With Intellectual Disabilities (ICF/IIDs) have closed or downsized, their average size has fallen markedly, as has the number that are publicly owned. We probe the relationship between ownership type and four measures of care quality in ICF/IIDs. Data on deficiency citations suggest that for-profits underperform other ownership types, although data on complaints show no clear pattern. Meanwhile, data on staffing ratios and restrictive behavior management practices, based mostly on facility self-reports, generally tell the opposite story. Our results lend some credence to concerns regarding inadequate care in for-profit ICF/IIDs, while underscoring the importance of requiring ICF/IID operators to report more comprehensive, longitudinal data that are less prone to error and reporting bias.
Intellectual and developmental disabilities, 2022 · doi:10.1352/1934-9556-60.3.212