For Profit vs. Non-profit: Do YOU notice a difference?

[Cola89]

As in- Do you notice a difference in the work atmosphere, benefits, morale, or anything else when working at a 'for-profit' health care facility vs. one that is 'not for profit'? If so, do you have a preference and is it big enough to factor into which companies you'll apply to or at least when accepting a job offer? Please let me know how you feel!

[Rose_Queen, BSN, MSN, RN]

My facility is "not for profit" yet they rake in a $60M plus profit every year. The atmosphere is one that the bottom line matters most. Unlike the for profit facility across town that pays a percentage of the profits to all employees annually if they meet their goal. However, my facility does have newer equipment, nicer patient rooms, and a marble floor in the lobby. In order to meet not for profit status, they have to invest that profit into the facility in some manner. Unfortunately it isn't invested in better staffing, but that's pretty much a universal thing.

So no, I don't look at not for profit vs profit at all when looking at job postings.

[elkpark]

I would never work for a for-profit healthcare employer. That's just my own personal comfort level.

When I worked for several years as a psychiatric hospital surveyor for my state and CMS, we went into every psychiatric hospital and psychiatric unit (in a general hospital) in the state. While we knew going in whether the free-standing hospitals were nonprofit or for-profit, we discovered that some of the nonprofit community hospitals had contracted with a for-profit psychiatric management company to operate their psychiatric units (a lot of the small community hospitals, esp. in rural areas, felt that they didn't have the local "talent," or wouldn't be able to attract experienced psych people through their usual recruitment system, to operate the unit effectively). I hadn't realized until then that there were companies that did this; they provide a unit manager, nurse manager, social worker, psychologist, and, sometimes, one or more psychiatrists (that are all employees of the management company), and the staff nurses were regular employees of the hospital, but managed by the company employees managers. My survey partner and I discovered pretty quickly that we could tell without being told which units were being operated by the hospital itself, and which were being operated by one of these for-profit companies. The for-profit companies squeezed every nickel until it screamed and cut corners to a ridiculous (IMO) degree in order to maximize their profits. One unit actually decided that, in order to "save the nurses' time" (i.e., save $$$, although I'm not sure exactly how it was going to save money), they would no longer check clients' vital signs daily. We had a disproportionately high incidence of complaints, safety concerns, and sentinel events on the units operated by the for-profit management companies (that was also true of the freestanding for-profit psychiatric hospitals compared to the nonprofit facilities). Some of the hospitals that tried this had such a negative experience (and were scared enough of the ramifications for the overall hospital) that they cancelled the contracts and went back to operating the units themselves.

For profit healthcare operations have as their first, highest, priority turning the highest profit legally possible for their shareholders. If you or I happen to get some healthcare that we need in the process, that's nice, but their real priority is maximizing their profits by whatever means legally possible. They can be taken to court by their shareholders if they don't do everything they can to turn the maximum profit possible. Personally, I find that inappropriate and unacceptable for healthcare. I'm not demonizing the companies or individuals, just saying that it's not compatible with my personal values. Other people feel differently, and I'm fine with that. But it's important (IMO) to understand that there are significant differences between nonprofit and for-profit healthcare organizations.

There are some older threads here discussing people's opinions and experiences in working for for-profit hospital chains, that you might want to look for.

[turnforthenurse, MSN, NP]

I have worked for two non-profit hospitals and one for-profit. I hated the for-profit facility. I didn't like how they treated patients and how they would always order unnecessary tests. The overall atmosphere and culture was different in a way that I can't really describe compared to the non-profit hospitals.

[starmickey03, MSN, RN]

I've worked at two for profit hospitals and both were the same. They had old, outdated equipment, were always low on supplies, low pay, and everything always centered around money. Horrible experience and both times I left within three months because I hated every minute of it. After the second for profit hospital, I vowed to never work at another.

The non profit hospitals were completely the opposite.

[CoffeeRTC, BSN, RN]

LTC perspective: I worked for a facility that was owned by a huge for profit company. There were systems in place, rules for everything, corporate support...you know the thing. That company wanted to get out of the US and focus on their Canadian holdings (too many regulations in US) Fast forward, we were excited that a non profit organization would be taking over. The care would be better, owners that cared about the business....all that jazz, right? There is a huge difference in non profits. A non profit with a faith based organization vs just some people who own run facilities. Cost were cut dramatically..food supplies were cut, wound care supplies cheaper, meds/ supplements, personal care supplies, paper towel, incontinace care supples....cheap. No organization. Very little structure. I've always wanted to work for a non profit, but I guess what I'm saying...not all are created equally.

[VANurse2010]

I've never personally worked at a for-profit, but I did extensive clinical hours at one. The for-profit had dangerous staffing (up to 9:1 on med-surg nights), poor morale, and bizarre corporate policies that treated patients like Wal-Mart customers to an extent I haven't seen since. The non-profit I worked at wasn't hugely better, but there was at least somewhat more attention paid to safe staffing (although some units were still dangerous, such as my own) and they didn't charge the patient by the butt-wipe. The teaching hospital I work for now has shown by far the most concern for patient safety and safe staffing, although it is known for being horribly ruthless in collecting debts from the uninsured - to the point that the parents of a friend of mine had a lien put on their family farm.

[emmy27]

I've worked at several non-profit and one for-profit hospital. The best hospital was non-profit but the for-profit was second best.

The worst, by a mile, was non-profit.

For-profit does, obviously, have profit as its primary goal, which may raise ethical concerns. But it may also mean there is a strong corporate culture, professional management, and long-term policies and plans designed to maintain the organization, all of which can be good for staff.

Non-profit, ideally, is reinvesting whatever profit it may turn in to the organization rather than distributing it to shareholders. And some of the best hospitals in the world are non-profits. But there are plenty of dysfunctional nonprofits which lack professionalism and suffer from cronyism and financial waste in their boards and senior management. Non-profit doesn't automatically translate in to well-run, charitable to the community, or good employer.

Non-profit vs profit is something I'd take in to consideration when considering a job, but it wouldn't be a deal breaker- it would just be one data point.

I'd go back to the for-profit company I worked for before working at a non-profit hospital that restricted medical care based on religious mandates, for instance. And I'd rather have been staff OR patient at that for-profit hospital than at the worst non-profit I worked at, no question.

[TheCommuter, BSN, RN]

I've worked at for-profit facilities all of my decade-long nursing career and it's been more of the same: short staffing, noncompetitive pay, lack of supplies, and robust quarterly cash bonuses paid to administrators who contain costs enough to keep operations "under budget."

[toomuchbaloney]

I have worked primarily in not for profit settings, they are not all created equally, but they are not looking to

fleece insurance companies or patients.

I did work for a privately owned, for profit home health agency once. It was brutal and I won't do it again. It is

difficult to work for an employer who has need to make more and more money and as the wealth grows the

focus on excellence in care becomes less and less important.

Greed can be such a destructive and addicting thing.