The answer is: The nursing home industry in America.
Nursing homes funded by Medicaid receive a daily payment from the government for each resident every day. The government pays the facilities regardless of the quality of service provided. As a result, many nursing home owners; will put off facility repairs, serve lousy food and hire some of the most inept people to run their facilities to maximize profit. Of course, fines may be imposed and facility closure may be threatened The reality is that it is difficult to relocate nursing home residents to other facilities. Nursing home owners know this. Paying fines has become part of the nursing home business. The reality is the fines probably only result in even further reductions services to the residents of the facility.
An example of a nursing home choosing profits over the needs of its residents appeared here. Westside Health Care Center, an exclusively Medicaid funded facility, provides nursing home care to 40 residents in Ohio. After health workers and police from the Ohio Department of Public Health found 27 housing and fire code violations, the Department attempted to shut down the facility. The inspectors described the facility as ‘worse than any crack house they had come across.’ (emphasis added)
To combat the potential closure of his facility, the administrator filed an injunction to keep the nursing home open. A judge ruled in his favor and has set the matter for hearing later this month. Meanwhile, the 40 residents of Westside will continue to be the real losers of the situation as they continue to live in an obviously deplorable facility.
For laws related to Ohio nursing homes, look here.