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This article presents cross-country comparisons of trends in for-profit nursing home chains in Canada, Norway, Sweden, United Kingdom, and the United States. Using public and private industry reports, the study describes ownership, corporate strategies, costs, and quality of the 5 largest for-profit chains in each country. The findings show that large for-profit nursing home chains are increasingly owned by private equity investors, have had many ownership changes over time, and have complex organizational structures. Large for-profit nursing home chains increasingly dominate the market and their strategies include the separation of property from operations, diversification, the expansion to many locations, and the use of tax havens. Generally, the chains have large revenues with high profit margins with some documented quality problems. The lack of adequate public information about the ownership, costs, and quality of services provided by nursing home chains is problematic in all the countries. The marketization of nursing home care poses new challenges to governments in collecting and reporting information to control costs as well as to ensure quality and public accountability.

EPDF and EPUB available Open Access under CC-BY-NC-ND licence The pandemic has made unpaid care more visible through its absence, whilst also increasing the need for it. Drawing on a range of research projects covering Canada, Germany, Norway, Sweden, the UK and the US, this book documents a broad spectrum of unpaid work performed by residents, relatives, volunteers and staff in nursing homes. It demonstrates how boundaries between paid and unpaid work are flexible, varying considerably with conditions, time, place and intersectional populations. By examining the complex labour process within nursing homes, this book provides insight and understanding which will be critical in planning for nursing home care post-pandemic